26 de diciembre de 2019
Blue Cross and Blue Shield of New Mexico (BCBSNM) is excited to introduce a brand-new online prior authorization application via the Availity Portal, called Authorizations (HIPAA-standard 278 transaction). This new and more convenient functionality will be available to providers as of Jan. 30, 2020, making it faster and easier to submit and receive confirmation from BCBSNM. For Federal Employee Program® (FEP®), providers should continue to use their current prior authorization process until this the new application becomes available in the near future.
¿Qué significa?
BCBSNM’s current electronic prior authorization tool, iExchange®, will be deactivated on April 15, 2020, and all electronic prior authorization requests should be submitted using this new capability. This includes inpatient admissions, select outpatient services and behavioral health services handled by BCBSNM.
The process of submitting prior authorization requests to eviCore is not changing.
Medical and surgical predetermination of benefits requests should be submitted via fax or mail by using the Predetermination Request Form, along with the pertinent medical documentation.
¿Qué debe hacer?
During the transition period, providers should migrate from iExchange to the new five-step Availity Authorization application. Providers not yet registered with Availity can sign up today at Availity 
, at no charge. For registration assistance call Availity Client Services at 800-282-4548.
Submitting online prior authorization requests using Availity’s Authorizations application is easy and consists of only five steps:
- Iniciar sesión en Availity
- Select Patient Registration menu option, choose Authorizations & Referrals, then Authorizations
- Select Payer BCBSNM, then choose your organization
- Select Inpatient Authorization or Outpatient Authorization
- Review and submit your authorization
This new online option will increase administrative efficiencies for your organization by also allowing providers to:
- access and verify status of requests
- upload clinical medical records
- edit and/or extend requests
- obtain printable confirmation number for your records
Capacitación
BCBSNM is hosting complimentary webinars for providers to learn how to use this new online prior authorization submission application. Simply click on your preferred date and time below to register
- Jan. 29, 2020 – 1 p.m. to 2 p.m.
- Jan. 30, 2020 – 8 a.m. to 9 a.m.
- Feb. 3, 2020 – 10 a.m. to 11 a.m.
- Feb. 4, 2020 – 2:30 p.m. to 3:30 p.m.
- Feb. 5, 2020 – 9:30 a.m. to 10:30 a.m.
- Feb. 6, 2020 – 2:30 p.m. to 3:30 p.m.
Para Más Información
Watch for the new Availity Authorizations & Referral tip sheets, coming soon to the Provider Tools section of our website.
If you need further assistance or customized training, contact our Provider Education Consultants.
iExchange es una marca comercial de Medecision, Inc, una compañía aparte que ofrece soluciones de colaboración en la administración de servicios médicos para pagadores y profesionales de la salud.
eviCore is an independent specialty medical benefits management company that provides utilization management services for BCBSNM. eviCore is wholly responsible for its own products and services. Availity es una marca registrada de Availity, LLC, una compañía aparte que opera una red de información de salud para prestar servicios de intercambio de información electrónica a profesionales médicos. Availity presta servicios administrativos a BCBSNM. BCBSNM makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore and Availity. Si tiene alguna pregunta acerca de los productos o servicios ofrecidos por estos proveedores, debe comunicarse con el proveedor directamente.