In January 2021, the Blue Cross and Blue Shield System is launching Blue High Performance NetworkSM (Blue HPNSM), a new national network for large commercial employer groups. While Blue Cross and Blue Shield of New Mexico (BCBSNM) doesn’t currently offer this network, providers in our networks may provide urgent and emergent care to Blue HPN members from other BCBS Plans. The network follows the same procedures as our BlueCard® PPO.
What non-participating Blue HPN providers need to know
- Because Blue HPN is not available in New Mexico, urgent and emergent care provided by BlueCard PPO providers is covered for Blue HPN members.
- For these limited benefits, non-Blue HPN providers will be reimbursed according to their BCBSNM provider contract, as they are for other Preferred Provider Organization (PPO) products. All other services are considered out-of-network, and the member will need to pay 100 percent of the billed charges.
Recognizing Blue HPN members
You can identify Blue HPN members by their member ID card. Look for the Blue High Performance Network name on the front, along with the "HPN in a suitcase" logo. This logo indicates that Blue HPN rates apply.
Checking eligibility and benefits: Use Availity® or your preferred vendor to check eligibility and benefits for all Blue Cross and Blue Shield members before every scheduled appointment, including for Blue HPN members. Eligibility and benefit quotes include membership confirmation, coverage status and applicable copayment, coinsurance and deductible amounts. The benefit quote may also include information on applicable benefit prior authorization requirements. Ask to see the member’s ID card and a driver’s license or other photo ID to help guard against medical identity theft.
Filing claims: Submit local and out-of-area claims to BCBSNM as you typically would. Vea el Claims and Eligibility page of our website for more details.
Questions? Call the Customer Service number on the member’s ID card.
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 Availity. If you have any questions about the products or services provided by the vendor, you should contact the vendor directly.
Checking eligibility and/or benefit information and/or the fact that a service has been preauthorized is not a guarantee of payment. Los beneficios se determinarán una vez que se reciba el reclamo y se basarán, entre otras cosas, en la elegibilidad del asegurado y los términos del certificado de asegurado de la cobertura aplicable en la fecha en la que se prestaron los servicios. If you have any questions, call the number on the member's ID card.