Availity's Authorizations tool (HIPAA-standard 278 transaction) allows the electronic submission of inpatient admissions and select outpatient services handled by BCBSNM. Additionally, providers can also check status on previously submitted requests and/or update applicable existing requests.
Benefits of using this online functionality:
- No separate user enrollment needed
- Direct access within Availity portal
- Simplified 5-step process
How to access and use Availity Authorizations:
- Inicie sesión en Availity
- Select Patient Registration menu option, choose Authorizations & Referrals, then Authorizations
- Select Payer BCBSNM, then choose your organization
- Select a Request Type and start request
- Review and submit your request
For additional details, refer to the Availity Authorizations User Guide.
Important Tips:
- Check eligibility and benefits online first to determine if preauthorization is required for the service and/or procedure code(s). To learn more about checking eligibility and benefits via Availity, refer to the General Eligibility and Benefits Expanded tip sheet.
- Authorizations managed through eviCore healthcare (eviCore) will continue to be handled through the eviCore portal.
- Predetermination requests must be sent by fax or mail using the appropriate form in the Forms section.
Providers who are not yet registered with Availity, can sign up today at Availity, at no charge. If you need registration assistance, contact Availity Client Services at 800-282-4548.
¿Tiene preguntas?
Email our Provider Education Consultants. Be sure to include your name, direct contact information, Tax ID and/or Billing NPI.
Checking eligibility and/or benefit information 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, please call the 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. Si tiene alguna pregunta acerca de los productos o servicios ofrecidos por estos proveedores, debe comunicarse con el proveedor directamente.
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. BCBSNM makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore. Si tiene alguna pregunta acerca de los productos o servicios ofrecidos por estos proveedores, debe comunicarse con el proveedor directamente.