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Reminder: How to submit Blue Medicare PPO claims correctly

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Reminder: How to submit Blue Medicare PPO claims correctly
Please follow these guidelines when filing your Blue Medicare PPO claims:
• Providers may use their own clearinghouses for claims submission. However, the
AvailityВ® Health Information Network is the gateway for electronic claims submission
into the Blue Medicare PPO processing system.
• The payer ID for Blue Medicare PPO electronic claims submission is NMPPO.
• Submit your electronic claims as Medicare with receiver type C.
• The Blue Medicare PPO member ID alpha prefix is YID.
• Please submit your Blue Medicare PPO claims within 180 days of the date of service.
Claims that are not submitted within 180 days from the date of service are not eligible for
reimbursement. Blue Medicare PPO providers may not seek payment from members for
claims submitted after the filing deadline (except for applicable deductibles, copays, or
coinsurance amounts).
• Submit your Blue Medicare PPO paper claims on the CMS-1450 or CMS-1500 and mail
them to: Blue Medicare PPO, P.O. Box 3567, Scranton, PA, 18505. Do not submit
Blue Medicare PPO claims to BCBSNM in Albuquerque.
• Please submit both electronic and paper Blue Medicare PPO claims with the member’s
complete ID number exactly as shown on the member’s ID card, including the prefix
YID.
• For benefits and eligibility information and claims processing status, call Blue Medicare
PPO Provider Customer Service at 866-706-7745.
For more information, contact Cathie Rowland-Robert at (505) 816-2132 or via e-mail.
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.
Blue Review • Issue 8, 2009 • www.bcbsnm.com
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