Medicaid New Mexico Managed Care Plans

• Below is the list of managed care plans of Medicaid NM,

       1. Presbyterian Health Plan
       2. Western sky community care
       3. Molina Healthcare of NM
       4. United Healthcare
       5. BCBS NM

• Medicaid NM member has 10 digits Medicaid ID that can be used as policy ID when billing claim to Presbyterian, Western Sky Community care & Molina Healthcare of NM if the correct policy ID for these insurances is not available.

• To bill the claim to United Healthcare, it is necessary to have 9 digits policy ID which can be obtained through the Optum web portal.

• BCBS NM has a three-character alpha prefix in the first three positions. To obtain the correct policy ID, the Availity website can be utilized where the policy ID field uses three character prefix as "YIF" followed by 10 digits Medicaid ID. It will pull the patient information with the correct policy ID. "YIF" is the prefix used for BCBS NM patients.