Medical billing services in New Mexico
Billing, coding, credentialing and A/R follow-up for providers in New Mexico.
Billing in New Mexico: what is different
Turquoise Care replaced Centennial Care as New Mexico’s Medicaid managed care program in 2024.
Key payers and contractors in New Mexico
- Medicare Part A/B
- Novitas Solutions, Jurisdiction JHPortal: Novitasphere
- Medicare DME
- CGS, DME MAC Jurisdiction CDME supplier claims only · Portal: myCGS
- Medicaid
- New Mexico Medicaid (Turquoise Care)Portal: Turquoise Claims
- Blue Cross Blue Shield
- Blue Cross and Blue Shield of New Mexico
- Medicare Advantage
- UnitedHealthcare, Humana, Aetna, Wellcare, Blue plans and others, depending on the county
Contractor assignments and plan lists change. We confirm the current setup for your practice during onboarding.
How we work with New Mexico providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with Novitas Solutions through Novitasphere
- Credentialing and contracting with commercial and Blue plans
- Eligibility checks that confirm each patient’s plan and assigned MCO before the visit
- Prior authorization tracking by plan
- Denial, appeal and A/R follow-up under each payer’s filing limits
Medical billing in New Mexico: common questions
Do you bill New Mexico Medicaid and its managed care plans?
Yes. We bill New Mexico Medicaid fee-for-service claims and each Medicaid managed care plan, after confirming the patient’s assigned plan for the date of service.
Who processes Medicare claims in New Mexico?
Medicare Part A and B claims in New Mexico are processed by Novitas Solutions (Jurisdiction JH), and we submit and track them through Novitasphere. DME supplier claims go to a different contractor, CGS (DME MAC Jurisdiction C), through myCGS.
Can you credential new providers in New Mexico?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in New Mexico.
Get a free billing audit for your New Mexico practice
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.