Rural Health Care Delivery Fund

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Kevin S. Settlement

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PROVIDERS

The Human Services Department mission is: To transform lives. Working with our partners, we design and deliver innovative, high quality health and human services that improve the security and promote independence for New Mexicans in their communities.

Providers Overview

Nurse checking the baby's heartbeatThe Human Services Department oversees provider improvement in the Centennial Care program. Medical providers (Including hospitals and private practitioners) and managed care organizations can use this section to locate important provider resources.

With the close of the Public Health Emergency (PHE), the suspension of provider terminations has ended.

An E-Blast informing providers they would be terminated if their record has expired licenses and certification documents after August 22, 2023 was sent on 6/30/2023. The Medical Assistance Division (MAD) has decided to extend the deadline to 11/5/2023. 

Please review the Provider Type and Specialty Code list to understand what required documents you need to submit to continue participating as a Medicaid provider. The Provider Type and Specialty Code list can be upload using the below link: https://nmmedicaid.portal.conduent.com/static/ProviderInformation.htm#ProviderEnrollment

You must submit all required documents before or by 11/5/2023. All Medicaid providers that fail to provide required documents will be terminated effective 11/1/2023.

You can upload your documents using the below link:

https://nmmedicaid.portal.conduent.com/webportal/licenseUpload?lastNodeClicked=804

For questions or concerns, please contact the Consolidated Customer Service Center at 1-800-299-7304

If you are a provider and wish to apply to provide services for the Agency-Based Community Benefit (ABCB), click here Agency Based Community Benefits (ABCB) Program

For the ABCB service requirements, please see the Centennial Care Managed Care Policy Manual, click here Managed Care Policy Manual

PLEASE NOTE: From July 1st, 2021 HSD/MAD is accepting Provider Applications for all Agency Based Community Benefit Services.

Attention All Behavioral Health Non-Medicaid Providers

A critical incident is a reportable incident that may include, but is not limited to, abuse, neglect, exploitation, death, environmental hazards, or law enforcement intervention that encompasses the full range of covered services.
 
Important changes to the Critical Incident Reporting (CIR) process, effective July 1, 2017
Optum Health New Mexico (OHNM) is no longer the Administrative Services Organization (ASO) for the State of New Mexico Interagency Behavioral Health Purchasing Collaborative.
 
Critical incident reporting for non-Medicaid constituents
As of July 1, 2017, all CIRs for non-Medicaid constituents should be faxed to State of New Mexico Interagency Behavioral Health Purchasing Collaborative using a new CIR form and fax number. Continue to follow the instructions found in the Behavioral Health Critical Incident Reporting
Protocol (April 2018). Use the revised form (CIR form Appendix A, December 2017) that includes the Collaborative fax number (505) 476-9272.

Critical Incident Report Protocol

Critical Incident Report Form

Behavioral Health Collaborative

New Mexico Medicaid Portal

The New Mexico Medicaid Portal is an important link where providers can obtain information about policy & billing, claims submission, client eligibility, financial issues, Medicare, provider enrollment, third party liability, remittance advices, provider forms and more.

New Mexico Medicaid Portal

Conduent State Healthcare, LLC

Conduent is the Fiscal Agent for New Mexico Medicaid and has an integral role in the submission and processing of Medicaid claims. Should you need to contact Conduent, click on the following link to locate the appropriate Conduent Help Desk phone number.

Conduent Help Desk Contacts