Claims overview
Filing your claims should be simple. That’s why Amerigroup Community Care of New Mexico, Inc. uses Availity, a secure and full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to health care professionals. You can use Availity to submit and check the status of all your claims and much more at www.availity.com .
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EDI
Electronic data interchange (EDI) is the computer-to-computer exchange of business documents in a structured format. EDI provides a faster and cleaner method for delivering time-dependent data, saving you time compared to filing paper claims.
Provider disputes
You have the right to request an appeal of a claim decision. You may request this appeal on your own behalf or on behalf of a covered individual.
Reimbursement policies
These are policies outlining the basic terms for reimbursement of services covered under our members’ benefits plans. Also, these include definitions for terms used in the policies and disclaimer for the policies’ use.