How Blue Cross and Blue Shield of New Mexico (BCBSNM) Chooses Providers for Its Networks
How BCBSNM Chooses Health Care Providers
BCBSNM is committed to having provider networks that meet access standards. To join our networks, providers and BCBSNM must agree to a contract. Our networks include medical and behavioral health providers. On a regular basis, we check to see if:
- Provider locations meet member access needs
- Members can get covered services from our network providers
- We need to allow more providers into our networks
We make sure providers in our networks have proper credentials. We also require them to meet certain quality standards. Some of what we check for professional providers includes:
- Education and training
- Licensure
- Record related to disciplinary, legal, licensing, substance abuse, and medical-legal history
Among other things, BCBSNM also looks at costs when contracting with providers. Our goal is for members to access quality health care that is cost efficient.
Medical Providers
BCBSNM works to contract with providers that offer services in the following areas*:
Allergy / Immunology |
Internal Medicine |
Orthopedic Surgery |
Cardiology |
Infectious Disease |
ENT / Otolaryngology |
Cardiothoracic Surgery |
Nephrology |
Pediatrics |
Chiropractor |
Neurology |
Physiatry / Rehabilitative |
Dermatology |
Neurosurgery |
Plastic Surgery |
Endocrinology |
Obstetrics & Gynecology |
Podiatry |
Family Practice |
Oncology |
Pulmonary |
Gastroenterology |
Oncology / Radiation |
Rheumatology |
General Practice |
Ophthalmology |
Urology |
General Surgery |
Orthopedics |
Vascular surgery |
*This is not a complete list of provider specialties.
Behavioral Health Providers
BCBSNM works to contract with providers that offer services in the following areas*:
- Psychiatry
- Clinical Psychology
- Licensed Clinical Social Work
- Licensed Counseling, such as Clinical Counseling and Marriage and Family Therapy
*This is not a complete list of provider specialties.
How BCBSNM Chooses Hospitals
BCBSNM works to contract with hospitals that offer services in the following areas*:
- Acute Care
- Rehabilitation
- Inpatient Behavioral Health
*This is not a complete list of hospital types.
Please Note: Providers in our networks are not employed by, and are independent from, BCBSNM.