Commitment to Our Valued Providers
In response to the Covid-19 pandemic and New Mexico’s State of Emergency, Western Sky Community Care is working closely with HSD and all government agencies to maintain safe and efficient operations.
Western Sky Community Care continues to educate and update our staff on the Covdi-19 virus and implementing measures to minimize the spread of the virus.
This situation changes by the day and sometimes by the hour. WSCC is committed to clear and open communication with our providers.
- Care Coordination will continue operations via telephone and email.
- Authorizations and concurrent review will continue business as usual.
- Our Provider and Member Services Call Center continues to operate at normal business hours and our Provider Self-Service Portal remains available to providers 24/7.
- Claims processing and payment remains uninterrupted. We always encourage providers to enroll in Electronic Remittance Advices (ERA) and Electronic Fund Transfer (EFT).
- All cost share (co-pay, coinsurance, and deductible) will be waived across all products for any claim billed with the new COVID-19 testing codes.
- Western Sky has configured its systems to apply $0 member liability for those claims submitted utilizing these new COVID-19 testing codes.
- In addition to cost share, authorization requirements will be waived for any claim that is received with these specified codes.
- Providers billing with these codes will not be limited by provider type and can be both participating and non-participating.
- Adjudication of claims is currently planned for the first week of April 2020.
We have received several questions about waiving or modifying timely filing requirements. WSCC is working closely with HSD and providers and will provide an update regarding this question as soon as possible.
Claims & Billing
Any COVID-19 related claims should have the phrase 'COVID-19' in box 23 on both UB and CM1500 forms to facilitate tracking.
Please visit the Provider Billing Guidance for COVID-19 Testing section for information pertinent to your group or practice.
Any additional rates will be determined by further CMS and/or state-specific guidance and communicated when available.