Prior Authorization Important Update

Date: 12/11/19

Valued Western Sky Providers,

The New Mexico Human Services Department (HSD) is rolling out starting on January 1, 2020 a new standardized prior authorization form from the Office of Superintendent of Insurance (OSI). This requirement was outlined in bill SB188. HSD is requiring all MCOs, including Western Sky, to use this format.

To avoid any delays in processing authorization requests please use the standard form. Requests made without the correct document will be returned to the provider asking for the new form and any other needed information.

This change to prior authorization requests does NOT apply to Community Benefit Providers.

Behavioral health providers please be aware that the new form will be used in addition to current documents.

In an effort to make usage of the new standardized form Western Sky will be holding a series of teleconference forums where providers are encouraged to ask questions. The dates, times, and call information are listed at the end of this letter.

For questions about the legislation that prompted this change, please contact the Office of Superintendent of Insurance at (505) 827-4601.

FORUMS:

First Session
Date: 12/19/2019
Time: 9:30 am to 10:30 am
Call Information: 1 669 900 6833 Meeting ID: 641 811 288

Second Session
Date: 12/30/2019
Time: 9:30 am to 10:30 am
Call Information: 1 669 900 6833 Meeting ID: 510 076 996

 

Sincerely,

Western Sky Provider Relations

Fax: 1.833.597.0428