Grievances and Appeals Process for Members and Providers
BLUE CROSS & BLUE SHIELD OF NEW MEXICO
Members
See the BCBS member website: Understand BCBSNM Appeals and Grievances | Blue Cross and Blue Shield of New Mexico
Providers
First check the Claim Status Tool using either the member ID or claim number. If the claim qualifies, the appropriate review option will be displayed.
If no electronic option is available, please contact Provider Customer Service or submit a written claim review with supporting documentation by contacting
Blue Cross Blue Shield Turquoise Care Grievances.
Phone: 1-866-689-1523
Fax: 1-888-240-3004
Mailing address:
Turquoise Care Grievances
P.O. Box 660717
Dallas, TX 75266
Email address: GPDAG@bcbsnm.com
MOLINA Healthcare of New Mexico, Inc.
Members
Members may file an appeal or grievance by contacting the Molina Member Services Department.
Phone: (844) 862-4543, Hearing Impaired TTY/NM Relay: 1-800-659-8331 or 711
Fax: (505) 342-0583
Address:
Molina Healthcare of New Mexico, Inc.
Attn: Appeals & Grievances Department
PO Box 182273
Chattanooga, TN 37422
Email Address: MNM.Medicaid.MemberAppealsandGrievances@molinahealthcare.com
Providers
Providers may submit grievances by telephone, fax, email or in writing.
Molina Provider Contact Center
Phone: (855) 322-4078
Fax: (855) 378-3642
Address:
Molina Healthcare of New Mexico, Inc.
Attention: Claims Disputes/Adjustments
PO Box 182273
Chattanooga, TN 37422
Written Provider Appeals must be submitted via the Availity Essentials portal or faxed toll-free to (855) 378-3643.
PRESBYTERIAN HEALTH PLAN
Members
Members can find information and submit grievances and appeals through PHP Member Forms and Documents. Select Turquoise Care in the Plan Name field and choose Online Form to Submit a Grievance or Appeal.
Access the submission form here: Member Grievance and Appeal Submission Form
Providers
Providers can find information about and submit grievances and appeals at Provider Appeals and Grievances web page by selecting Provider Appeals and Grievances Form.
Presbyterian Customer Service Center
Phone: 505-923-5200
UNITED HEALTHCARE
Members
Members can find information about grievances and appeals under ‘member resources’ at https://www.uhc.com/communityplan/new-mexico/plans/medicaid/turquoise-care and published in the member handbook.
Members may also access grievance and appeal information through their myUHC portal account at https://member.uhc.com/myuhc
Member Services
Phone: 1-877-236-0826, TTY 711
Address:
UnitedHealthcare Community Plan Turquoise Care
Appeals and Grievances
P.O. Box 31364
Salt Lake City, UT 84131-0364
Providers
Providers can find information about grievances and appeals in the New Mexico 2026 UHC Turquoise Care Provider Manual or in their UHC provider portal account at UnitedHealthcare Provider Portal resources.
Phone: 888-702-2202
Address:
UnitedHealthcare Community Plan Turquoise Care
Appeals and Grievances
P.O. Box 31364
Salt Lake City, UT 84131-0364
Contact the Health Care Authority, Medical Assistance Division with questions or concerns: MADINFO.HCA@hca.nm.gov.