Provider Information
Electronic Data Exchange (EDI)
Link to Companion Guides, EDI Forms, and FAQs
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New Mexico Medicaid Third Party Assessor/Utilization Review for Fee-For-Service

For more information, go to https://www.hca.nm.gov/hca-forms/

Emergency Medical Services for Non-Citizens (EMSNC) Claims Process

For more information, go to https://www.hca.nm.gov/hca-forms/

Third Party Liability (TPL)

For more information, go to https://www.hca.nm.gov/hca-forms/

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Forms, Publications, and Instructions
For more information on HSD program policies, refer to: New Mexico Medical Assistance Division Program Policy Manual
Adjustments,Voids, and Inquiries

For more information, go to https://www.hca.nm.gov/hca-forms/
HSD/MAD Forms

For more information, go to https://www.hca.nm.gov/hca-forms/
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Self-Direction FMA Forms (Mi Via & Self-Directed Community Benefit)

All self-directed forms are available on the Palco website: https://palcofirst.com/new-mexico/

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