Presbyterian

Health Plan, Inc.

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    Presbyterian Health Plan members can log into myPRES to determine which providers in Presbyterian’s network of more than 9,000 providers are covered by their plan.

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  • Presbyterian Medical Group Providers

    Presbyterian Medical Group has more than 850 providers in 50 specialties at more than 100 clinics throughout New Mexico – all dedicated to your health and comfort.

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    Find out about the newest staff and the latest technology, and all the other happenings at Presbyterian.

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Home|Employers & Producers|Forms and Resources|Employer and Producer Forms and Documents

Coverage That Makes Sense

Presbyterian Health Plan, Inc. wants to help. Below are documents that are frequently requested. If you can't find what you are looking for, please contact us.

General

Presbyterian Senior Care Table of Commission RatesProducer Commissions Authorization/Agreement for Direct Deposit

Guidelines

Field Underwriting Guidelines (Group)

Forms

HIPAA - General Release of Information Form: Member/SubscriberMedicare Sales Appointment Confirmation FormMember Termination/Change Form (for groups only)My Care Unique Service Reimbursement Form

Questions and Answers

4-Tier Prescription Drug commonly asked questionsCommonly asked questions about non-par providers (R&C, DDs etc)

Presbyterian Group Benefit Information

Benefit Briefs

PresElect Plans (Group size 2-50 PPO)Smart Care Plans (Group size 2-50 HMO)Value Care Plans (Group size 2-50 HMO)Vantage Care Plans (Group sizes 2-50 and 51+ HDHP, qualified HSA plans)Custom Care Plans (Group size 51+ HMO)Preferred Care Plans (Group size 51+ PPO)Smart Care Plans (Group size 51+ HMO)

Procedural Forms - Quoting a Group with Presbyterian

Census FormLarge Group UMAFRate Request FormUMAF Medical Assessment Form, EnglishUMAF Medical Assessment Form, Spanish

Procedural Forms - Enrolling a Group with Presbyterian

Employee Action Form, EnglishEmployee Action Form, SpanishEmployee Action Form PIC/PHP, Spanish (enrollment /change /waiver)Employer Group Information SheetExhibit B, Bank Draft Authorization (Required for Groups 1 - 9)New Group Submission ChecklistCOBRATransition of Care Form

Individual Plans

Presbyterian's Individual and Family Plans

Questions?

  • Call our knowledgeable associates on our Employer/Producer hotline:
  • 505-923-5656 or 1-866-246-9877
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