Presbyterian

Providers

Claims

Learn more about the options available to provide quick and accurate claims processing at Presbyterian.

Electronic Payment - Presbyterian ePayment Center

Presbyterian offers electronic remittance advice/electronic funds transfer (ERA/EFT) transactions at no charge to contracted medical providers.

Providers may enroll in Presbyterian’s electronic payment (ePayment) portal by visiting the following link.

Online Registration

Should providers have any questions about this service, or should they require additional assistance, they may contact our ePayment Client Services team at 1-855-774-4392 or by email at Help@ePayment.Center

More information about how to register

Submitting Claims Electronically

Electronic claims transmission (ECT) saves time and money and helps make the claims process as efficient as possible. Here are some other benefits of submitting claims electronically:

  • The average time to process and electronic claim is seven days, compared to 14 days for paper claims.
  • You save the cost of postage and paper when you submit electronically.
  • Your office receives a quicker confirmation of claims receipt and integrity of the data.
  • There is a higher percentage of claims accuracy, resulting in faster payment.
Fast Claim is designed to accommodate lower volume claim submitting practices that would like to submit claims electronically directly to Presbyterian at no cost. For questions, contact your relationship executive.

 

To learn more about ECT, please refer to the Claims Section of the Provider Manual or contact your Provider Network Management relationship executive.

Checking Claim Status

The easiest way to check the status of a claim is through the myPRES portal. Providers can access myPRES 24 hours a day, seven days a week. If additional assistance is needed, please contact the Provider Claims Activity Review and Evaluation (CARE) Unit (505) 923-5757 or 1 (888) 923-5757.

Login to myPRES

Medicaid Enrollment Guidelines

All individual and group providers are required to enroll with the New Mexico Human Services Department (HSD) to order, refer, prescribe or render services to Centennial Care members to ensure timely claims payments. Without enrollment, claims may be denied.

Learn more about Medicaid enrollment

Contracted Clearinghouses

Contact our contracted Clearinghouses to see which one is the best fit for your practice management system.

  • Availity
  • P.O. Box 550857
  • Jacksonville, FL 32255-0857
  • Telephone
  • 1-800-AVAILITY (282-4548)
  • ClaimMD
  • P.O. Box 1177
  • Pecos, NM 87552
  • Telephone
  • 505-757-6060
  • Change Healthcare
  • 1283 Murfreesboro Rd.
  • Nashville, TN 37217
  • Telephone
  • 1-877-469-3263, Option 2
  • HealthXnet
  • 7471 Pan American Freeway NE
  • Albuquerque, NM 87109
  • Telephone
  • 505-346-0290 or 1-866-676-0290

  • Chaplaincy Services

    We provide ministry and emotional support for patients and their families and support for healthcare workers in times of crisis. Let us help.

    Learn More.
  • Presbyterian Health Plan News & Updates

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

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