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Internal Dispute Resolution Process

The Federal IDR process is available only for certain services, such as out-of-network emergency services, certain services provided by out-of-network providers at an in-network facility, or out-of-network air ambulance services. The Federal IDR process is also only available if a state All-Payer Model Agreement or specified state law does not apply; otherwise, the state Agreement or law applies. To view information about the Federal IDR process, please review this document.


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The Friday Health Plans portal is your one-stop shop where you can:

  • Check authorization statuses
  • Access claims data
  • Search for forms
  • Review provider manual
  • View member eligibility

Sign up for the Friday Health Plans Provider Portal and submit your provider information for approved access.


Claims Information: New Mexico

Payer ID: H0657

Mailing/Claims Address: Friday Health Plans, PO Box 21594, Eagan, MN 55121 (If you send a claim to the Sidney, NE PO Box, it will be forwarded).

Provider Service: 844-805-5000
New Mexico Provider Support Email: NM-Providers@fridayhealthplans.com
Referrals and Prior Auth (Fax): 888-610-0019 or email nm-medical@fridayhealthplans.com 
Pharmacy-Prior Auth: Call 855-712-2779 or fax form to 833-434-0563
Contract Questions: NM-Providers@fridayhealthplans.com
Credential Contact for Current Providers: providers@fridayhealthplans.com
Open Negotiation Requests: IDR@fridayhealthplans.com
To speak with a nurse or obtain an authorization after hours, please call 844-805-5000. Translation services available.

Interested in joining the Friday Health Plans network?
You can inquire about being on the Friday Health Plans network by emailing us at NM-Providers@fridayhealthplans.com


NEW MEXICO UPDATES

Notice: New Mexico Senate Bill 317 Notice 

Senate Bill 317 titled “No Behavioral Health Cost Sharing” (SB 317), signed into New Mexico law on April 8, 2021, becomes effective January 1, 2022, and is scheduled to expire on December 31, 2026. Among other requirements, SB 317 is requiring health plans to waive cost-sharing on behavioral health (BH) services. View the notice.