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MHNM Network Management Contact Information
2024 Marketplace Provider Manual
2023 Marketplace Provider Manual
Gold Card Status Lookup Tool
Prior Authorization LookUp Tool
2025 Q1 Prior Authorization Guide and Form
2024 Q4 Prior Authorization Guide and Form
2024 Q3 Prior Authorization Guide and Form
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2024 Q1 Prior Authorization Guide and Form
2023 Q4 Prior Authorization Guide and Form
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2023 Q1 Prior Authorization Guide and Form
2024 Q4 Formulary Changes Notices
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2024 Q4 Prior Authorization Code Matrix
2024 Q3 Prior Authorization Code Matrix
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2024 Q1 Prior Authorization Code Matrix
2023 Q3 Prior Authorization Code Matrix
2023 Q2 Prior Authorization Code Matrix
2023 Q1 Prior Authorization Code Matrix
No Surprises Act - Independent Dispute Resolution Form (Non-Contracted Providers only)
Pharmacy PA Systems Downtime Notice 2024
Provider Change Form
Provider Reconsideration Review (PRR) Form
New Mexico Synagis Prior Authorization Form
New Mexico Uniform Prior Authorization Form
Provider Information Form
Member Authorization to Release PHI Forms (en español)
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Behavioral Health Outpatient Treatment Request Form
Behavioral Health Higher Level of Care
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