Molinalogo

Requests for out-of-state services are for those medical services that cannot be provided within the state of New Mexico. These services require prior authorization. Requests for out-of-state services can be received by fax or phone call. If the request is initiated by phone call, all required documentation will be submitted via fax. Inter Qual can be utilized, however the Medical Director makes the final decision. The approval information is annotated on the document from the out-of-state provider. A letter of approval is also generated and faxed to the out-of-state provider. The approval information includes the authorization number, dates of service, approved service, and approved facility.