Medical billing services in New Mexico

We run eligibility, claim scrubbing, status checks and denial routing on automation — then put certified coders on the claims that actually need a decision. Built around Turquoise Care, commercial payers, and every EHR New Mexico practices already run.

98.6%

Clean claim rate, vs. 82–88% manual

28–34

Days in A/R, vs. 45–60 manual

24 hrs

To route and appeal a denial

Built for how New Mexico practices actually get paid

Turquoise Care, IHS and tribal billing, frontier-county coverage and commercial plans layered together trip up out-of-state billing companies. We built for that mix on purpose.

Turquoise Care

Billing and follow-up across all four MCOs — BCBS NM, Molina, Presbyterian and UnitedHealthcare Community Plan — plus fee-for-service Medicaid.

Commercial payers

Claims scrubbed against each payer's specific rules before submission, not after a denial comes back.

Rural & frontier coverage

Telehealth billing, cross-county referrals and delayed-documentation workflows handled correctly.

50+ EHR integrations

RXNT, AdvancedMD, athenahealth, eClinicalWorks, Kareo, CareCloud, Epic and more — no rip-and-replace.

Automation runs the repeat work. Coders run the judgment calls.

Most billing companies scale by hiring more billers. We scale with automation first, and add specialists only where a claim genuinely needs a human decision.

Eligibility verified automatically

Coverage and MCO assignment confirmed before the appointment, not discovered after a denial.

Claims scrubbed pre-submission

Checked against payer-specific coding edits and modifier rules before they ever reach BCBS NM, Molina, Presbyterian or UnitedHealthcare.

Denials routed, not shelved

Automatically categorized by root cause and assigned to a coder for appeal, usually within 24 hours.

Status visible in real time

A live dashboard shows where every claim stands — no phone call to a billing company required.

AI agents that learn payer patterns

Denial-prevention rules for New Mexico's payer mix improve continuously instead of living in one biller's memory.

Less admin for your front desk

Authorizations and payer calls move off staff who were never hired to make them.

Manual billing vs. Resolute's automation

Manual (industry avg.)

Resolute MSO

Clean claim rate

82–88%

98.6%

Days in A/R

45–60 days

28–34 days

Denial follow-up

Manual, queue-based

Auto-routed, 24 hrs

Claim status visibility

By phone or email

Real-time dashboard

Cities and regions we serve across New Mexico

Albuquerque

The state's densest concentration of specialty and multi-provider groups.

Santa Fe

Credentialing support for independent and boutique specialty practices.

Las Cruces

Mixed NM/TX Medicaid and commercial claims routed correctly by payer state.

Rio Rancho

Fast credentialing for a growing number of new practice openings.

Farmington & Roswell

Automated eligibility for wide rural catchment areas.

Hobbs & Carlsbad

Frontier billing workflows built for the southern NM corridor.

Gallup & Los Lunas

IHS/tribal fee-for-service billing alongside Turquoise Care claims.

How the engagement works

Audit

We review your collections, denials, A/R ageing and coding patterns and send written findings.

Design

We map your payers, specialties and systems into a workflow with automation rules built in.

Transition

We connect to your EHR, complete enrollments and run a parallel period so nothing drops.

Operate & report

Daily claim work, ongoing denial prevention and reporting you can actually read.

Got Questions?
We've Got Answers

New Mexico medical billing FAQs

Yes — we bill and follow up with all four MCOs: BCBS NM, Molina Healthcare of New Mexico, Presbyterian Health Plan and UnitedHealthcare Community Plan, plus fee-for-service Medicaid.

Yes — we serve practices statewide, including Farmington, Roswell, Hobbs, Carlsbad, Clovis and Gallup, since onboarding is fully remote.

Most billing companies charge 4–9% of collections. Resolute MSO starts at 2.99%, with no flat fees or long-term contracts.

Two to six weeks, covering payer enrollment (including Turquoise Care), data migration and a parallel-run period.

We integrate with 50+ EHR/PM platforms including RXNT, AdvancedMD, athenahealth, eClinicalWorks and Epic.