Checklists
- Alternative Benefit Plan (ABP) Exemption
- Applied Behavior Analysis (ABA)
- Dental Services
- Developmental Disabilities Traditional Waiver Budget
- Developmental Disabilities Traditional Waiver Level of Care
- Emergency Medical Services for Non-Citizens (EMSNC)
- Fee-for-Service (FFS) Prior Authorization – includes contact lenses and inpatient rehab services
- ICF/IID Level of Care
- Mi Via Developmental Disabilities Level of Care
- Mi Via Medically Fragile Level of Care
- Mi Via Service and Support Plan (SSP)/Budget
- Non-DRG LTAC Hospital
- Out-of-State Services
- Program of All-Inclusive Care for the Elderly (PACE) Level of Care
- Supports Waiver Agency-Based Budget
- Supports Waiver Level of Care
- Supports Waiver Participant-Directed Budget
Level of Care Determination Scoring Instructions
Uniform Prior Authorization Form
Replaces MAD forms 301, 303 and 616 as of Jan. 1, 2020.
Fax Numbers
- Applied Behavior Analysis: 888-515-2067
- MCO client information update requests: 888-562-2755
- Mi Via participants: 800-251-9993
- Urgent fee-for-service prior authorizations: 888-562-2755
Comagine Health Provider Portal
The Comagine Health Provider Portal is a web-based application for submitting authorization requests and supporting documents.
Go to the Comagine Health Provider Portal
For help or password resets, please call Comagine Health at 866-962-2180.
To get started with the Comagine Health Provider Portal, please complete the registration packet and email it to nmprovider@comagine.org. After we receive your registration packet we will send you an email with your login credentials.
Comagine Health Provider Portal Registration Packet
Administrator Guide
Administrator Guide (Aug. 15, 2017)
User Guide
User Guide (Aug. 25, 2016)
Frequently Asked Questions
Quick Start Guides
- Dental Services
- ICF/IID Level of Care
- Medical Outpatient Services
- Mi Via Budget
- Mi Via Level of Care
- Program of All-Inclusive Care for the Elderly (PACE) Level of Care
- Home and Community-Based Waiver Level of Care Documents
- Supports Waiver Budget
- Supports Waiver Level of Care
- Traditional Waiver Budget
- Traditional Waiver Level of Care
- UM Authorization
- UNM C.O.R.E. Budget
Compliments and Complaints Letter
Compliments and Complaints Letter (June 2021)