Read Provider Update
This monthly newsletter delivers updates on policies, changes to benefits, and other news you need to know.
- P = Professional
- B = Behavioral health
- F = Facilities
A Word from Dr. Shafi
P B F
May 1, 2024
As you know, May is Mental Health Month. It’s a very important time to raise awareness about the pre...
P B F
Apr 1, 2024
As many of you know, my medical background is as an OB/GYN, so championing maternal health is someth...
P B F
Mar 1, 2024
Primary care is the backbone of the healthcare system. Primary care providers (PCPs) are usually a p...
BCBSRI Update
P F
May 1, 2024
Effective July 1, 2024, updates will be made in the online authorization tool for the following Inte...
P F
May 1, 2024
In order to make the appeals process more efficient, please ensure you provide a valid name and phon...
P B F
May 1, 2024
At BCBSRI, we are committed to providing the best care to our members regardless of their race, gend...
Provider Relations
P B F
May 1, 2024
BCBSRI invites providers to join us on Tuesday, May 14 from 10-11 a.m. for a conference call with th...
P B F
May 1, 2024
Understanding and meeting linguistic needs of our members is a shared concern of BCBSRI and our cont...
P B F
May 1, 2024
As a reminder, you should always review member benefits and eligibility on bcbsri.com provider porta...
Physician & Provider Call Center
P B F
Jul 1, 2023
As a reminder, there is a functionality on the BCBSRI Provider Portal that allows providers to send ...
P B F
Jun 1, 2021
Did you know our secured Physician and Provider Portal offers the following:
•Check member benef...
Quality
P
Apr 1, 2024
The first seven to 30 days following hospital discharge can be an overwhelming transition for patien...
P
Mar 1, 2024
As we head into Colorectal Cancer Awareness Month this March, we want to highlight some of the quali...
P
Feb 1, 2024
Each year, BCBSRI is required to participate in nationally recognized quality studies, called the He...
Behavioral Health
B
May 1, 2024
The BCBSRI Behavioral Health Case Management program is staffed by experienced mental health and sub...
B
May 1, 2024
Celebrated annually in May, Mental Health Month provides an opportunity to promote awareness, offer ...
B
May 1, 2024
At InStride Health, children, teens, and young adults (ages seven-22) receive evidence-based treatme...
Pharmacy
P F
May 1, 2024
Fluticasone HFA has been added to all BCBSRI commercial formularies as a preferred tier medication. ...
P F
Apr 18, 2024
Fluticasone HFA has been added to all BCBSRI commercial formularies as a preferred tier medication. ...
P B F
Apr 1, 2024
Large Group and Small Group Markets FormularyThe information below is effective as of April 1, 2024 ...
Products & Benefits
P B F
Dec 1, 2019
In the large group portfolio, we will also be adding eight Network Blue New England Options plans, a...
P B F
Dec 1, 2019
Our regional BlueCHiP family is expanding in the small group market with Effective January 1, 2020, ...
P B F
Dec 1, 2019
Effective January 1, 2020, BCBSRI will become the insurer for all Lifespan employees. Below is a qui...
Claims
P B F
Apr 1, 2024
BCBSRI is not a PPO network sharing plan. We are not allowed to price based on our participating pro...
P B F
Jan 1, 2024
BCBSRI claims department has seen an increase in claims rejecting for no eligibility because claims ...
P B F
Nov 1, 2023
If you are correcting a claim due to an audit finding, you must submit Medical Records with your cor...
Policies
P F
May 1, 2024
G2211 will be considered NSR effective July 1, 2024Effective July 1, 2024, CPT G2211 code will be NS...
P F
May 1, 2024
Prior Authorization via Web-Based Tool for Durable Medical Equipment (DME)Effective July 1, 2024, HC...
P F
May 1, 2024
The following policies were recently reviewed for annual update. The full texts of these policies ar...