How is the three-month grace period handled for providers?

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Health insurance issuers like Blue Cross are obligated to pay claims for covered services rendered during the first month of the grace period. During the second and third months of the grace period, health insurance carriers may pend claims until the member has either paid the premiums owed or the grace period has ended. At the end of the grace period, if the member has not paid their premiums, claims may be denied.

During the grace period, Blue Cross will notify providers that their claims are pended because the member is in the grace period. In addition, we are working to ensure that when providers contact Blue Cross to confirm eligibility, they are informed that the member’s eligibility is pended as a result of the grace period. 

Members who may be eligible for this grace period will have a ZBN prefix on their ID card. It is important to note that not every member who purchases coverage through HealthSource RI in the individual market will be eligible for premium subsidies or for the grace period. 

For all other members enrolled through HealthSource RI or directly through Blue Cross, there will be a one-month grace period for members who are delinquent in paying their bills. Blue Cross will continue to pay claims during this one-month period.