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. Collins

P B F
May 1, 2021
In June 2018, we held our first Medical Expense Trend (MET) Summit, where we invited our provider co...
P B F
Mar 1, 2021
Of course, the COVID-19 vaccine is THE topic of the moment. And as the state’s largest health insure...
P B F
Feb 1, 2021
Blue Cross & Blue Shield of Rhode Island (BCBSRI), in partnership with Eliza Corporation (Eliza)...

BCBSRI Update

F
May 1, 2021
As you may know, Blue Cross & Blue Shield of Rhode Island (BCBSRI) uses InterQual® Criteria Guid...
P B F
May 1, 2021
The Temporary Cost Share Waiver for Treatment of Confirmed Cases of COVID-19 policy has been extende...
P F
May 1, 2021
BCBSRI is taking the following additional steps to support its members during the COVID-19 pandemic:...

Provider Relations

P B F
May 1, 2021
As a BCBSRI-contracted provider, it is your obligation to coordinate member care with contracted, in...
P B F
Apr 1, 2021
As a BCBSRI-contracted provider, it is your obligation to coordinate member care with contracted, in...
P B F
Oct 1, 2020
We have updated the credentialing form for new providers looking to become participating BCBSRI prov...

Quality

P
May 1, 2021
BCBSRI is committed to making it easier for your practice to be successful in all areas of quality i...
P
Apr 1, 2021
As a reminder, the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey was sent t...
P
Apr 1, 2021
BCBSRI is committed to making it easier for your practice to be successful in all areas of quality i...

Behavioral Health

B
May 1, 2021
The Dementia Care Coordination Program is a referral-based program based on a Veterans Administratio...
P B F
Apr 1, 2021
April is National Alcohol Awareness Month. Founded and sponsored by the National Council on Alcohol ...
P B
Nov 12, 2020
Program overview: The Dementia Care Coordination Program is an evidence-informed intervention based ...

Pharmacy

P B F
Apr 1, 2021
The information below is effective as of April 1, 2021 and applies to all commercial BCBSRI products...
P F
Apr 1, 2021
The following Commercial MDR drugs will require step therapy through a biosimilar effective 4/1/21: ...
P
Mar 1, 2021
As part of our ongoing efforts to make high-quality and affordable healthcare available to our membe...

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
May 1, 2021
As a reminder, when filing a claim for an unlisted procedure code, please include the Unlisted Proce...
P B F
Apr 1, 2021
As a reminder when sending in Medical Records to BCBSRI, a valid coversheet should be placed on top ...
P B F
Mar 1, 2021
As a reminder when sending in Medical Records to BCBSRI, a valid coversheet should be placed on top ...

Policies

P
May 1, 2021
We have completed our review of the April 2021 CPT code changes, including any Category II performan...
P
May 1, 2021
Effective July 1, 2021, the following changes are being made for several genetic testing services:  ...
P F
May 1, 2021
The following policies were recently reviewed for annual update. The full texts of these policies ar...
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