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
Oct 1, 2021
According to the recently published Blue Cross Blue Shield Association (BCBSA) report “Racial Dispar...
P B F
Sep 1, 2021
Earlier this summer, I had the amazing opportunity to participate in the 2020 Olympic games in Tokyo...
P B F
Aug 1, 2021
In the 1950s and 1960s, the doctor’s housecall was a normal occurrence, and regular visits by doctor...

BCBSRI Update

P B
Oct 1, 2021
As a reminder, our BlueCHiP Direct Advance plan is available to the individual commercial market thr...
P F
Sep 1, 2021
As a reminder, our BlueCHiP Direct Advance plan is available to the individual commercial market thr...
P F
Aug 1, 2021
eviCore updated processing rules on July 14th for all Medicare code change requests.  The new proc...

Provider Relations

P B F
Oct 1, 2021
Please mark your calendars for the next provider conference call with the Director of Provider Relat...
P B F
Oct 1, 2021
BCBSRI will conduct administrative terminations of provider agreements for providers who have not su...
P B F
Sep 1, 2021
BCBSRI will conduct administrative terminations of provider agreements for providers who have not su...

Physician & Provider Call Center

P B F
Jun 1, 2021
  Did you know our secured Physician and Provider Portal offers the following: •Check member benef...

Quality

P
Oct 1, 2021
COMPREHENSIVE DIABETES CARE Measure definition:Percentage of patients with diabetes (type 1 & 2...
P
Sep 1, 2021
Well-child assessment Percentage of children (three-17 years old) who had an outpatient visit with ...
P
Aug 1, 2021
Breast cancer screening Women ages 50-74 who had a mammogram to screen for breast cancer in the pas...

Behavioral Health

B
Oct 1, 2021
National Depression Screening Day, observed annually on the Thursday of the first full week in Octob...
B
Sep 1, 2021
Throughout the pandemic, healthcare workers’ top priority, as always, was the health and safety of t...
B
Sep 1, 2021
Every September, the Substance Abuse and Mental Health Services Administration (SAMHSA) sponsors Nat...

Pharmacy

P B F
Oct 1, 2021
The formulary changes noted below are effective as of October 1, 2021 and apply to all commercial BC...
P F
Aug 1, 2021
As part of our ongoing efforts to make high-quality and affordable healthcare available to our membe...
P B F
Jul 1, 2021
The information below is effective July 1, 2021 and applies only to the individual market segment in...

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 F
Jul 1, 2021
As a reminder, when filing a claim for an unlisted procedure code, please include the Unlisted Proce...
P B F
Jun 1, 2021
As a reminder, when filing a claim for an unlisted procedure code, please include the Unlisted Proce...
P B F
May 1, 2021
As a reminder, when filing a claim for an unlisted procedure code, please include the Unlisted Proce...

Policies

P F
Oct 1, 2021
We have completed our review of the October 2021 CPT code changes, including any Category II perform...
P F
Oct 1, 2021
Effective January 1, 2022, colorectal cancer screenings will be covered as a preventive health servi...
P F
Oct 1, 2021
Effective November 1, 2021, Genetic Testing Services will be updated to allow CPT code 81538 for Med...