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
Dec 1, 2022
Matthew Collins, M.D., M.B.A. is BCBSRI’s executive vice president and chief medical officer, with c...
P B F
Nov 1, 2022
  Matthew Collins, M.D., M.B.A. is BCBSRI’s executive vice president and chief medical officer, wit...
P B F
Oct 1, 2022
Matthew Collins, M.D., M.B.A. is BCBSRI’s executive vice president and chief medical officer, with c...

BCBSRI Update

P B F
Dec 1, 2022
As a reminder, the prefix for State of Rhode Island employees is R2I (R 2 and the letter “I”). We ha...
P B F
Dec 1, 2022
BlueCHiP for Medicare Advance  Effective January 1, 2023, BlueCHiP for Medicare Advance (Advance) ...
P B F
Oct 1, 2022
At BCBSRI, we believe that high quality care is equitable care, and we are committed to providing th...

Provider Relations

P B F
Dec 1, 2022
Coming in mid-January BCBSRI is introducing an updated version of our IVA. The new IVA will be able ...
P B F
Dec 1, 2022
Recently National Grid was bought out by Rhode Island Energy. With this purchase, their employees’ i...
P F
Dec 1, 2022
BCBSRI currently uses eviCore for high-end radiology and cardiology prior authorizations. Effective ...

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
Dec 1, 2022
This year, the CDC is observing National Influenza Vaccination Week from December 5-9. This month’s ...
P
Oct 1, 2022
Preventing falls and subsequent hip and vertebral fractures is important for our senior population. ...
P
Sep 1, 2022
Interested in optimizing your quality and incentive program performance? BCBSRI has a dedicated tea...

Behavioral Health

B
Dec 1, 2022
BCBSRI is excited to share that as of November, two additional behavioral health practices began off...
B
Dec 1, 2022
The BCBSRI behavioral health case management program is staffed by experienced mental health and sub...
B
Nov 1, 2022
This month’s Hints for HEDIS is Osteoporosis Management in Women who Had a Fracture (OMW). Measure ...

Pharmacy

P F
Dec 7, 2022
The Inflation Reduction Act (IRA) will take effect on January 1, 2023.The Act includes the following...
P F
Dec 1, 2022
Effective January 1, 2023, BCBSRI will cover the infliximab biosimilar products, Avsola and Inflectr...
P
Nov 1, 2022
Effective January 1, 2023, BCBSRI will cover the infliximab biosimilar products, Avsola and Inflectr...

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
Mar 16, 2022
**This update will not take place this weekend and it will be rescheduled to a future date. **   B...
P B F
Jan 7, 2022
BCBSRI will be implementing changes to bluegateway.bcbsri.com and the system was supposed to be unav...
P B F
Dec 1, 2021
BCBSRI will be implementing changes to bluegateway.bcbsri.com and the system will be unavailable fro...

Policies

P F
Dec 1, 2022
Glucose Monitoring – Continuous                                                        Effective Ja...
P F
Dec 1, 2022
The following policies were recently reviewed for annual update. The full texts of these policies ar...
P F
Dec 1, 2022
The following new policies were recently created: Digital Health Technologies: Diagnostic Applicati...