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
Sep 1, 2020
In last month’s column, I talked about glaring examples of disparities in healthcare over many decad...
P B F
Aug 1, 2020
The idea of disparities existing in healthcare is not new; it’s something the industry has grappled ...
P B F
Jul 1, 2020
Think back to pre-pandemic times, when telemedicine—although used increasingly in recent years—was p...

BCBSRI Update

P B F
Sep 8, 2020
Blue Cross and Blue Shield of Rhode Island (BCBSRI) has updated the Temporary Telemedicine/Telehealt...
P
Sep 1, 2020
Blue Cross & Blue Shield of Rhode Island (BCBSRI) is partnering with WINFertility who is a leade...
P B F
Sep 1, 2020
The Temporary Telemedicine Telehealth and Telephone Services During the COVID 19 Crisis policy, effe...

Provider Relations

P B F
Sep 1, 2020
During the COVID-19 pandemic, we’ve had to rethink our in-person fall seminars and have opted to con...
P B F
Aug 1, 2020
Electronic attestations are now live on our secure provider portal and have replaced fax attestation...
P F
Aug 1, 2020
The MHK portal has a new feature available for providers. If your office has submitted a request thr...

Quality

P
Sep 1, 2020
BCBSRI is committed to making it easier for your practice to be successful in all areas of quality i...
P
Aug 1, 2020
Hints for HEDIS® (and more)         P BCBSRI is committed to making it easier for your practice to ...
P
Jul 1, 2020
BCBSRI is committed to making it easier for your practice to be successful in all areas of quality i...

Behavioral Health

B
Sep 1, 2020
Every September, the Substance Abuse and Mental Health Services Administration (SAMHSA) sponsors Nat...
B
Sep 1, 2020
If a provider renders methadone maintenance services to a BCBSRI commercial member who has federal M...
P B
Aug 1, 2020
Behavioral health providers—including psychiatrists, clinical nurse specialists, psychiatric nurse p...

Pharmacy

P B F
Aug 1, 2020
BCBSRI offers home delivery option or an extended supply network pharmacy for new prescriptions or r...
P F
Aug 1, 2020
The following codes are being added to Medicare MDR with a 10/1/20 effective date (effective 10/1/20...
P F
Jun 1, 2020
Due to the COVID-19 pandemic, BCBSRI has extended all clinical authorization approvals by Prime Ther...

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
Jul 1, 2020
Effective for claims received on and after October 5, 2020,  electronically submitted secondary clai...
P F
Apr 1, 2020
If a member receives the same radiology procedure multiple times on the same day from different prov...
P F
Apr 1, 2020
During the COVID-19 pandemic, eviCore has increased their authorization span from 90 to 180 days. An...

Policies

P F
Sep 1, 2020
The following policies were recently reviewed for annual update. The full texts of these policies ar...
P B F
Sep 1, 2020
BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...
P F
Aug 1, 2020
We have completed our review of the additional CPT and HCPCS code changes for July 2020. These updat...
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