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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, 2022
As you know, May is Mental Health Awareness Month. Factors related to the pandemic over the last two...
P B F
Apr 1, 2022
Heart disease is the top cause of death in the U.S. today, and the leading cause of death for people...
P B F
Mar 1, 2022
It’s amazing to think that we’re now at the second anniversary of the start of the COVID-19 pandemic...

BCBSRI Update

P F
May 16, 2022
As you may know, BCBSRI uses InterQual® Criteria Guidelines (InterQual) offered through Change Healt...
P B F
May 1, 2022
Your office could see an increase time for claims processing for some Direct Pay member claims. If a...
P B F
May 1, 2022
How to view authorizations BCBSRI providers can view authorizations in the MHK provider portal by e...

Provider Relations

P B F
May 1, 2022
Effective July 1, 2022, BCBSRI will require the National Drug Code (NDC) to be filed on all claims s...
P B
May 1, 2022
The Place of Service (POS) 10 Telemedicine Payment Policy outlines BCBSRI’s implementation of a new ...
P B
Apr 1, 2022
The Place of Service (POS) 10 Telemedicine Payment Policy outlines BCBSRI’s implementation of a new ...

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
May 1, 2022
This month’s Hints for HEDIS is for Osteoporosis Management in Women who Had a Fracture (OMW). Meas...
P
Apr 1, 2022
TRC (Transitions of Care: Medication Reconciliation)    This month’s Hints for HEDIS will cover bes...
P
Mar 1, 2022
This month’s Hints for HEDIS includes an informative refresher on the Colorectal Cancer Screening (C...

Behavioral Health

B
May 1, 2022
Mental Health Month was started in 1949 by the national organization Mental Health America to raise ...
B
Apr 1, 2022
Founded and sponsored by the National Council on Alcohol and Drug Dependence (NCADD), Alcohol Awaren...
B
Mar 1, 2022
The Substance Use and Mental Health Leadership Council of RI (SUMHLC) is offering an opportunity to ...

Pharmacy

P F
Apr 1, 2022
As part of our ongoing efforts to make high-quality and affordable healthcare available to our membe...
P
Mar 1, 2022
The first interchangeable biosimilar insulin product has been approved by the FDA. Viatris has relea...
P F
Feb 4, 2022
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
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
May 1, 2022
We have completed our review of the April 2022 CPT code changes, including any category II performan...
P F
May 1, 2022
This policy was updated on April 20, 2022 to include new HCPCS codes effective April 1, 2022. Effe...
P F
May 1, 2022
Effective July 1, 2022, diagnosis coding in the Fecal Calprotectin Testing policy will be edited to ...