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. Manocchia

P B F
May 1, 2019
In 2014, we created a patient-centered pharmacy program that was designed to support adding pharmaci...
P B F
Apr 1, 2019
Technology connects patients with the healthcare they need, which is why an online provider director...
P B F
Mar 1, 2019
BCBSRI’s mission is clear: To improve our members’ health and peace of mind by facilitating their ac...

BCBSRI Update

P
May 1, 2019
Our Utilization Management (UM) department has streamlined the PCP admission request process for ski...
P
May 1, 2019
This year, BCBSRI will roll out a specialist-focused performance rating program to provide and share...
P
May 1, 2019
In the January Provider Update, Gus Manocchia, M.D., BCBSRI’s executive vice president and chief med...

Provider Relations

P F
May 1, 2019
As you might have learned at our 2018 Fall Provider Seminars, MHK (formerly MedHok) will be replacin...
P B F
May 1, 2019
As a BCBSRI-contracted provider, you have an obligation to coordinate members’ care with contracted,...
P B F
May 1, 2019
Is your office looking to add or remove a practice address with BCBSRI? The practitioner change form...

Quality

P
May 1, 2019
BCBSRI is committed to making it easier for your practice to be successful in all areas of quality i...
P
Apr 1, 2019
The Transitions of Care (TRC) measure assesses the percentage of discharges for members age 18 or ol...
P
Mar 1, 2019
We are committed to working with you to improve the quality of care and health outcomes for our memb...

Behavioral Health

P B F
May 1, 2019
Mental Health Month was started in 1949 by the national organization Mental Health America to raise ...
B
Apr 1, 2019
Beacon Health Options, BCBSRI’s behavioral health partner, is available 24/7 to assist with finding ...
B
Apr 1, 2019
Founded and sponsored by the National Council on Alcohol and Drug Dependence (NCADD), Alcohol Awaren...

Pharmacy

P
May 1, 2019
Pharmacy benefit coverage for Commercial members will be updated effective May 1, 2019 to include co...
P
Apr 1, 2019
The BCBSRI Commercial formulary for April is now available. You can view the summary that provides d...
P
Mar 1, 2019
Consistent with our management practice, April 1, 2019 is the next scheduled update of the BCBSRI Co...

Products & Benefits

P B F
Jan 1, 2019
Effective October 1, 2018, BCBSRI launched a new product family, Access Blue New England. It will be...
P B F
Jan 1, 2019
Effective January 1, 2019, the Blue Cross and Blue Shield Federal Employee Program® (FEP) is launchi...
P B F
Jan 1, 2019
Upon enrollment, our members are granted certain rights and protection of these rights in all their ...

Claims

P F
May 1, 2019
BCBSRI follows the Medicare National Correct Coding Initiative (NCCI) edits to ensure that all claim...
P B F
Apr 1, 2019
Effective April 1, 2019, BCBSRI will require the provider taxonomy code to be submitted on all claim...
P B F
Mar 1, 2019
Effective April 1, 2019, BCBSRI will require the provider taxonomy code to be submitted on all claim...

Policies

P F
May 1, 2019
We have completed our review of the additional CPT and HCPCS code changes for January 2019. These up...
P B F
May 1, 2019
Behavioral Health Integration Services policy PBF This policy documents payment guidelines for Coll...
P F
May 1, 2019
The following policies were recently reviewed for annual update. The full text of these policies is ...