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. Shafi

P B F
Sep 1, 2023
If you have been living or working in Rhode Island during the last 12 years, particularly as a parti...
P B F
Aug 1, 2023
  Hi! I’m Dr. Farah Shafi, and as you may have heard, I recently joined Blue Cross & Blue Shield...
P B F
Jul 1, 2023
We are excited to announce that Dr. Farah Shafi has joined Blue Cross & Blue Shield of Rhode Isl...

BCBSRI Update

P F
Sep 1, 2023
As a reminder, according to our Vitamin-D Testing Medical Policy, CPT Codes 82306 (Vitamin D; 25 hyd...
P B F
Sep 1, 2023
On the BCBSRI MHK Provider Portal, provider correspondence is now available under the “View Authoriz...
P B F
Aug 1, 2023
The MHK Provider Portal has had a system upgrade as of 7/28. We are asking that providers please cle...

Provider Relations

P B
Sep 1, 2023
When you are due for recredentialing, BCBSRI will verify with CAQH that you have a current applicati...
P B F
Sep 1, 2023
BCBSRI invites providers to join us on Tuesday, September 12, 2023 from 10:00am-11:00am for a confer...
P B
Sep 1, 2023
If you are a participating provider with BCSBRI and are moving out of state, you cannot practice if ...

Physician & Provider Call Center

P B F
Jul 1, 2023
As a reminder, there is a functionality on the BCBSRI Provider Portal that allows providers to send ...
P B F
Jun 1, 2021
  Did you know our secured Physician and Provider Portal offers the following: •Check member benef...

Quality

P
Sep 1, 2023
Our 2023 PCP Quality Improvement Program (PQIP) has expanded to include two new measures: Kidney Hea...
P
Jul 1, 2023
BCBSRI’s quality concierge team is looking to partner with your practice to help you maximize member...
P
Jun 1, 2023
This measure will now be included in our PQIP 2023 Pediatric Measure set. Tips and Tricks: Include...

Behavioral Health

B
Sep 1, 2023
BCBSRI, in partnership with The Substance Use & Mental Health Leadership Council of Rhode Island...
B
Sep 1, 2023
Suicide can affect anyone regardless of age, gender, racial/ethnic background, or socioeconomic stat...
B
Sep 1, 2023
Founded in 1989, National Recovery Month brings awareness to mental and substance use disorders and ...

Pharmacy

P F
Mar 1, 2023
For NEHP members with a RI PCP, inquiries regarding medical drugs should be directed to the member’s...
P F
Feb 6, 2023
For NEHP members with a RI PCP, inquiries regarding medical drugs should be directed to the member’s...
P B F
Jan 1, 2023
The Inflation Reduction Act (IRA) will take effect on January 1, 2023.The Act includes the following...

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
Apr 1, 2023
As a reminder, when filling out a CMS-1500 form and submitting it to BCBSRI for claims processing, i...
P B F
Jan 1, 2023
As a reminder when sending medical records to BCBSRI, a valid coversheet should be placed on top of ...
P B F
Mar 16, 2022
**This update will not take place this weekend and it will be rescheduled to a future date. **   B...

Policies

P F
Sep 1, 2023
Emergency Department Services/Waiver of Copayment                                                   ...
P B F
Sep 1, 2023
The following policies were recently reviewed for annual update. The full texts of these policies ar...
P B F
Sep 1, 2023
BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...