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

BCBSRI Update

P B F
Dec 1, 2018
We are committed to ensuring the accuracy of the information in our Find a Doctor tool, the online d...
P B F
Dec 1, 2018
The Rhode Island Business Group on Health (RIBGH) and Blue Cross & Blue Shield of Rhode Island (...
P B
Dec 1, 2018
The Centers for Medicare and Medicaid Services (CMS) established a code set to cover the Collaborati...

Quality

P
Dec 1, 2018
The following tips will aid you in optimizing your HEDIS performance as the year comes to an end and...
P
Oct 1, 2018
The Million Hearts® campaign is a national initiative with a goal of at least one million fewer card...
P
Oct 1, 2018
Please note: HEDIS excludes Medicare members age 66 and older as of December 31 of the measurement y...

Behavioral Health

B
Dec 1, 2018
The HEDIS measure Follow-up After Hospitalization for Mental Illness (FUH) is the percentage of disc...
B
Dec 1, 2018
The HEDIS measure Follow-Up Care for Children Prescribed ADHD Medication focused on the percentage o...
B
Dec 1, 2018
The HEDIS measure Antidepressant Medication Management (AMM) applies to the percentage of members wh...

Pharmacy

P B
Dec 1, 2018
In our ongoing efforts to make high-quality and affordable healthcare available to our members, BCBS...
P B
Oct 1, 2018
Consistent with our management practice, October 1, 2018 marked the next scheduled update of the BCB...
P B F
Sep 1, 2018
Effective October 1, 2018, the BCBSRI Pharmacy Formulary will be updated to remove the generic equiv...

Products & Benefits

P B
Dec 1, 2018
Effective October 1, 2018, BCBSRI launched a new product family, Access Blue New England. It will be...
P B F
Dec 1, 2018
Effective January 1, 2019, the Blue Cross and Blue Shield Federal Employee Program® (FEP) is launchi...
P B F
Oct 1, 2018
Effective October 1, 2018, BCBSRI is launching a new product family, Access Blue New England. It wil...

Claims

P F
Dec 1, 2018
BCBSRI follows the American Medical Association (AMA) Current Procedural Terminology (CPT) guideline...
P
Dec 1, 2018
BCBSRI follows CMS guidelines on assistant-at-surgery services that are reimbursable; however, BCBSR...
P B
Dec 1, 2018
As a reminder, when a BCBSRI participating provider renders services to a BCBSRI Blue plan member in...

Policies

P B F
Dec 1, 2018
Effective January 1, 2019, the CPT code 90840 will be a covered and separately reimbursed for servic...
P F
Dec 1, 2018
Effective December 1, 2018 the prosthetic urethral lift policy has been updated to reflect that the ...
P F
Dec 1, 2018
Effective January 1, 2019, the following CPT codes for Transesophageal Echocardiography (TEE) (73312...