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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
Jan 1, 2022
This month represents many things…a new year, a clean slate, and a fresh start for so many of us. In...
P B F
Dec 1, 2021
Climate change is always a topic of much discussion, but it was in the spotlight recently around the...
P B F
Nov 1, 2021
The vision of Blue Cross & Blue Shield of Rhode Island (BCBSRI) is to passionately lead a state ...

BCBSRI Update

P B F
Jan 1, 2022
BCBSRI encourages its participating providers to collaborate with us in supporting LGBTQ communities...
P F
Jan 1, 2022
The Centers for Medicare and Medicaid Services (CMS) reminds Medicare Advantage Organizations (MAOs)...
P B F
Jan 1, 2022
Questions about Special Enrollment Periods (SEPs)? By now, you’ve heard the news that all of our 2...

Provider Relations

P B
Jan 1, 2022
Primary care providers (PCPs) accept responsibility for arranging and coordinating the overall healt...
P B F
Jan 1, 2022
Effective January 1, 2022, BCBSRI will began offering a new Medicare Advantage non-referral-based pr...
P B
Jan 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
Jan 1, 2022
2022 PCP Quality Incentive Program highlights The PCP Quality Incentive Program incents PCPs for hi...
P
Oct 1, 2021
COMPREHENSIVE DIABETES CARE Measure definition:Percentage of patients with diabetes (type 1 & 2...
P
Sep 1, 2021
Well-child assessment Percentage of children (three-17 years old) who had an outpatient visit with ...

Behavioral Health

B F
Jan 1, 2022
Effective January 1, 2022, BCBSRI behavioral health utilization and case management functions have b...
P F
Dec 1, 2021
As communicated, effective 1/1/2022, BCBSRI Behavioral Health utilization and case management functi...
B
Nov 3, 2021
Training 1: Documentation: The Foundation to Quality Care Learning ObjectivesUpon completion of the...

Pharmacy

P
Jan 1, 2022
The information below is effective as of January 1, 2022 and applies only to the individual market s...
P B F
Jan 1, 2022
Non-specialty pharmacy A new preferred home delivery pharmacy and/or a new option for certain membe...
P
Dec 1, 2021
Beginning January 1, 2022, the below list of drugs will require step therapy for Medicare members as...

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
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...
P F
Nov 1, 2021
Blue Cross Blue Shield of Massachusetts (BCBSMA) is initiating a new utilization management program ...

Policies

P F
Jan 1, 2022
We have completed our review of the January 2022 CPT code changes, including any category II perform...
P F
Jan 1, 2022
Effective March 1, 2022, several ICD-10 diagnosis codes will no longer require authorization when fi...
P F
Jan 1, 2022
The following policies were recently reviewed for annual update. The full texts of these policies ar...