Longer wait times
At this time, you may experience longer wait times than usual when calling BCBSRI or using secure messaging. We are working to increase the capacity of our Provider Service Center during this global COVID-19 pandemic and are answering secure messages in the order in which they are received. Please note that updating an existing secure message may result in delays to responding to your inquiry. We apologize for any delays and thank you for your patience.

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. Collins

P B F
Mar 1, 2020
Last month, my column focused on the attributes of high-value primary care, its importance, and its ...
P B F
Feb 1, 2020
For many years, the health system in the U.S. has been criticized for rewarding volume of services r...
P
Jan 1, 2020
Blue Cross & Blue Shield of Rhode Island (BCBSRI) is committed to improving our members’ health ...

BCBSRI Update

P B F
Apr 1, 2020
BCBSRI is in contact with government officials so we can share up-to-date information regarding the ...
F
Apr 1, 2020
Effective March 1, 2020, notification is no longer required for maternity admissions for five days o...
P
Apr 1, 2020
In spring 2019, BCBSRI launched the PCP performance ratings program to highlight strong performing p...

Provider Relations

P F
Apr 1, 2020
Effective March 18, 2020, all cost share will be waived for BCBSRI members for any telehealth/teleme...
P F
Apr 1, 2020
BCBSRI is in contact with government officials so we can share up-to-date information regarding coro...
P
Apr 1, 2020
BCBSRI is in contact with government officials so we can share up-to-date information regarding the ...

Quality

P
Jan 1, 2020
The following CPT Category II Codes have been updated by the American Medical Association (AMA). Ple...
P
Dec 1, 2019
As the year comes to a close, it’s time to plan for 2020. The case has been made for taking a year-r...
P
Nov 1, 2019
Prenatal and postpartum care (PPC) We are committed to working with you to improve the quality of c...

Behavioral Health

B
Mar 1, 2020
The HEDIS measure Follow-Up Care for Children Prescribed ADHD Medication (ADD) is the percentage of ...
B
Mar 1, 2020
The HEDIS measure Follow-Up After Hospitalization for Mental Illness (FUH) is the percentage of disc...
B
Mar 1, 2020
The HEDIS measure Antidepressant Medication Management shows the percentage of members 18 years of a...

Pharmacy

P F
Dec 1, 2019
As part of the annual formulary development and management process, the next scheduled update of the...
P B F
Oct 1, 2019
As part of our standard formulary management process of implementing formulary updates twice per yea...
P F
Oct 1, 2019
Effective December 1, 2019, BCBSRI will begin requiring prior authorization for an expanded list of ...

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 F
Apr 1, 2020
If a member receives the same radiology procedure multiple times on the same day from different prov...
P F
Apr 1, 2020
During the COVID-19 pandemic, eviCore has increased their authorization span from 90 to 180 days. An...
P F
Mar 1, 2020
ICD-10-CM provides significant improvements through greater diagnosis coding detail and the ability ...

Policies

P F
Apr 1, 2020
We have completed our review of the additional CPT and HCPCS code changes effective April 1, 2020, a...
P F
Apr 1, 2020
Effective June 1, 2020, prior authorization will be required for BlueCHiP for Medicare and recommend...
P F
Apr 1, 2020
Effective April 1, 2020, the Transcatheter Mitral Valve Repair medical policy has been updated to in...
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