• P = Professional
  • B = Behavioral health
  • F = Facilities

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 ...
P
Mar 1, 2020
Please remember to include the NPI of the servicing facility on your CMS-1500 form Box 32A. This wil...
P
Mar 1, 2020
If you have a BCBSRI member with an NEHP or State of Rhode Island anchor plan, a cross-border notifi...
P F
Mar 1, 2020
If a member receives the same radiology procedure multiple times on the same day from different prov...
P B F
Feb 1, 2020
If… With a…. Going to see a…. Then…. Member has a RI NEHP plan RI PCP a RI specialist Obt...
P F
Feb 1, 2020
BCBSRI follows the Medicare National Correct Coding Initiative (NCCI) edits to ensure that all claim...
P B F
Jan 1, 2020
BCBSRI requires that all services rendered by the same provider on the same date of service to be fi...
P
Dec 1, 2019
As a reminder, ancillary claims are filed with the local plan as follows: Lab provider: The locatio...
P B F
Dec 1, 2019
Our Grievance and Appeals Unit (GAU) has updated the appeals request form and the claims adjustment ...
P B F
Nov 1, 2019
Our Grievance and Appeals Unit (GAU) has been working hard to update the appeals request form and th...
P F
Sep 1, 2019
As you know, CMS requires completion of a 2728 form for all newly diagnosed ESRD patients. The form ...
P F
Sep 1, 2019
Please remember to include the NPI of the servicing facility on your CMS-1500 form Box 32A. This wil...
P
Sep 1, 2019
As a reminder, in November 2018, our system was updated to allow claims to pull a referral by the pr...
P B
Jun 1, 2019
BCBSRI follows the Medicare National Correct Coding Initiative (NCCI) edits to ensure that all claim...
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...
P B F
Mar 1, 2019
BCBSRI requires providers to report the name and the Type 1 National Provider Identifier (NPI) of th...
P
Mar 1, 2019
Effective immediately, please indicate your referral number from Health Trio on your CMS-1500 form i...
P B F
Feb 1, 2019
Some providers expect to be reimbursed at the locally negotiated Blue rate or Medicaid rate they are...
P B F
Feb 1, 2019
BCBSRI is not a PPO network sharing plan. We are not allowed to price based on our participating pro...
P
Feb 1, 2019
Effective immediately, please indicate your referral number from Health Trio on your CMS-1500 form i...
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