At BCBSRI, we continue to improve our members’ health and peace of mind by facilitating their access...

As a reminder, any claim denied with a lower case “b” has been denied by Optum. All medical records ...

BCBSRI has been selected for a CMS Risk Adjustment Data Validation (RADV) audit for diagnoses captur...

To offer best-in-class services related to utilization management (UM) functions, we are pleased to ...

BCBSRI has seen an increase in claims processed by out-of-network providers or laboratories which we...

The Centers for Medicare and Medicaid Services (CMS) reminds Medicare Advantage Organizations to con...

As a reminder, Advance Notices of Noncoverage (ANN) are not recognized for Medicare Advantage Plans....

Effective November 1, 2025, all related readmission appeal requests/documentation must be submitted ...

As a reminder, if you are a contracted Urgent Care Center, you must file claims as a group and not a...

BenefitsImprovements: All telemedicine visits will have a $0 cost share. All services rendered as te...

Now that Medicare has stopped allowing telehealth for non-behavioral health services, how will this ...

At BCBSRI, we continue to improve our members’ health and peace of mind by facilitating their access...

BCBSRI has been selected for a CMS Risk Adjustment Data Validation (RADV) audit for diagnoses captur...

To offer best-in-class services related to utilization management (UM) functions, we are pleased to ...

BCBSRI has been selected for a CMS Risk Adjustment Data Validation (RADV) audit for diagnoses captur...

To offer best-in-class services related to utilization management (UM) functions, we are pleased to ...

The Centers for Medicare and Medicaid Services (CMS) reminds Medicare Advantage Organizations to con...

BCBSRI has seen an increase in claims processed by out-of-network providers or laboratories which we...

To offer best-in-class services related to utilization management (UM) functions, we are pleased to ...

Primary care providers (PCPs) accept responsibility for arranging and coordinating the overall healt...

BCBSRI is actively pursuing National Committee for Quality Assurance (NCQA) Health Equity Accreditat...

BCBSRI is not a PPO network sharing plan, so we are not allowed to price based on our participating ...

As a reminder, D-SNP member ID cards do not display copays or coinsurance amounts. D-SNP members hav...

To offer best-in-class services related to utilization management (UM) functions, we are pleased to ...