Jan 3, 2023

BCBSRI suspending prior authorizations for Skilled Nursing admission ONLY effective 1/6/23-3/31/23

Effective January 6, 2023 through March 31, 2023 Blue Cross & Blue Shield of Rhode Island (BCBSRI) will suspend prior authorization requirements for Skilled Nursing admissions for Medicare Advantage and all other products including (New England Health Plan members with a RI PCP) with the exception of Federal Employee Program (FEP).

Skilled Nursing Facility:

You will be responsible to notify the Utilization Management team of an admission prior to day three of admission. Please fax notification of admission and supporting clinical information to (401) 459-1623 at that time. BCBSRI will continue to require concurrent stay reviews on all members. You may contact the SNF Utilization Management team at (401) 459-1000 ext. 3364 for any questions.

Prospect members please fax to (401) 429-6377.