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Jan 1, 2022

BlueRI for Duals (HMO-DSNP): Our new Medicare Advantage product effective January 1, 2022

Effective January 1, 2022, BCBSRI will began offering a new Medicare Advantage non-referral-based product for the Medicare market. BlueRI for Duals (HMO-DSNP) supports our commitment and our efforts to make healthcare simpler for our members and your patients. This plan will provide health benefits for people who are “dual-eligible,” meaning they qualify for both Medicare and Medicaid.

This plan’s provider network includes all facilities, specialists, systems of care, and primary care providers (PCPs) associated with accountable care organizations (ACOs). Any PCP that is not associated with an ACO will not participate with this product. Letters were sent to providers in mid-October 2021 advising if they were part of the network or not.

Any in-network D-SNP provider will be required to take an initial training that is due by March 30, 2022, as well as annual refresher training. The training documents can be found at bcbsri.com/provider. After completing the training, providers are asked to fill out the D-SNP Provider Attestation Form to ensure their training is accounted for.

We will individually follow-up with providers who fail to take the initial and annual trainings to inform them and offer assistance. Providers will be advised that the training must be completed within 10 days of that notification. If the training is still outstanding after the 10-day period, it will be referred to the BCBSRI medical director for additional follow-up and assistance.

As always, we ask that you verify BCBSRI member benefits and eligibility by logging on to the secure provider portal of bcbsri.com to confirm member coverage prior to rendering services. PCPs who have any questions regarding this product can contact pcprequests@bcbsri.org; all other providers should contact Provider Relations at 1-844-707-5627.