Apr 1, 2021

Medical Records Cover Sheet Reminder

As a reminder when sending in Medical Records to BCBSRI, a valid coversheet should be placed on top of the Medical Records and all necessary information should be filled out.

The following forms are considered a cover sheet:

Claim Adjustment form

Appeal form

Medical Records form

DME Unlisted Code form

Unlisted Procedure Claim form Professional

Unlisted Procedure Claim form Facility

Response letter to request for Medical Record

Effective 05/01/2021 the Medical Records team will be returning any Medical Records received without any of the above referenced forms as a cover sheet.

All of these cover sheets can be found on bcbsri.com > Providers > Forms