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May 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 the provider portal under forms.