As a reminder, providers, provider offices and facilities are not allowed to bill member’s upfront for payment if they have a deductible. 

When the provider receives the formal response (remittance advice) from BCBSRI stating the amount applied toward the patient's cost share for the corresponding service, the provider must automatically send any applicable refunds to the patient in a timely manner if the final adjudication indicates the member has overpaid the provider above their contractual cost share. The refund should be sent without requiring any communication from the member requesting such a refund. Additionally, the refund should be made back to the original source of payment.

For more details related to this policy, please click here.