Jun 1, 2024

Reminder: Medical necessity appeals (including level of care appeals) – contact information needed

To make the appeals process more efficient, please ensure you provide a valid name and phone number on your appeal requests for the person who will schedule peer-to-peer discussions. According to State of RI regulations, BCBSRI will make two attempts to schedule a peer-to-peer discussion for appeals denied for medical necessity. If our Grievances and Appeals Unit is unable to schedule the peer-to-peer, the appeal will be reviewed based on the clinical information available.

We ask that you include the full name and a valid phone number of the person responsible for scheduling the peer-to-peer discussion in your appeal request to ensure BCBSRI will be able to schedule it with a Medical Director.