Mar 1, 2024

Requirement to refer members to in-network providers

BCBSRI has recently seen an increase in claims processed by out-of-network providers or laboratories which were referred by a participating BCBSRI provider. As a BCBSRI-contracted provider, it is your obligation to coordinate member care with contracted, in-network providers, for all BCBSRI plans and products. This includes services such as durable medical equipment, radiology, behavioral health providers, and clinical laboratory and pathology services.

To keep you up to date on all BCBSRI network developments, the following laboratories do not participate in BCBSRI’s network:

  • Accu Reference Lab
  • Quest Diagnostics
  • Total Toxicology
  • U.S. Lab & Radiology, Inc.

The following DME supplier does not participate in BCBSRI’s network:

  • Zynex Medical

Before establishing a referral relationship, please confirm that the provider/group you will be referring members to is contracted within BCBSRI’s network. You can confirm participation by checking provider status using our Find a Doctor tool.