As part of Blue Cross & Blue Shield of Rhode Island’s (BCBSRI) implementation of the CMS-0057 Interoperability and Prior Authorization Final Rule, BCBSRI is preparing to support new electronic prior authorization and provider Access capabilities beginning January 1, 2027.

Electronic Prior Authorization (ePA) is offered as an additional channel and does not replace existing prior authorization submission methods, such as fax, payer portals, or other established channels

These capabilities are intended to make prior authorization more efficient by improving electronic information exchange between providers, EHR systems, and BCBSRI.

 At this stage, we are beginning outreach to provider organizations to understand current readiness and identify the appropriate contacts for future onboarding.

Our goal is to begin the conversation, understand your current EHR environment, and determine what level of support or coordination may be needed.

As a first step, we would like to:

• Identify the appropriate EHR, IT, operational, or clinical contact for your organization
• Understand whether your EHR currently supports electronic prior authorization capabilities
• Share BCBSRI’s planned approach and expected onboarding timeline
• Discuss any questions or support your organization may need

 BCBSRI will work with provider organizations and EHR partners throughout the onboarding process and will provide additional technical guidance, testing information, and implementation details as needed.

For additional background on CMS-0057, please review the BCBSRI Provider Education Material. 

 Next Step: Identify the appropriate EHR, IT, and operational contacts within your organization and work with them to review the BCBSRI Provider Onboarding Guide

For questions or to initiate onboarding activities, contact interops-onboarding@bcbsri.org. The BCBSRI onboarding team will coordinate the next steps and schedule an introductory onboarding session.