Read Provider Update
This monthly newsletter delivers updates on policies, changes to benefits, and other news you need to know.
- P = Professional
- B = Behavioral health
- F = Facilities
BCBSRI Update
P B F
Nov 1, 2025
As a reminder, when filing with Medicare first when a member has Coordination of Benefits, please en...
P B F
Nov 1, 2025
Arkansas Blue will begin using Skai Blue for national account members starting in 2025, which means ...
P B F
Nov 1, 2025
As a reminder, please ensure you are reviewing the 2026 benefit booklets once they are available&nbs...
Provider Relations
P B F
Nov 1, 2025
BCBSRI invites providers to join us on Wednesday, November 12, from 10-11 a.m. for a conference call...
P
Nov 1, 2025
BCBSRI specialists and Provider Relations are seeing an increase in PCP referrals being entered into...
P B F
Oct 1, 2025
BCBSRI invites providers to join us on Wednesday, October 15, from 10-11 a.m. for a conference call ...
Physician & Provider Call Center
P B F
May 1, 2025
Beginning June 1, 2025, our Provider Call Center will implement a transaction limit of five cl...
P B F
Jul 1, 2023
As a reminder, there is a functionality on the BCBSRI Provider Portal that allows providers to send ...
P B F
Jun 1, 2021
Did you know our secured Physician and Provider Portal offers the following:
•Check me...
Quality
P
Nov 1, 2025
Hemoglobin A1c (HbA1c) testing and controlHbA1c is a blood test that reflects a patient’s average bl...
P
Sep 1, 2025
As the year winds down and stress ramps up, it’s more important than ever to ensure accurate blood p...
P
Sep 1, 2025
Fall Prevention and the Health Outcomes Survey (HOS)Why it mattersThe Health Outcomes Survey (HOS) e...
Behavioral Health
B
Nov 1, 2025
Major depression is one of the most common mental health disorders, affecting more than 21 million A...
B
Nov 1, 2025
BCBSRI has collaborated with providers throughout Rhode Island to ensure that our members have acces...
P B
Nov 1, 2025
The BCBSRI Behavioral Health Case Management program is staffed by experienced mental health and sub...
Pharmacy
P B F
Nov 1, 2025
The following drugs will require Prior Authorization beginning on October 1, 2025 for Commercial and...
P B F
Oct 1, 2025
The following drugs will require Prior Authorization beginning on October 1, 2025 for Commercial and...
P B F
Oct 1, 2025
Large Group and Small Group Markets Formulary This information is effective as of October 1, 20...
Products & Benefits
P F
Aug 1, 2025
Under the Patient Protection and Affordable Care Act (PPACA), coverage is provided for many pre...
P B F
Dec 1, 2019
In the large group portfolio, we will also be adding eight Network Blue New England Options plans, a...
P B F
Dec 1, 2019
Our regional BlueCHiP family is expanding in the small group market with Effective January 1, 2020, ...
Claims
P B F
Apr 1, 2024
BCBSRI is not a PPO network sharing plan. We are not allowed to price based on our participating pro...
P B F
Jan 1, 2024
BCBSRI claims department has seen an increase in claims rejecting for no eligibility because claims ...
P B F
Nov 1, 2023
If you are correcting a claim due to an audit finding, you must submit Medical Records with your cor...
Policies
P F
Nov 1, 2025
COVID-19 Monoclonal Antibody Treatment and Antiviral IV MedicationsThis policy was updated to correc...
P F
Nov 1, 2025
*NEW POLICY* Prior Authorization of Physical and Occupation Therapy ServicesEffective January 1, 202...
P F
Nov 1, 2025
The following policies were recently reviewed for annual update. The full texts of these policies ar...