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
Oct 1, 2024
The Centers for Medicare and Medicaid Services (CMS) reminds Medicare Advantage Organizations to con...
P B F
Oct 1, 2024
BCBSRI has seen an increase in claims processed by out-of-network providers or laboratories which we...
P
Oct 1, 2024
As our Medicare Advantage members continue to take advantage of the 2024 supplemental vision hardwar...

Provider Relations

P B F
Oct 1, 2024
PCP $0 Cost SharingAll PCP visits (including sick visits) will now have a $0 copay for dates of serv...
P B F
Oct 1, 2024
BCBSRI invites our participating providers to join us on Tuesday, October 1 from 10-11 a.m...
P F
Oct 1, 2024
BCBSRI remains committed to improving the health of our members by providing access to high quality,...

Physician & Provider Call Center

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
Oct 1, 2024
Preventive care measures in HEDIS are designed to ensure that patients receive essential screenings ...
P
Sep 1, 2024
The BCBSRI Quality Team would like to remind all primary care providers participating in the PCP Qua...
P
Aug 1, 2024
What are Gap in Care (GIC) reports?Each month, BCBSRI shares important quality care gap information ...

Behavioral Health

B
Oct 1, 2024
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by de...
B
Oct 1, 2024
Major depression is one of the most common mental health disorders, affecting more than 16 million A...
B
Oct 1, 2024
The Mi Gente Program, sponsored by Lifespan, utilizes a new clinical model to engage Latinx youth an...

Pharmacy

P B F
Oct 1, 2024
Large Group and Small Group Markets FormularyThe information below is effective as of October 1, 202...
P F
Oct 1, 2024
As part of our ongoing efforts to make high-quality and affordable healthcare available to our membe...
P F
Sep 1, 2024
As part of our ongoing efforts to make high-quality and affordable healthcare available to our membe...

Products & Benefits

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, ...
P B F
Dec 1, 2019
Effective January 1, 2020, BCBSRI will become the insurer for all Lifespan employees. Below is a qui...

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
Oct 1, 2024
We have completed our review of the October 2024 Healthcare Common Procedure Coding System (HCPCS) c...
P F
Oct 1, 2024
Telemedicine Telephone Services for Commercial Products & Medicare Advantage PlansEffective Janu...
P F
Oct 1, 2024
Biomarker Testing in Risk Assessment and Management of Cardiovascular DiseaseEffective December 1, 2...