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

A Word from Dr. Shafi

P B F
Jun 1, 2024
In March of this year, we welcomed five more provider locations to our ever-growing network of LGBTQ...
P B F
May 1, 2024
As you know, May is Mental Health Month. It’s a very important time to raise awareness about the pre...
P B F
Apr 1, 2024
As many of you know, my medical background is as an OB/GYN, so championing maternal health is someth...

BCBSRI Update

P B F
Jun 1, 2024
As a reminder, as a participating provider/group, your contract with BCBSRI prohibits charging membe...
P F
Jun 1, 2024
To make the appeals process more efficient, please ensure you provide a valid name and phone number ...
P B
Jun 1, 2024
As a reminder, BCBSRI does not credential groups (outside of ancillary). BCBSRI credentials individu...

Provider Relations

P B F
Jun 1, 2024
BCBSRI is committed to continuously improving its overall payment integrity solutions to prevent ove...
P B F
Jun 1, 2024
BCBSRI invites providers to join us on Tuesday, June 11 from 10-11 a.m. for a conference call with t...
P B F
Jun 1, 2024
BCBSRI is proud to partner with our providers to help care for patients in a culturally and linguist...

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 member benef...

Quality

P
Jun 1, 2024
The BCBSRI Quality Concierge Team is a team of nurses and highly qualified healthcare quality profes...
P
Apr 1, 2024
The first seven to 30 days following hospital discharge can be an overwhelming transition for patien...
P
Mar 1, 2024
As we head into Colorectal Cancer Awareness Month this March, we want to highlight some of the quali...

Behavioral Health

B
Jun 17, 2024
BCBSRI’s Supervisory Protocol has been expanded to include Physician Assistants.  Effective July 1, ...
B
Jun 1, 2024
BCBSRI, in partnership with Aware Recovery, is offering our in-network providers a free Continuing E...
B
Jun 1, 2024
Sources: psychologytoday.com; verywellmind.com; mayoclinic.org; apa.org; samhsa.gov; bcbsri.comBehav...

Pharmacy

P
Jun 1, 2024
Fluticasone HFA has been added to all BCBSRI commercial formularies as a preferred tier medication. ...
P F
May 1, 2024
Fluticasone HFA has been added to all BCBSRI commercial formularies as a preferred tier medication. ...
P F
Apr 18, 2024
Fluticasone HFA has been added to all BCBSRI commercial formularies as a preferred tier medication. ...

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
Jun 1, 2024
G2211 will be considered NSR effective July 1, 2024Effective July 1, 2024, CPT G2211 code will be NS...
P F
Jun 1, 2024
Minimal Residual Disease Testing for CancerEffective August 1, 2024, the medical criteria used to de...
P F
Jun 1, 2024
The following policies were recently reviewed for annual update. The full texts of these policies ar...