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
Mar 1, 2026
To offer best-in-class services related to utilization management (UM) functions, we are pleased to ...
P B F
Mar 1, 2026
As we approach the annual Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) ...
P B F
Mar 1, 2026
BCBSRI is committed to providing our members with access to high-quality health care that is consist...
Provider Relations
P B F
Mar 1, 2026
BCBSRI invites providers to join us on Tuesday, March 10, from 10-11 a.m. for a conference call with...
P B F
Mar 1, 2026
network are required to complete the annual D-SNP training by March 31, 2026. To help providers comp...
P B F
Mar 1, 2026
When looking on the Provider Portal, you will see a new section under Provider Update called “Member...
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
Feb 1, 2026
The Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey season begins in March, a...
P
Jan 1, 2026
Improving post-fracture care for at-risk patientsAs a healthcare provider, actively addressing osteo...
P
Dec 1, 2025
The Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey is an annual, s...
Behavioral Health
B
Mar 1, 2026
Self-harm and self-injury refer to behaviors in which an individual intentionally inflicts harm on t...
P B
Mar 1, 2026
The BCBSRI Behavioral Health Case Management program is staffed by experienced mental health and sub...
P B
Mar 1, 2026
BCBSRI has collaborated with providers throughout Rhode Island to ensure that our members have acces...
Pharmacy
P F
Mar 1, 2026
Effective February 26, 2026 Apretude® will transition from the medical benefit to the pharmacy (Rx) ...
P B F
Mar 1, 2026
Large Group and Small Group Markets FormularyThe information in the link above is effective as of Ap...
P F
Mar 1, 2026
The following brand name and generic drugs with preferred alternatives be excluded from coverag...
Products & Benefits
P
Nov 1, 2025
Under the Patient Protection and Affordable Care Act (PPACA), coverage is provided for many pre...
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...
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
Mar 1, 2026
Preventive Services for Medicare Advantage Plans Annual Well Visits are now allowed up t...
P B F
Mar 1, 2026
Acute Hepatitis Panel Effective May 1, 2026, for CPT code 80074, the covered diagnosis list wil...
P F
Mar 1, 2026
The following policies were recently reviewed for annual update. The full texts of these policies ar...