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
Dec 1, 2025
To offer best-in-class services related to utilization management (UM) functions, we are pleased to ...
P B F
Dec 1, 2025
Upcoming portfolio updates for January 2026 in the individual marketEffective January 1, 2026, we ar...
P B F
Dec 1, 2025
BenefitsImprovements:All telemedicine visits will have a $0 cost share. All services rendered as tel...
Provider Relations
P B F
Dec 1, 2025
As a reminder, all BCBSRI participating providers, groups and in the D-SNP network are required to c...
P B F
Dec 1, 2025
BCBSRI invites providers to join us on Tuesday, December 9, from 10-11 a.m. for a conference call wi...
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...
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
Dec 1, 2025
The Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey is an annual, s...
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...
Behavioral Health
P B
Dec 1, 2025
BCBSRI has collaborated with providers throughout Rhode Island to ensure that our members have acces...
P B
Dec 1, 2025
The BCBSRI Behavioral Health Case Management program is staffed by experienced mental health and sub...
B
Nov 1, 2025
Major depression is one of the most common mental health disorders, affecting more than 21 million A...
Pharmacy
P F
Dec 1, 2025
The following drugs are new to the market effective December 1, 2025 and all require prior authoriza...
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...
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
Dec 1, 2025
Timely Filing This policy was updated to reflect a few changes:A reminder to providers about co...
P F
Dec 1, 2025
Biomarker Testing in Risk Assessment and Management of Cardiovascular Disease  ...
P F
Dec 1, 2025
The following policies were recently reviewed for annual update. The full texts of these policies ar...