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
Oct 1, 2026
Starting October 1, 2026, offices experiencing a HealthTrio password issue, including password reset...
P B F
Oct 1, 2026
In November, Rhode Island will join communities far and wide in recognizing World Diabetes Day and N...
P F
Oct 1, 2026
Effective October 1, 2026, BCBSRI will implement a correct coding edit within our claims processing ...
Provider Relations
P B F
Oct 1, 2026
BCBSRI invites providers to join us on Tuesday, October 13, from 10-11 a.m. for a conference call wi...
P B
Sep 1, 2026
We have identified claims being submitted with in-office place of service codes combined with teleme...
P B F
Sep 1, 2026
BCBSRI invites providers to join us on Tuesday, September 8, from 10-11 a.m. for a conference call w...
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
Oct 1, 2026
The Health Outcomes Survey (HOS) is an important Medicare survey that helps capture members’’ experi...
P
Sep 1, 2026
Osteoporosis Management in Women (OMW) is a Medicare Advantage HEDIS measure focused on women a...
P
Aug 1, 2026
Understanding diabetic measuresKidney Health Evaluation for Patients with Diabetes (KED), Glycemic S...
Behavioral Health
B
Oct 1, 2026
Major depression is one of the most common mental health disorders in the United States, affecting m...
B
Oct 1, 2026
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by pe...
P B
Oct 1, 2026
The BCBSRI Behavioral Health Case Management program is staffed by experienced mental health and sub...
Pharmacy
P B F
Oct 1, 2026
BCBSRI and Prime Therapeutics will transition from SimplicityRx to JudiRx to administer the Medicare...
P B F
Oct 1, 2026
Large Group and Small Group Markets Formulary The information at the link above is effective as...
P B F
Oct 1, 2026
BCBSRI would like to inform providers of an upcoming change in coverage for the medications listed b...
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
Oct 1, 2026
Non-Reimbursable Health Service Codes PolicyEffective October 1, 2026, the following codes have been...
P F
Oct 1, 2026
2026 Home Health Care Services - Skilled Services This policy was updated to reflect that servi...
P F
Oct 1, 2026
Laboratory Testing Investigational ServicesEffective December 1, 2026, CPT codes 0355U, 0362U, 0365U...