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 F
Sep 1, 2026
Effective October 1, 2026, BCBSRI will implement a correct coding edit within our claims processing ...
P F
Sep 1, 2026
Effective July 13, eviCore no longer allows authorizations to be entered into their authorization po...
P B F
Sep 1, 2026
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To offer best-in-class services related to utilization management (UM) functions, we are ...
Provider Relations
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...
P B F
Sep 1, 2026
At BCBSRI protecting provider and member information remains a top priority. As part of our ongoing ...
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
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...
P
Jul 1, 2026
Understanding the CAHPS SurveyThe Consumer Assessment of Healthcare Providers and Systems (CAHPS) is...
Behavioral Health
P B
Sep 1, 2026
TalkSpace is a virtual behavioral health provider group that connects members with licensed clinicia...
B
Sep 1, 2026
The most recent studies published by the CDC reveal that in 2024 over 48,000 Americans died by suici...
B
Sep 1, 2026
The lives of millions of Americans who struggle with mental illness and substance use disorders have...
Pharmacy
P B F
Sep 1, 2026
Large Group and Small Group Markets Formulary This information is effective as of October 1, 20...
P F
Sep 1, 2026
BCBSRI would like to inform providers of an upcoming change in coverage for the medications listed b...
P F
Sep 1, 2026
Effective September 1, 2026, iDose TR (J7355) and Durysta (J7351) will require prior authorization u...
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 B F
Sep 1, 2026
2026 Home Health Care Services - Skilled Services This policy was updated to reflect that servi...
P F
Sep 1, 2026
Molecular Testing in the Management of Pulmonary NodulesEffective November 1, 2026 all CPT codes in ...
P F
Sep 1, 2026
The following policies were recently reviewed for annual update. The full texts of these policies ar...