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 our Medical Directors
P B F
May 1, 2023
LouAnne Giangreco, M.D. is BCBSRI’s senior medical director, medical affairs. Dr. Giangreco joined u...
P B F
Apr 1, 2023
Gonzalo Paz-Soldán, M.D., CPE is BCBSRIs senior medical director for clinical transformation. Dr. Pa...
P B F
Mar 1, 2023
Gonzalo Paz-Soldán, M.D., CPE is BCBSRI’s senior medical director for clinical transformation. Dr. P...
BCBSRI Update
P B F
May 1, 2023
BCBSRI encourages its participating providers to collaborate with us in supporting LGBTQ communities...
P F
Apr 1, 2023
Effective June 1, 2023 updates will be made in MHK for the follow subsets:
- CP Procedures: Decomp...
P B F
Apr 1, 2023
At BCBSRI, we believe that high-quality care is equitable care, and we are committed to providing th...
Provider Relations
P B F
May 1, 2023
BCBSRI invites providers to join us on Tuesday, May 9, 2023 from 10:00am-11:00am for a conference ca...
P B F
May 1, 2023
**Bold items updated on 5/10**
As you are likely aware, the Federal Public Health Emergency (PHE...
P B F
Apr 1, 2023
The Centers for Medicare & Medicaid Services (CMS) reminds Medicare Advantage Organizations to c...
Physician & Provider Call Center
P B F
Jun 1, 2021
Did you know our secured Physician and Provider Portal offers the following:
•Check member benef...
Quality
P
May 1, 2023
BCBSRI sends Gaps in Care Reports monthly to practices across our network. These reports provide val...
P
Apr 1, 2023
Measure focus: Eye exam for patients with diabetes
The percentage of members ages 18-75 with diabet...
P
Mar 1, 2023
Measure description: The percentage of women 16-24 years of age who were identified as sexually acti...
Behavioral Health
B
May 1, 2023
In partnership with the Substance Use & Mental Health Leadership Council of Rhode Island (SUMHLC...
B
May 1, 2023
The BCBSRI Behavioral Health Case Management program is staffed by experienced mental health and sub...
B
May 1, 2023
Mental Health America (MHA) is the nation’s leading community-based nonprofit dedicated to addressin...
Pharmacy
P F
Mar 1, 2023
For NEHP members with a RI PCP, inquiries regarding medical drugs should be directed to the member’s...
P F
Feb 6, 2023
For NEHP members with a RI PCP, inquiries regarding medical drugs should be directed to the member’s...
P B F
Jan 1, 2023
The Inflation Reduction Act (IRA) will take effect on January 1, 2023.The Act includes the following...
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
Apr 1, 2023
As a reminder, when filling out a CMS-1500 form and submitting it to BCBSRI for claims processing, i...
P B F
Jan 1, 2023
As a reminder when sending medical records to BCBSRI, a valid coversheet should be placed on top of ...
P B F
Mar 16, 2022
**This update will not take place this weekend and it will be rescheduled to a future date. **
B...
Policies
P F
May 1, 2023
Phototherapy for the Treatment of Seasonal Affective Disorder
Effective July 1, 2023, HCPCS code...
P F
May 1, 2023
The following policies were recently reviewed for annual update. The full texts of these policies ar...
P F
May 1, 2023
The following new policies were recently created and will be effective July 1, 2023:
Handheld Radio...