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 Dr. Shafi
P B F
Apr 1, 2024
As many of you know, my medical background is as an OB/GYN, so championing maternal health is someth...
P B F
Mar 1, 2024
Primary care is the backbone of the healthcare system. Primary care providers (PCPs) are usually a p...
P B F
Feb 1, 2024
As you know, February is American Heart Month, an important time to shine a spotlight on heart disea...
BCBSRI Update
P F
Apr 1, 2024
When submitting a request for prior authorization to prevent delays in determinations, please be sur...
P B F
Apr 1, 2024
This year’s topic is “RI’s Youth Behavioral Health Crisis: Paths to Resolution.” Hear from a wide-ra...
P B F
Apr 1, 2024
Please send updated Contact Information for your practice, including email and telephone numbers. Pl...
Provider Relations
P B F
Apr 1, 2024
BCBSRI invites providers to join us on Tuesday, April 9 from 10-11 a.m. for a conference call with t...
P B F
Apr 1, 2024
The Centers for Medicare and Medicaid Services (CMS) reminds Medicare Advantage Organizations to con...
P B F
Mar 1, 2024
We went live in late February for the new claims on line project. Below are dates and times of live ...
Physician & Provider Call Center
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 member benef...
Quality
P
Apr 1, 2024
The first seven to 30 days following hospital discharge can be an overwhelming transition for patien...
P
Mar 1, 2024
As we head into Colorectal Cancer Awareness Month this March, we want to highlight some of the quali...
P
Feb 1, 2024
Each year, BCBSRI is required to participate in nationally recognized quality studies, called the He...
Behavioral Health
P B
Apr 1, 2024
National Alcohol Awareness Month was founded in 1987 by The National Council on Alcoholism and Drug ...
P B
Mar 11, 2024
BCBSRI in partnership with the Substance and Mental Health Leadership Council (SUMHLC), is offering ...
B
Mar 1, 2024
Non-suicidal self-injury (NSSI) is a behavior in which an individual inflicts physical harm on thems...
Pharmacy
P B F
Apr 1, 2024
Large Group and Small Group Markets FormularyThe information below is effective as of April 1, 2024 ...
P F
Mar 1, 2024
Please note Avastin (J9035) does require Prior Authorization to be reviewed by Prime for Medicare me...
P
Feb 15, 2024
If you have a patient with Covid-19 who is in one of our Medicare Advantage plans and you prescribe ...
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 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
Apr 1, 2024
The following new policies were recently created:Axillary Reverse Mapping for the Prevention of Brea...
P F
Apr 1, 2024
The following policies were recently reviewed for annual update. The full texts of these policies ar...
P F
Apr 1, 2024
Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms Effective June 1, 2024, C...