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
1 mar, 2023
Gonzalo Paz-Soldán, M.D., CPE is BCBSRI’s senior medical director for clinical transformation. Dr. P...
P B F
1 feb, 2023
  Matthew Collins, M.D., M.B.A. is BCBSRI’s executive vice president and chief medical officer, with...
P B F
1 ene, 2023
Matthew Collins, M.D., M.B.A. is BCBSRI’s executive vice president and chief medical officer, with c...

BCBSRI Update

F
14 mar, 2023
Effective 1 de abril de 2023 BCBSRI will resume prior authorization requirements for Skilled Nursing admi...
P B F
1 mar, 2023
Healthcare should work for all of us. At BCBSRI, we believe that getting to know our members better—...
P B F
1 mar, 2023
The United States Department of Health and Human Services (HHS) declared a public health emergency (...

Provider Relations

P B F
1 mar, 2023
Effective 1 de enero de 2023, all existing and new BlueRI for Duals (D-SNP) members received new ID car...
P B F
1 feb, 2023
BCBSRI encourages its participating providers to collaborate with us in supporting the LGBTQ communi...
P B F
1 ene, 2023
As a reminder, the prefix for State of Rhode Island employees is R2I (R 2 and the letter “I"). We ha...

Physician & Provider Call Center

P B F
1 jun, 2021
  Did you know our secured Physician and Provider Portal offers the following: •Check member benef...

Quality

P
1 mar, 2023
Measure description: The percentage of women 16-24 years of age who were identified as sexually acti...
P
1 feb, 2023
Key measure updates: Colorectal cancer screening will widen its age range to 45-75 years of age to ...
P
1 dic, 2022
This year, the CDC is observing National Influenza Vaccination Week from 5 de diciembre-9. This month’s ...

Salud conductual

B
1 mar, 2023
What is NSSI? Non-suicidal self-injury (NSSI) is a behavior in which an individual inflicts physic...
B
1 mar, 2023
BCBSRI’s Supervisory Protocol has been expanded to include Mental Health Counselor Associates and Ma...
B
9 feb, 2023
BCBSRI’s Supervisory Protocol has been expanded to include Mental Health Counselor Associates and Ma...

Farmacia

P F
1 mar, 2023
For NEHP members with a RI PCP, inquiries regarding medical drugs should be directed to the member’s...
P F
6 feb, 2023
For NEHP members with a RI PCP, inquiries regarding medical drugs should be directed to the member’s...
P B F
1 ene, 2023
The Inflation Reduction Act (IRA) will take effect on 1 de enero de 2023.The Act includes the following...

Products & Benefits

P B F
1 dic, 2019
In the large group portfolio, we will also be adding eight Network Blue New England Options plans, a...
P B F
1 dic, 2019
Our regional BlueCHiP family is expanding in the small group market with Effective 1 de enero de 2020, ...
P B F
1 dic, 2019
Effective 1 de enero de 2020, BCBSRI will become the insurer for all Lifespan employees. Below is a qui...

Reclamos

P B F
1 ene, 2023
As a reminder when sending medical records to BCBSRI, a valid coversheet should be placed on top of ...
P B F
16 mar, 2022
**This update will not take place this weekend and it will be rescheduled to a future date. **   B...
P B F
7 ene, 2022
BCBSRI will be implementing changes to bluegateway.bcbsri.com and the system was supposed to be unav...

Policies

P F
1 mar, 2023
We have completed our review of the 20 de abril23 CPT code changes, including any category II performan...
P F
1 mar, 2023
Orthognathic Surgery          Effective 1 de mayo de 2023, these services will now be medically necessar...
P B F
1 mar, 2023
The following policies were recently reviewed for annual update. The full texts of these policies ar...
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