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. Collins

P B F
1 abr, 2021
Earlier this year, Blue Cross & Blue Shield of Rhode Island (BCBSRI) launched a new virtual care...
P B F
1 mar, 2021
Of course, the COVID-19 vaccine is THE topic of the moment. And as the state’s largest health insure...
P B F
1 feb, 2021
Blue Cross & Blue Shield of Rhode Island (BCBSRI), in partnership with Eliza Corporation (Eliza)...

BCBSRI Update

P F
1 abr, 2021
Beginning on 2 de abril de 2021, you may notice a change to some of the InterQual content used during the...
P F
1 abr, 2021
The Temporary Cost Share Waiver for Treatment of Confirmed Cases of COVID-19 policy has been extende...
P F
1 abr, 2021
Some fields in MHK will be moved effective 3 de mayo de 2021: The “Contact Name" field will be moved to a...

Provider Relations

P B F
1 abr, 2021
As a BCBSRI-contracted provider, it is your obligation to coordinate member care with contracted, in...
P B F
1 oct, 2020
We have updated the credentialing form for new providers looking to become participating BCBSRI prov...
P B F
1 sep, 2020
During the COVID-19 pandemic, we’ve had to rethink our in-person fall seminars and have opted to con...

Quality

P
1 abr, 2021
As a reminder, the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey was sent t...
P
1 abr, 2021
BCBSRI is committed to making it easier for your practice to be successful in all areas of quality i...
P
1 mar, 2021
BCBSRI is committed to making it easier for your practice to be successful in all areas of quality i...

Salud conductual

P B F
1 abr, 2021
April is National Alcohol Awareness Month. Founded and sponsored by the National Council on Alcohol ...
P B
12 nov, 2020
Program overview: The Dementia Care Coordination Program is an evidence-informed intervention based ...
B
1 sep, 2020
Every September, the Substance Abuse and Mental Health Services Administration (SAMHSA) sponsors Nat...

Farmacia

P B F
1 abr, 2021
The information below is effective as of 1 de abril de 2021 and applies to all commercial BCBSRI products...
P F
1 abr, 2021
The following Commercial MDR drugs will require step therapy through a biosimilar effective 4/1/21: ...
P
1 mar, 2021
As part of our ongoing efforts to make high-quality and affordable healthcare available to our membe...

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 abr, 2021
As a reminder when sending in Medical Records to BCBSRI, a valid coversheet should be placed on top ...
P B F
1 mar, 2021
As a reminder when sending in Medical Records to BCBSRI, a valid coversheet should be placed on top ...
P B F
1 ene, 2021
These enhancements include auto-approvals as well as a single location to submit both acute inpatien...

Policies

P F
1 abr, 2021
We have completed our review of the 20 de abril21 CPT code changes, including any Category II performan...
P F
1 abr, 2021
Effective 1 de junio de 2021, the allowable code list will be updated within this payment policy for hospi...
P F
1 abr, 2021
Effective 1 de junio de 2021, medical necessity criteria will be added for the AlloSure Heart and AlloSure...
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