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
1 dic, 2024
Effective 1 de enero de 2025, BCBSRI will remove the non-skilled benefit for all Medicare Advantage pla...
P F
1 dic, 2024
Effective 1 de enero de 2025, authorization requests for infertility services for our fully insured mem...
P
1 dic, 2024
BCBSRI is committed to supporting primary care providers and is excited to announce additional reimb...
Provider Relations
P
9 dic, 2024
Effective 1 de enero de 2025, State of Rhode Island employees who have a plan with a prefix of ‘R2I’ wi...
P B F
1 dic, 2024
BCBSRI invites providers to join us on martes, diciembre 10, 2024 from 10-11 a.m. for a confere...
P B F
1 dic, 2024
PCP $0 cost sharingAll PCP visits (including sick visits) will now have a $0 copay for dates of serv...
Physician & Provider Call Center
P B F
1 jul, 2023
As a reminder, there is a functionality on the BCBSRI Provider Portal that allows providers to send ...
P B F
1 jun, 2021
Did you know our secured Physician and Provider Portal offers the following: •Check me...
Quality
P
1 nov, 2024
Screenings for members with diabetesBCBSRI’s PQIP program currently includes three diabetes-specific...
P
1 oct, 2024
Preventive care measures in HEDIS are designed to ensure that patients receive essential screenings ...
P
1 sep, 2024
The BCBSRI Quality Team would like to remind all primary care providers participating in the PCP Qua...
Salud conductual
B
1 dic, 2024
Pelago is a virtual substance use management provider that supports teenagers over 15 (16 and above ...
B
1 dic, 2024
As of 1 de enero de 2025, Headway will join BCBSRI’s network as a virtual provider group that delivers ...
B
1 dic, 2024
The BCBSRI Behavioral Health Case Management program is staffed by experienced mental health and sub...
Farmacia
P F
1 dic, 2024
As part of our ongoing efforts to make high-quality and affordable healthcare available to our membe...
P B F
1 dic, 2024
The Medicare Prescription Payment Plan is a new payment option in the prescription drug law that wor...
P F
1 nov, 2024
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, 2024
BCBSRI is not a PPO network sharing plan. We are not allowed to price based on our participating pro...
P B F
1 ene, 2024
BCBSRI claims department has seen an increase in claims rejecting for no eligibility because claims ...
P B F
1 nov, 2023
If you are correcting a claim due to an audit finding, you must submit Medical Records with your cor...
Policies
P F
5 dic, 2024
UPDATE 12/5/2024 *CPT codes 0913T, 0914T, 0915T, 0916T, 0917T, 0918T, 0923T, 0933T will not req...
P F
1 dic, 2024
We have completed our review of the enero de 2025 CPT code changes, including any category II perform...
P F
1 dic, 2024
Arthrotomy for Temporomandibular Joint (TMJ) Evaluation of Hearing Impairment or Loss &nbs...