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1 ene, 2024

Applying member’s correct name on claims

BCBSRI claims department has seen an increase in claims rejecting for no eligibility because claims are being completed incorrectly by the providers/groups. It is important to complete the claim form correctly according to what is on the member’s card or found on bcbcsri.com. 

Scenarios of what has been found: 

  • Member has a double last name.
  • Member’s first or last name is spelled incorrectly.
  • Member’s middle name is put with their last name.
  • Member has a double last name but it was not completed on the claim form. 
  • Member’s prior last name has not been changed with BCBSRI, but member has changed it on your end.

If you have any questions regarding how a member is set up in our system, please review the members eligibility on our provider portal on bcbsri.com. If you have any additional questions after reviewing the information, please contact our Provider & Physician Call Center at (401) 274-4848.