We’ve learned about issues from some of our members regarding health reimbursement accounts (HRAs) and health savings accounts (HSAs). Per our 2019 Provider Manual, for consumer-driven health (CDH) plans including HSAs, HRAs, and flexible spending accounts (FSAs), BCBSRI does not allow in-network participating providers to require payment for services that are applied toward the patient's health plan deductible or coinsurance benefit, at the point of service and before the claim is submitted to BCBSRI. Additional information regarding this policy can be found in our Payment Policy titled Provider Guidelines for Requesting Point of Service Payment and Maintaining Patient Credit Card Information.

What is an HRA?

An HRA is an employer-funded account that combines with your major medical plan. The employer uses the HRA to pay for portions of the member’s qualified deductible and coinsurance expenses. The main purpose of an HRA is to help control healthcare costs while maintaining high-quality coverage.

How can I tell if a member has an HRA account?

An HRA symbol is found at the bottom right hand corner of the member’s card. Below is a sample of an insurance card with the HRA symbol.

When can I bill the member?

The member should not be billed until the claim is adjudicated and processed to your remittance advice. The remittance advice will then show if there is any member liability for billing purposes.

BCBSRI automatically sends the claim to London Health within three days. If a member has an HRA, you should not be billing the member prior to London Health’s claim being adjudicated. London Health typically processes your claim for the in network deductible amount within a week to 10 days of you receiving your BCBSRI remittance advice. For more information on the HRA payment process, visit our “Alerts and Updates" section on the Provider portal.

Effective 1 de julio de 2019, the City of Providence adopted a custom HRA plan for some of their membership. Please note the HRA identifier on the BCBSRI ID card. In addition, a custom HRA ID card has been issued for these members via London Health Administrators that can be presented at the time of service. You can find a copy of their HRA card in the “Alerts and Updates" section on the Provider portal.

If you have any questions on how to identify a member with an HRA plan or questions on our policy for members with an HRA plan, please contact Provider Relations at 1-844-707-5627.