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6 feb, 2023

Out of State NEHP Plans with RI PCP - Medical Drug Authorizations

For NEHP members with a RI PCP, inquiries regarding medical drugs should be directed to the member’s home plan for benefit confirmation. Previous Issues with claims denying for no authorization have been corrected and BCBSRI claims will no longer deny for no authorization. However, final approved is based on the benefits of the member's home plan. Any benefit questions should be directed to the home plan.