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 ene, 2026
Effective 1 de enero de 2026, CMS is updating the turnaround time requirement for routine cases from 14...
P F
1 ene, 2026
Effective diciembre 15, 2025, providers who are credentialed as an oncologist affiliated with Brown C...
P B F
1 ene, 2026
Arkansas Blue will begin using Skai Blue for national account members starting in 2026, which means ...
Provider Relations
P B F
1 ene, 2026
BCBSRI invites providers to join us on Tuesday, enero 13, from 10-11 a.m. for a conference call wi...
P B F
1 ene, 2026
As a reminder, all BCBSRI participating providers, groups and in the D-SNP network are required to c...
P F
1 ene, 2026
As a reminder, if a Nurse Practitioner (NP) or Physician Assistant (PA), is not credentialed as a NP...
Physician & Provider Call Center
P B F
1 may, 2025
Beginning 1 de junio de 2025, our Provider Call Center will implement a transaction limit of five cl...
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 ene, 2026
Improving post-fracture care for at-risk patientsAs a healthcare provider, actively addressing osteo...
P
1 dic, 2025
The Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey is an annual, s...
P
1 nov, 2025
Hemoglobin A1c (HbA1c) testing and controlHbA1c is a blood test that reflects a patient’s average bl...
Salud conductual
P B
1 ene, 2026
The BCBSRI Behavioral Health Case Management program is staffed by experienced mental health and sub...
B
1 ene, 2026
January is Mental Wellness Month, a perfect opportunity to transition away from the hectic holiday s...
P B
1 ene, 2026
BCBSRI has collaborated with providers throughout Rhode Island to ensure that our members have acces...
Farmacia
P B F
1 ene, 2026
The following drugs will require PA effective 1 de enero de 2026 ...
P F
1 dic, 2025
The following drugs are new to the market effective 1 de diciembre de 2025 and all require prior authoriza...
P B F
1 nov, 2025
The following drugs will require Prior Authorization beginning on 1 de octubre de 2025 for Commercial and...
Products & Benefits
P
1 nov, 2025
Under the Patient Protection and Affordable Care Act (PPACA), coverage is provided for many pre...
P F
1 ago, 2025
Under the Patient Protection and Affordable Care Act (PPACA), coverage is provided for many pre...
P B F
1 dic, 2019
In the large group portfolio, we will also be adding eight Network Blue New England Options plans, a...
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 B F
1 ene, 2026
BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...
P F
1 ene, 2026
The following new policies were created. Effective dates vary so please review the full text of thes...
P F
1 ene, 2026
The following policies were recently reviewed for annual update. The full texts of these policies ar...