- Bcbsri login provider If you require assistance submitting a behavioral health notification, we have several tools and guides available for you on the Provider Portal on BCBSRI. Secure messaging is located on the left-hand tool bar once you log in to bcbsri. An important component of our commitment is our continued efforts to reward primary care providers (PCPs) for improving quality and closing High-Value Provider network consists of Care New England, Oak Street Health, and Prospect CharterCARE primary care provider (PCP) groups. (UM) criteria are available online? The formulary is a great tool to help members and providers understand what drugs the plan covers, which of these drugs have UM edits, such as prior authorization, quantity limit, and/or Step Medical Procedures are considered medically necessary when the criteria in the BCBSRI online prior authorization tool has been met. You’ll get a week’s worth of meals delivered BCBSRI invites providers to join us on Tuesday, Following the call, we will post a summary of topics covered to our Provider Conference Info page on our secure provider portal. Medicare Advantage See all your options, compare plans, and enroll. Click here. ; Medicare Supplement Help cover costs with a Plan 65 option. Note: Members with Check status of all claims submitted with your National Provider Identifier (NPI). Provider Manual - Home Page. com or if you need assistance with MHK, please contact our Provider Relations team at ProviderRelations@bcbsri. Check patient eligibility to verify effective dates of coverage, copays, deductibles, and other information. Prior authorizations can be requested using the phone 1-888-233 . Therefore, we would like to inform you that there is a new language resource available to you on the BCBSRI provider portal. for a conference call with the Provider Relations team, who will provide updates and reminders on important topics and changes for 2025. It only takes a couple of minutes and will help us improve our service. What can you do in the RI Medicaid Health Care Portal. Review the following and click on the register now link, if applicable. COM 2024 Prior Authorization for Procedures Effective 8. View our provider manual for information about claims, referrals and provider networks and programs. The first step is to gain a better understanding of the healthcare needs of our members and their communities. org Personalized Trainings: ProviderRelations@bcbsri. Whether you want to check your deductible, find a doctor, or order a new ID card, you can do it all from here. org for any additional issues 1. com provider portal to request prior authorizations beginning October 1, 2019. , Pawtucket High-Value Providers (HVP) are PCP groups with patient-centered and innovative care models that coordinate interdisciplinary care. Deliveries are made Monday through Friday only. Please continue to use your BCBSRI payer ID when submitting electronic claims. All other marks and names are property of their respective owners. org Personalized Trainings: Kathleen. Change your 2024 medical and dental plan; Cancel your electronic payments ; Add Dependent Form (for plans purchased directly from BCBSRI) 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 MEDICAL COVERAGE POLICY | 2 (401) 274-4848 WWW. Reminder: Please attend a provider portal training session. Date of birth (YYYY-MM-DD) Title Navigation. effective date:11|01|2024 policy last reviewed:03/06|2024 overview Medicare Advantage See all your options, compare plans, and enroll. For more information on the meals program, call Independent Living Systems at 833-853-8946 (toll free) and provide your BCBSRI Member ID number. BCBSRI offers our Medicare Advantage members a meal delivery program through ILS Meals by Independent Living Systems. If you have Blue Cross Vision, use this option for routine eye exams, glasses, and contacts. You’ll get a week’s worth of meals delivered to your door—up to four times a year—when you get home from an inpatient hospital stay. Small Group Quoting and Rating Questions. Surgical Procedure Anatomical Modifier. COM 2024 Prior Authorization of Procedures 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. com effective date: 03|01|2025 policy last reviewed: 11/06|2024 overview 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. By selecting "Close Window," you will return to Provider Central. We also offer a plan, BlueCHiP Direct Advance, that includes a smaller network of providers than the BlueCHiP Direct plan. org:8080 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. COM Effective April 1, 2010 for labs: All sleep laboratories must be accredited by the American Academy of Sleep Medicine (AASM). The Centers for Medicare and Medicaid Services (CMS) reminds Medicare Advantage Organizations to continue working with their contracted health care providers to review, update, and certify existing provider information in the National Plan and Provider On the BCBSRI MHK Provider Portal, provider correspondence is now available under the “View Authorizations” section. Reach out to Provider. com effective date: 10|01|2024 policy last reviewed: 08/07|2024 overview Requests for authorization of genetic testing should be submitted via the BCBSRI online prior authorization tool, which is available to BCBSRI-participating providers. Asset Publisher. 1 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. USING YOUR BCBSRI ONLINE MEMBER ACCOUNT See next page > 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. ProviderAccess User ID Password (Forgot password?) Don't have a User ID? Register Now. Learn more about your plan options. BCBSRI providers can view authorizations in the MHK provider portal by expanding the drop-down and selecting “View Authorizations” on the left side of the page. ILS Meals is one of the nation’s largest nutritional providers, delivering high Requests for authorization of genetic testing should be submitted via the BCBSRI online prior authorization tool, which is available to BCBSRI-participating providers. With a single log-in or phone call, your clients' employees can access health and wellness apps, plan information, care management, and customer service—and get personalized health support from BCBSRI wants all Rhode Islanders to have quality, affordable, and equitable care when they need it. effective date: 03 |01 2025 policy last reviewed:11 |20 2024 overview As a reminder, there is a functionality on the BCBSRI Provider Portal that allows providers to send inquiries via secure messaging. With a single log-in or phone call, you can access health and wellness apps, plan information, care management, and customer service—and get personalized health support from Care Guides, nurses, and coaches. ILS Meals is one of the nation’s largest nutritional providers, delivering high-quality Requests for authorization of genetic testing should be submitted via the BCBSRI online prior authorization tool, which is available to BCBSRI-participating providers. 1. ; Extra Help Plans Medicare + Medicaid and the new Access plans. As of January 1, 2025, Headway will join BCBSRI’s network as a virtual provider group that delivers quality mental health care to both children and adults by connecting members with providers quickly and efficiently. Therefore, you are about to leave the Blue Cross & Blue Shield of Mississippi website and enter another website not operated by Blue Cross & Blue Shield of Mississippi. To obtain access to bcbsri. Register; Search. CPT codes, descriptions and data copyright ©2023 American Medical Association. Broker of Record/Disaffiliations; Commissions & VUE/Vertafore Broker Portal; Broker Portal . Through this secure and easy to use internet portal: Healthcare providers and Billing Agents can enroll as a Trading Partner with RI Medicaid. National Plan and Provider Enumeration System Reminder . The requesting provider of the authorization can now view correspondence which have been sent via fax or mail. To continue, enter the following characters in the field below. ; February 15 - September 30, Requests for authorization of genetic testing should be submitted via the BCBSRI online prior authorization tool, which is available to BCBSRI-participating providers. effective date: 11 |01 2024 policy last reviewed:01 |03 2024 overview 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. For paper claims submissions, use the CMS-1500 form. com effective date: 03|01|2025 policy last reviewed: 11/20|2024 overview BCBSRI’s BH staff will be in touch with you within 3 business days to provide your authorization number needed for claims processing. All rights reserved. Get the latest provider news and updates. Forgot your Username? Let us help. If the provider does not attend the training, will BCBSRI follow up? Yes, BCBSRI will follow up with the individual provider after the Q1 deadline. to return to your home page The PRC is for Blue Cross Blue Shield of Vermont contracted providers only - access will be denied if you are not contracted with us. Claims may be filed either electronically or on paper for Blue Cross & Blue Shield of Rhode Island (BCBSRI) plan members and out-of-state Blue Cross & Blue Shield plan members. This will allow BCBSRI to establish a provider in our system to support claims adjudication and demonstrate compliance with the BCBSRI administrative policies: • Signed current BCBSRI Participating Provider Agreement ** • W-9 Form ** • Type II NPI Form 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. If you have 150 providers in your group, all 150 will need to take the training and fill out the attestation form. 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 MEDICAL COVERAGE POLICY | 2 (401) 274-4848 WWW. Provider Manual. com. . We’ll explain everything you need to know about the $0 benefits that come with our BlueCHiP for Medicare (HMO-POS) plans and the extra benefits you could get if you qualify for Extra Help or Medicare + Medicaid. 11/17/2020 - Provider conference call regarding COVID-19 pandemic; 06/24/2020 - Provider conference call regarding COVID-19 pandemic; 06/10/2020 - Provider conference call regarding COVID-19 pandemic; 05/27/2020 - Provider conference call regarding COVID-19 pandemic; 05/20/2020 - Provider conference call regarding COVID-19 pandemic 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 MEDICAL COVERAGE POLICY | 3 (401) 274-4848 WWW. Save time and learn about our provider portal tools today. Enroll as a Blue Cross provider, update provider information, or begin Let us know what you think. Provider Inquiry is for registered, nonregistered and out-of-state providers. com click on the Preauthorization hyperlink on the left-hand side of the page. We encourage you to submit any questions you would like addressed during the call related to the topics above, or to other topics, to 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 MEDICAL COVERAGE POLICY | 2 (401) 274-4848 WWW. If you are calling by telephone, please dial (401) 459-5900 and enter conference ID: 713 719 061#. to 4:30 p. Using secure messaging, you can ask questions about: Eligibility/prior authorization/benefits – For Rhode Island members only 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 MEDICAL COVERAGE POLICY | 2 (401) 274-4848 WWW. C. All other providers may fax a prior authorization request to Utilization Management at (401) 272-8885. If you are interested in BlueCHiP Direct Advance, call our sales team at (401) 459-1000 . As of May 2007, we are accepting the • Select your primary care provider • Manage your HSA or HRA • Make a monthly premium payment • Review claim details, and • Connect directly with customer service. The majority of BlueCard electronic inquiries are answered within 48-72 hours (Monday through Friday during regular office hours). If you are calling by telephone, please dial (401) 459-5900 and enter conference 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. COM 2024 Prior Authorization of Procedures Let us know what you think. COM 2024 Prior Authorization of Procedures ©2024 Blue Cross and Blue Shield of North Carolina. Relations@bcbsri. Sharing information like race, ethnicity, and gender identity supports that effort. On January 1, BlueCare Connect will replace myBCBSRI. Outpatient providers will be routed to our new MHK tool in September, rather than the current “Clear Coverage” platform. Send paper claims to: Dental Claims Administrator P. If you are a member of Blue Cross & Blue Shield of Rhode Island, you can use the same online services at lower rates available exclusively to members of Blue Cross & Blue Shield of Rhode Dental provider portal This site is your central resource with information like patient eligibility, claims status, and payments. If you provider is listed on BCBSRI but not appearing in your authorization request screen, please ensure this information is correct and updated with BCBSRI. London Health is an innovative third-party administrator with expertise in administering consumer-directed health plans for employers while helping them lower employee benefit and human resources expenses. Simply click the hyperlink of the correspondence you wish to view and the correspondence will appear in a new window. Why choose BCBSRI? Shop plans. Login; Log in for full access to: Time-sensitive news, fee schedules, eTools for administrative transactions, and more. You also can view a quick summary of benefits below: 2025. News and Updates. All other providers should fax the request to Utilization Medicare Advantage See all your options, compare plans, and enroll. Last name. bcbsri. Date of birth (YYYY-MM-DD) Title. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Health care professionals get help with the UnitedHealthcare Provider Portal including login, registration, and training. Paper claims. Larger offices can continue to submit through their clearing 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 MEDICAL COVERAGE POLICY | 2 (401) 274-4848 WWW. Dental policies; Claims filing Electronic claims. During business hours: Calls must be returned the same business day. Use the Find a Doctor tool if your vision exam is covered under your medical plan. The training documents can be found below. Blue Cross Blue Shield FEP Dental complies with all applicable Federal civil rights laws, to include both Title VII and Section 1557 of the ACA. If you do not know who your Administrator is, contact your Provider Relations Representative. Behavioral health providers, as you are aware behavioral health notifications have been moved from Beacon Health to the BCBSRI MHK Provider Portal as of January 1, 2022. All sleep laboratory providers performing sleep testing services must participate and be in good standing with Medicare 22. In order to complete this request, please be sure that you have successfully logged in to the website. org for assistance. Health care professionals like you can We offer two ways to find patient eligibility information — by logging into our secured provider portal or by calling Provider Inquiry, an automated response system. Check Prior Authorization Status Check Prior Authorization Status For dates of service on or after October 1, 2019 providers must access EviCore by accessing the bcbsri. We are currently beginning the pilot stage of our testing, and are hoping to go live for all providers in January of 2024. In the middle of the Preauthorization page, locate the hyperlink BCBSRI invites providers to join us on Tuesday, December 10, 2024 from 10-11 a. Just show your BCBSRI member ID card; Earn up to $250 (both subscriber and covered spouse) in wellness rewards; Member discounts with Blue365 on gyms, nutrition services, fitness trackers, and more health and lifestyle brands; A Requests for authorization of genetic testing should be submitted via the BCBSRI online prior authorization tool, which is available to BCBSRI-participating providers. 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. Electronic inquiry: Submit a HIPAA 270 transaction (eligibility) to BCBSRI. To attend the session online, please join using Microsoft Teams. org. Physicians and professionals: 1-800-344-8525; Hospitals or facilities: 1-800-249-5103 BCBSRI Provider Portal: Use the Eligibility Search by Member ID in the Patient Eligibility section of the secure portal. View their BCBSRI benefits; Select or update their primary care provider (PCP) Find doctors and labs in their health network; Compare costs for medical tests and procedures; Review detailed claims data; Check their deductible or health savings account (HSA) balance, if applicable; View all family members covered under their plan; Assign a delegate On January 1, BlueCare Connect will replace myBCBSRI. Find an eye doctor. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. m. Please note this information would not be shared outside of BCBSRI. You are currently logged in to your account. This feature will show any open authorizations and up to six months of approved authorizations. P B F. S. com provider portal, you will be all set! If you do not have access to the provider portal, please contact Provider Relations at ProviderRelations@bcbsri. They’ll coordinate your care and any needed specialist referrals to help keep you healthy. ). If you are a billing service, contact the practice Local Administrator to be granted access to the Provider Resource Center. corp. BCBSRI. Benefits Pro Portal. As in past years, BCBSRI is updating its allowable amounts/rates for common evaluation and management (E&M) services for primary care providers (PCP), as well as specialist providers. Our goal is to make sure that our members continue to have access to effective medications at the lowest possible cost. COM Commercial Products Only: E0676 Medicare Advantage Plans: Please refer to the resources above for coverage of E0676. Box 69427 For more information on the meals program, call Independent Living Systems at 833-853-8946 (toll free) and provide your BCBSRI Member ID number. First name. After completing the training, you are to complete the D-SNP Provider Attestation Form below. The NPI and Tax ID you enter must match what’s in BCBSRI’s system. Did you know our secured Physician and Provider Portal offers the following: • Check member benefits and eligibility • View Remittance Advices (RAs) online • View claim status • Submit preauthorization requests through MHK • Send secure messages to our Physician & Provider Call Center team instead of calling Do you feel your office needs a better experience Excellus BCBS participating providers may register for an online account. Blue Cross NC Security Verification. 2024. Privacy & Legal 500 exchange street, providence, ri 02903-2699 medical coverage policy | 3 (401) 274-4848 www. Requests for authorization of genetic testing should be submitted via the BCBSRI online prior authorization tool, which is available to BCBSRI-participating providers. effective date:10|01|2024 policy last reviewed:08/07|2024 overview As an in-network provider with the BlueRI for Duals (HMO-D-SNP) network, you are required to take an initial training that is due by March 31, 2025 and annual refresher training on a yearly basis. Out-of-state: 1-800-676-2583. Login Login. to 6:00 p. You have selected a link to a website operated by a third party. org All providers shall make necessary arrangements to ensure the availability of care to members on a 24/7 basis, including coverage by another physician/providers. Login Required. 2. Forgot your Password? Let us help. Dental Direct Basic; Dental Direct Standard; Dental Direct Plus; Dental Direct Elite Reach out to Provider. ILS Meals is one of the nation’s largest nutritional providers, delivering high-quality Beginning January 1, 2025, BCBSRI requires that participating providers, who treat or diagnose patie P F . To access your fee schedule, you can log on to our secure Provider Portal and click “fee schedules” on the left-hand navigation. If you're a non participating provider learn about joining our network. A BCBSRI Medicare advisor will be available to review your application for accuracy and completeness: Your Blue Store SM in Cranston, East Providence, Lincoln, Narragansett, or Warwick; Dunkin Donuts (740 Branch Ave, Providence)—noon to 5 PA Login Portlet. This list is current as of July 1, 2024, and is subject to change. effective date: 03 |01 2024 policy last reviewed: The BCBSRI wellness program makes it easy—and fun—to take steps toward better health. com 500 exchange street, providence, ri 02903 -2699 medical coverage policy | 1 (401) 274-4848 www. O. Small offices will be able to submit claims directly through bcbsri. Any trip over 20 miles will count as additional trips and will be subtracted from your 24 trip total. Providers and doctors call these Blue Cross & Blue Shield Rhode Island phone numbers for eligibility and other questions. to 8:00 p. This type of coordinated care makes it easier for you to find your way through the healthcare system so you can focus on getting or staying healthy. COM 2024 Prior Authorization of Procedures BCBSRI offers our Medicare Advantage members a meal delivery program through ILS Meals by Independent Living Systems. COM 2025 Prior Authorization of Procedures 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. org Interested in joining Blue Cross & Blue Shield of Rhode Island? Practice Staff? Login Here. Don’t have an account? We comply with applicable Federal civil rights laws and do not discriminate on the basis of Need information about your plan? Is this for me? If you buy insurance on your own, not through an employer, you'll learn how to choose, purchase, and get the most out of a plan Email: BrokerOperations@bcbsri. Oct 1, 2024. © 2020 Blue Cross & Blue Shield of Rhode Island. Call Monday through Friday 8:00 a. BCBSRI invites our participating providers to join us on Tuesday, Following the call, we will post a summary of topics covered to our Provider Conference Info page on our secure provider portal. Nov 1, 2024. ILS Meals is one of the nation’s largest nutritional providers, delivering high-quality Let us know what you think. PEBA; BlueCross BlueShield of South Carolina; Press Room; Contact Us; Assistance. com effective date: 11|01|2024 policy last reviewed: 03/06|2024 overview Requests for authorization of genetic testing should be submitted via the BCBSRI online prior authorization tool, which is available to BCBSRI-participating providers. Only system administrator accounts can Reach out to Provider. Providers: Claims Filing Information for In-Network & Out-of-Network Providers. BCBSRI will be eliminating the Individual HealthMate PPO Medicare Advantage Plan. BlueLine (401) 272-1590 1-800-327-6712 24/7 How to use BlueLine. effective date: 11|01|2024 policy last reviewed: 03/06|2024 overview Add Dependent Form (for plans purchased directly from BCBSRI) Use this form if you already have a policy with BCBSRI and need to add a new dependent (for example, newborn, spouse, etc. Physician and Provider Service Center (401) 274-4848 or 1-800-230-9050 Monday through Friday 8:00 a. They are unbelievably helpful! Erin B. Procedure codes in the range 10000-69999 having a Medicare Physician Fee Schedule (MPFS) bilateral i P Please ask your administrator or BCBSRI Provider Relations for assistance adding your provider to BCSRI. COM 2025 Prior Authorization of Procedures administrator to gain access to bcbsri. Headway matches providers with members based on the geographic location, demographic information, care delivery preferences and Coming soon BCBSRI will be introducing online web claim submission through bcbsri. In the middle of the Preauthorization page locate the hyperlink for the type of service that is being If the provider is missing, please ask the administrator of your account to add the appropriate provider (s) to the bcbsri Self-guided Study: Complete the 2025 Provider Attestation form CMS Annual Requirement for ALL providers, cannot be delegated. Failing to provide direct contact information may delay the provider's enrollment request. 2024 Or, on Saturday, December 7, you can submit your application in person at one of the following locations. Understanding and meeting the linguistic needs of our members is a shared concern of BCBSRI and our contracted providers. 2 Doctors Online is a telemedicine service provided by American Well®, an independent company that administers Doctors Online on behalf of BCBSRI. Please note from time to time it may be necessary for our Medical Director or their designee to speak to the provider directly. ILS Meals is one of the nation’s largest nutritional providers, delivering high-quality 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. Healthy Blue is an HMO D-SNP plan with a Medicare contract and a contract with the Louisiana Medicaid program. Your primary care provider (PCP) is at the heart of your healthcare experience. As part of our ongoing efforts to make high-quality and affordable healthcare available to our members, BCBSRI regularly reviews the list of prescription drugs we cover on the commercial formularies. Utilization management review requirements and BCBSRI is updating its behavioral health fee schedules for Commercial and Medicare Advantage products for dates of service occurring on or after December 1, 2024. ILS Meals is one of the nation’s largest nutritional providers, delivering high 500 exchange street, providence, ri 02903-2699 medical coverage policy | 3 (401) 274-4848 www. Utilization Management. com or call our Customer Service Department at 1-800-267-0439, October 1 - February 14, seven days a week, 8:00 a. Previously limited to four digits, this extension option allows for more accurate contact information, making communication with our UM team easier for those who have extensions more than four digits long. Skip to main content Please note this information would not be shared outside of BCBSRI. Providers can perform various actions from this screen, including viewing Medicare Advantage See all your options, compare plans, and enroll. BCBSRI has dedicated resources to providing additional educational training sessions and we encourage all network providers to take advantage of this opportunity. effective date: 04|01|2025 policy last reviewed: 12/04|2024 overview Click the button below to login to your Benefits Pro Portal, or call us at 866-413-2582 (TTY: 711). com x ai Your primary care provider (PCP) can coordinate your care with specialists, labs, hospitals, and any other providers you might need. Please log in to access this service. Node:bclrprvappp2001. Does every provider in my group need to take the training and attest? Yes. Check claims status and patient eligibility, view remittances, and review the Provider Administrative Manual. By selecting "Continue," you acknowledge that you have read and understood the statement below, and you wish to leave Provider Central. Get easy access to your digital ID card, electronic documents (go paperless!), claim status, and benefit information—all in one place. effective date: 11 |01 2024 policy last reviewed: Become a participating provider Use this form to add a new practice or a new provider within a practice. Provider Directory This directory provides a list of Group BlueCHiP for Medicare’s network providers. ; Trading Partners 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 MEDICAL COVERAGE POLICY | 6 (401) 274-4848 WWW. As long as you have access to the bcbsri. Out-of-State Plans. Requests for medical procedures should be obtained via the BCBSRI online prior authorization tool, which is available only to participating providers. bcbsal. Medicare Advantage plans; Extra Help plans; Medicare Supplement; FAQ; Special enrollment period; Meet our sales team; Contact us; Understanding Medicare. London Health works collaboratively with BCBSRI to combine the benefits of CDHPs with wellness to lower costs and increase employee engagement. Self-guided Study: Complete the 2025 Provider Attestation form CMS Annual Requirement for ALL providers, cannot be delegated. Other updates BCBSRI has also made other rate adjustments in its fee schedule, both upward and downward, generally following Medicare changes and continuing Medicare Advantage See all your options, compare plans, and enroll. BCBSRI. 500 exchange street, providence, ri 02903 -2699 medical coverage policy | 1 (401) 274-4848 www. Forgot User Name? Forgot Password? All trademarks unless otherwise noted are the property of Blue Cross & Blue Shield of Rhode Island or the Blue Cross and With a single log-in or phone call, you can access health and wellness apps, plan information, care management, and customer service—and get personalized health support from Care Guides, nurses, and coaches. BCBSRI Update. After successful login to bcbsri. Simon@bcbsri. Welcome Providers. New user? Register Now. 23. Printed Materials and Plan Specifics: ProviderRelations@bcbsri. Last log in: Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association. If you already have dental coverage with BCBSRI, you can find everything you need to know about your plan, including covered services and claims, through the Dental Benefits section of your online account. Medical; Dental; Behavioral Health; Resources; About. In the BCBSRI MHK Provider Portal, providers will now have the ability to add a six-digit extension to their contact phone number. Group HealthMate will continue. 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 Dear Provider, Blue Cross & Blue Shield of Rhode Island (BCBSRI) is committed to improving the health of our members and all Rhode Islanders, by supporting access to high-quality, cost-effective healthcare. The program runs through your online member account and is also available on your phone—at no additional cost to you. effective date: 04|01|2025 policy last reviewed: 12/04|2024 overview As a member of Blue Cross & Blue Shield of Rhode Island (BCBSRI), you have easy 24/7 access to health plan information through your online member account at bcbsri. Explore this site for useful tools and information. Note: If user does not have access to the Preauthorization tab, instruct them to contact their We suggest you to view this website in recommended screen resolution (1280 X 800), for more details click here 1 Available within our service area for HMO & HMO-POS plans only/PPO plan has out-of-service benefit of 50% coinsurance/trip. Phone call response: After hours: Calls must be returned within one hour by the provider or covering provider. Depending on your Check your plan wherever you are. You’ll get a week Identifying rendering physician/provider information; Identifying referral physician/provider information, if appropriate; Charge of the service; Patient treatment information, including diagnosis, CPT®, or HCPCS code for the service and any applicable modifier(s), date services were rendered, and service site; Tax identification number (TIN) BCBSRI always goes above and beyond to make sure I'm receiving the best healthcare possible. HVPs offer programs that focus on improving member health outcomes Let us know what you think. In order to become a participating provider, the following documents are required. These sessions are typically 30-60 minutes long and will consist of a demo of the authorization process and trained staff BCBSRI is committed to improving health equity for our members and the healthcare system. Call Monday through Providers: Close. iwm wevhgz jpnt trrlgeqqk umbip glpo hjjjyqjq ijj hgqgk vnuoj