March 2017
Effective January 1, 2017, primary care providers were required to submit referrals through BCBSRI's web-based referral management tool for members enrolled in BlueCHiP Commercial, BlueCHiP for Medicare Advance and New England Health Plan (NEHP) products. Specialists must have a referral in place before rendering services, and the claim may be denied if services are rendered without a referral entered in the tool. Effective April 1, 2017, insertion of a subcutaneous implantable cardioverter-defibrillator requires prior authorization for Commercial products, and peripheral subcutaneous field stimulation for chronic neuropathic pain is submitted using unlisted CPT 64999.