CommercialAdministrativeHigh impact
Requirement to refer members to in-network providers
Blue Cross Blue Shield of Rhode Island·RI·Physician / Behavioral Health
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
BCBSRI now requires all contracted providers to refer members only to in-network providers for all services including DME, radiology, behavioral health, and lab services. Four specific laboratories are confirmed as out-of-network and should not be used for referrals.
Action Required
By January 1, 2026: All providers must verify network status of referral partners using BCBSRI's Find a Doctor tool before establishing referral relationships. Stop referring to Accu Reference Lab, Quest Diagnostics, Total Toxicology, and U.S. Lab & Radiology immediately. Update referral workflows to include network verification step for DME, radiology, behavioral health, and laboratory services. Claims may be denied or processed out-of-network if referred to non-contracted providers.