CommercialPrior AuthMedium impact
WINFertility update
Blue Cross Blue Shield of Rhode Island·RI · OB-GYN, Endocrinology·Physician / Facility
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Effective January 1, 2025, BCBSRI will no longer delegate infertility service authorization requests to WINFertility. All authorization requests for infertility services for fully insured members must now be submitted directly through the BCBSRI portal (MHK).
Action Required
By January 1, 2025: Billing and authorization staff must stop submitting infertility service authorization requests through WINFertility. Begin submitting all authorization requests for BCBSRI fully insured members through the BCBSRI portal (MHK). Update workflow procedures and train staff on the new authorization process to avoid claim denials.