CommercialAdministrativeHigh impact
Requirement to refer members to in-network providers
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Oct 1, 2024
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 (Accu Reference Lab, Quest Diagnostics, Total Toxicology, and U.S. Lab & Radiology) are confirmed as out-of-network and cannot be used for referrals.
Action Required
Immediately: All providers must verify network status of referral destinations using BCBSRI's Find a Doctor tool before establishing any referral relationships. Update referral protocols to exclude the four listed out-of-network laboratories (Accu Reference Lab, Quest Diagnostics, Total Toxicology, U.S. Lab & Radiology). Staff must check provider participation for all DME, radiology, behavioral health, and laboratory referrals to prevent out-of-network claims.