CommercialPrior AuthHigh impact
Reducing administrative burden and increasing access to care
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +3 more·Provider Update
We identified it
Jun 19, 2026
Summary
BCBSRI is eliminating approximately 65% of prior authorization requirements for primary care physicians by early 2025, including many radiology and cardiology services. This change applies to both commercial and Medicare plans and is part of an effort to reduce administrative burden on providers.
Action Required
By early 2025: Billing team should monitor BCBSRI communications for specific lists of services no longer requiring prior authorization. Update billing system workflows to remove prior auth requirements for affected radiology and cardiology services once detailed lists are provided. Continue current prior authorization processes until specific guidance is received.