CommercialAdministrativeHigh impact
Requirement to refer members to in-network providers
Blue Cross Blue Shield of Rhode Island·RI·Physician / Behavioral Health
Effective date
Jul 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 labs are confirmed as out-of-network and should not be used for referrals.
Action Required
Immediately: All providers must verify network status of referral destinations using BCBSRI's Find a Doctor tool before making referrals. Stop referring to Accu Reference Lab, Quest Diagnostics, Total Toxicology, and U.S. Lab & Radiology, Inc. Update referral workflows to include network verification step for DME, radiology, behavioral health, and lab services to avoid out-of-network claims processing.