CommercialAdministrativeMedium impact
Reimbursing members
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Jun 1, 2024
We identified it
Jun 19, 2026
Summary
BCBSRI reinforces that participating providers cannot charge members beyond contracted allowances and must refund any overpayments within 45 days of receiving contractual payment. If refunds are not issued within 45 days, BCBSRI will reimburse the member directly and offset the amount from future provider settlements.
Action Required
Immediately: Billing team must review all member payments collected above contracted allowances and issue refunds within 45 days of receiving BCBSRI contractual payments. Implement tracking system to monitor refund deadlines to avoid automatic offsets from future settlements. Update billing procedures to prevent charging members beyond contracted rates.