CommercialAdministrativeMedium impact
BCBSRI does not Credential Groups
Blue Cross Blue Shield of Rhode Island·RI·Physician / Behavioral Health
Effective date
Jun 1, 2024
We identified it
Jun 19, 2026
Summary
BCBSRI does not credential groups except for ancillary services - they only credential individual providers within groups. When creating new groups, each provider must complete individual credentialing applications or Provider Change Forms (PCF) if already credentialed with BCBSRI.
Action Required
Immediately: Stop sending group contracts to BCBSRI credentialing for professional providers. For new groups, billing team must ensure each individual provider completes separate credentialing applications with BCBSRI. For existing BCBSRI providers joining new groups, submit Provider Change Forms (PCF) instead. Always submit professional claims using the rendering provider's individual NPI and Type 2 billing NPI.