CommercialAdministrativeHigh impact
Reimbursing members
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
May 1, 2024
We identified it
Jun 19, 2026
Summary
BCBSRI reminds providers that contracts prohibit charging members beyond contracted allowances. Any member refunds must be issued within 45 days of receiving contractual payment, or BCBSRI will reimburse the member directly and offset future provider settlements.
Action Required
Immediately: Billing team must ensure all member refunds for overpayments are processed within 45 days of receiving BCBSRI contractual allowance payments. Implement tracking system to monitor refund timelines. Finance team should review all outstanding member credits and issue refunds promptly to avoid BCBSRI offsetting future settlements.