Medicare AdvantageAdministrativeHigh impact
D-SNP coinsurance reminder
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Summary
Effective January 1, 2024, Blue RI for Duals (D-SNP) members received new ID cards that no longer display copays or coinsurance amounts. Members still have 20% coinsurance on PCP visits (excluding annual physicals), X-rays, specialist visits, and Part B DME supplies, but all copays/coinsurance must be billed to Medicaid rather than the member.
Action Required
Immediately: Billing team must update procedures for all Blue RI D-SNP members - do not bill members directly for any copays or coinsurance. Submit all D-SNP copays/coinsurance to Medicaid as secondary payer. If practice is not an approved Medicaid provider, copays/coinsurance cannot be collected from the member. Update billing system to flag D-SNP claims and ensure proper Medicaid secondary billing for PCP visits, specialist visits, X-rays, and Part B DME supplies with 20% coinsurance.