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CommercialPrior AuthMedium impact

Notification and authorization removal for home health services

Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Days to comply

Summary

Effective January 1, 2024, BCBSRI will no longer require notification or prior authorization for home health services across all products. Home care agencies can stop using the MHK provider portal for authorization requests.

Action Required

Action needed
By January 1, 2024: Billing team must update home health service workflows to remove prior authorization requirements for BCBSRI patients. Stop submitting requests through MHK provider portal. Update billing software to remove prior auth flags for home health services. For retrospective claims prior to Jan 1, 2024, fax to BCBSRI at (401) 459-1623 or Prospect at 1-844-762-9230.