CommercialPrior AuthHigh 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
Summary
Effective January 1, 2024, BCBSRI is eliminating notification and prior authorization requirements for all home health services across all products. Home care agencies will no longer need to use the MHK provider portal for requests, and several additional changes are being implemented for mental health services and referral requirements.
Action Required
By January 1, 2024: Billing team must update systems to remove prior authorization requirements for all home health services for BCBSRI members. Stop using MHK provider portal for home health requests. Update billing workflows to process home health claims directly without authorization holds. For any retrospective home healthcare delivered before January 1, 2024, fax requests to BCBSRI at (401) 459-1623 or Prospect at 1-844-762-9230.