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Corrected Claims after an audit findings

Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Nov 1, 2023
We identified it
Jun 19, 2026
Days to comply

Summary

When correcting claims due to audit findings, medical records must now be submitted with the corrected claim. Claims will continue to be denied if medical records are not attached to the correction.

Action Required

Action needed
Immediately: Billing team must attach medical records to all corrected claims that are being resubmitted due to audit findings. Update billing workflow to require medical record attachment before claim resubmission. Train staff that corrected claims will be denied without proper medical documentation attached.