CommercialAdministrativeMedium impact
Reminder: Reimbursing members after claim adjustments
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
We identified it
Jun 19, 2026
Summary
BCBSRI reminds providers that if they collect copays, deductibles, or coinsurance at point of service but later receive direct payment from BCBSRI, they must refund the member within 45 days of receiving the remittance advice. This prevents double-charging members for the same service.
Action Required
Immediately: Billing team must establish a process to track claims where point-of-service payments were collected and monitor remittance advices for direct BCBSRI payments. When direct payment is received, refund the member within 45 days of RA receipt. Update billing workflows to flag these scenarios and set up calendar reminders to ensure compliance with the 45-day refund deadline.