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 providers must refund members within 45 days after receiving payment from the insurer if they collected copays, deductibles, or coinsurance upfront but were later reimbursed directly by BCBSRI. This is a reminder of an existing requirement, not a new policy change.
Action Required
Immediately: Billing team must review all BCBSRI claims where copays, deductibles, or coinsurance were collected upfront and the practice was later reimbursed directly by BCBSRI. Refund affected members within 45 days of receiving the remittance advice. Implement workflow to track and process these refunds to avoid compliance issues.