Medicare AdvantageReimbursementHigh impact
BlueRI for Duals – New ID cards for January 1 and 20% coinsurance
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +2 more·Provider Update
Effective date
Jan 1, 2023
We identified it
Jun 19, 2026
Summary
BlueRI for Duals (D-SNP) members received new ID cards effective January 1, 2023, that no longer display copays/coinsurance amounts. These members now have 20% coinsurance for PCP visits (excluding annual physicals), dental-related medical services, X-rays, Part B medications, and DME supplies, which must be billed to Medicaid.
Action Required
Immediately: Billing team must update workflows to bill all D-SNP copays and coinsurance to Medicaid after receiving payment from BCBSRI. Do not bill patients directly for 20% coinsurance on PCP visits, dental-related medical services, X-rays, Part B medications, or DME supplies. Verify Medicaid provider status - if not enrolled as Medicaid provider, patient cannot be billed for these amounts.