CommercialPrior AuthHigh impact
BCBSRI will resume prior authorization requirements for Skilled Nursing admissions
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +2 more·Facility
Effective date
Apr 1, 2023
We identified it
Jun 19, 2026
Summary
BCBSRI will resume requiring prior authorization for all Skilled Nursing Facility admissions starting April 1, 2023. This reverses a previous suspension of prior auth requirements and will affect all patients being admitted to SNF facilities covered by BCBSRI plans.
Action Required
By April 1, 2023: All providers must obtain prior authorization from BCBSRI before admitting patients to Skilled Nursing Facilities. Update billing workflows to include prior auth verification step before SNF admissions. Train discharge planning staff to initiate prior auth requests. Claims for SNF admissions without prior authorization will be denied.