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
Effective January 1, 2023, BlueRI for Duals (D-SNP) members received new ID cards without copay/coinsurance amounts displayed, and now have 20% coinsurance for services like PCP visits (excluding annual physical), dental, X-rays, Part B medications and DME supplies. Providers must bill D-SNP copays/coinsurance to Medicaid, and cannot bill members directly if they are not approved Medicaid providers or if Medicaid doesn't cover the amount.
Action Required
Immediately: Billing team must update procedures for BlueRI for Duals (D-SNP) members to bill 20% coinsurance to Medicaid for PCP visits (excluding annual physical), dental services, X-rays, Part B medications and DME supplies. Update billing software to automatically route D-SNP coinsurance claims to Medicaid. Train staff to never bill D-SNP members directly for copays/coinsurance. Verify Medicaid provider enrollment status to ensure ability to bill coinsurance amounts.