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 information displayed, and now have a 20% coinsurance for services like PCP visits, dental, and X-rays. Providers must bill the coinsurance to Medicaid, and if not Medicaid-contracted, cannot bill members for these amounts.
Action Required
Immediately: Billing team must update procedures for BlueRI for Duals members - bill 20% coinsurance for PCP visits (excluding annual physicals), dental, and X-rays to Medicaid as secondary payer. Update staff training to recognize new ID cards without copay displays. If practice is not Medicaid-contracted, write off coinsurance amounts rather than billing members.