CommercialPrior AuthMedium impact
Entering Authorizations for out of state members
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Oct 1, 2022
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island has updated their process for entering authorizations for out-of-state members. The policy provides step-by-step guidance on using the bcbsri.com portal to obtain authorizations for members whose home plan is outside Rhode Island, directing providers to the member's home plan authorization site.
Action Required
Immediately: Staff responsible for obtaining prior authorizations must review the updated screenshots and process on the bcbsri.com portal for out-of-state BCBS members. Update authorization workflow to use the portal's redirect feature to access the member's home plan authorization site when dealing with out-of-area members.