CommercialPrior AuthMedium impact
Helpful reminders about prior authorizations in the BCBSRI MHK provider portal
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Jul 1, 2022
We identified it
Jun 19, 2026
Summary
BCBSRI has issued updated guidance for submitting prior authorization requests through their MHK provider portal, emphasizing correct provider network status selection and proper request types. Key reminders include never selecting 'Non-Participating Provider' unless truly out-of-network, using actual admit dates for inpatient requests, and using BH request types only for behavioral health services.
Action Required
Immediately: Staff submitting prior authorizations through BCBSRI MHK portal must verify they never check 'Non-Participating Provider' box unless truly out-of-network, always select 'Par' status for servicing providers/facilities when available, use 'BH Outpatient' and 'BH Inpatient' request types only for behavioral health services, and include actual admit dates for inpatient authorization requests. Train all prior authorization staff on these requirements to prevent processing delays and cancellations.