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Access to care standards for all providers
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, Pediatrics +1 more·Provider Update
Effective date
Jul 1, 2022
We identified it
Jun 19, 2026
Summary
This policy establishes access to care standards defining which providers can serve as Primary Care Providers (PCPs) and their responsibilities for coordinating member healthcare. It specifies that PCPs must be board-certified physicians in internal medicine, pediatrics, or family medicine, or qualified nurse practitioners, physician assistants, and some Ob/Gyns.
Action Required
Review current provider credentialing to ensure all PCPs meet the specified qualifications (board-certified MDs/DOs in internal medicine, pediatrics, or family medicine, or appropriately licensed nurse practitioners, physician assistants, and qualifying Ob/Gyns). Verify that access to care monitoring standards are being met for member accessibility to PCPs, behavioral health providers, and specialists.