CommercialAdministrativeMedium impact
Direct Pay Claims Pending
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
May 1, 2022
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island Direct Pay member claims may now be suspended for up to 150 days if members owe premiums, extended due to COVID-19 public health emergency. Providers cannot bill patients during suspension and must wait for claim release or coverage termination denial.
Action Required
Immediately: Billing team must monitor BCBS RI Direct Pay claims for extended pending status up to 150 days. Do not bill patients for suspended claims until receiving payment or termination denial. Update accounts receivable processes to track these extended pending periods and adjust collection workflows accordingly.