CommercialPrior AuthHigh impact
BCBSRI will resume prior authorization for Skilled Nursing admission effective March 1, 2022
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, Emergency Medicine +4 more·Facility
Effective date
Mar 1, 2022
We identified it
Jun 19, 2026
Summary
BCBSRI is reinstating prior authorization requirements for skilled nursing facility admissions starting March 1, 2022. This means providers must obtain approval before patients can be admitted to skilled nursing facilities for BCBSRI members.
Action Required
By March 1, 2022: All clinical staff must obtain prior authorization from BCBSRI before arranging skilled nursing facility admissions for BCBSRI members. Update discharge planning workflows to include prior auth step. Update EMR templates to remind providers of this requirement. Failure to obtain prior authorization may result in denied coverage for skilled nursing stays.