CommercialAdministrativeMedium impact
MHK Reminders
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
May 3, 2021
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island updated their MHK prior authorization system with important provider selection requirements and interface changes. When submitting prior auth requests, billing staff must select providers with 'Par' status instead of 'Contracted' status to increase automatic approval rates and avoid clinical review delays.
Action Required
Immediately: Train all staff who submit prior authorizations in MHK to select only providers with 'Par' status in the Provider Status field, avoiding 'Contracted' status providers. Update workflows to account for relocated Contact Name field (now under ZIP Code line) and optional Contact Phone field. Ensure staff never select the 'non participating provider' checkbox in MHK.