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Blue Cross Blue Shield of Rhode Island·RI · OB-GYN, Family Medicine·Provider Update
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield Rhode Island has published detailed HEDIS quality measure guidance for prenatal and postpartum care (PPC), providing specific documentation requirements and procedures that must be captured to meet quality metrics. This affects billing and documentation practices for OB/GYN visits and related prenatal/postpartum services.
Action Required
Immediately: Review current prenatal and postpartum visit documentation to ensure compliance with HEDIS PPC requirements. Update EMR templates to include required elements: pregnancy documentation (LMP, EDD, gestational age), obstetrical examinations (fetal heart tones, fundus height), required lab panels (obstetric panel including hematocrit, WBC, hepatitis B, rubella, syphilis tests), and postpartum care elements (pelvic exam, vital signs, depression screening). Train providers on proper documentation to capture quality metrics and avoid gaps in care reporting.