CommercialAdministrativeHigh impact
Requirement to refer members to in-network providers for all BCBSRI products
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Jun 1, 2021
We identified it
Jun 19, 2026
Summary
BCBSRI providers must refer members only to in-network providers for all services including durable medical equipment, radiology, behavioral health, and lab services. Three specific laboratories (Total Toxicology, U.S. Lab & Radiology Inc., and Quest Diagnostics) are confirmed as out-of-network and should not be used for referrals.
Action Required
Immediately: All providers must verify network status using BCBSRI's Find a Doctor tool before establishing any referral relationships. Stop referring BCBSRI members to Total Toxicology, U.S. Lab & Radiology Inc., and Quest Diagnostics. Update referral protocols and staff training to require network verification for all services including DME, radiology, behavioral health, and laboratory services. Failure to use in-network providers may result in coverage issues for patients.