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
Apr 1, 2021
We identified it
Jun 19, 2026
Summary
BCBSRI contracted providers must now refer members exclusively to in-network providers for all services including durable medical equipment, radiology, behavioral health, and laboratory services. Three specific laboratories (Total Toxicology, U.S. Lab & Radiology Inc., and Quest) are confirmed as out-of-network and cannot be used for BCBSRI member referrals.
Action Required
Immediately: All providers must verify network status using BCBSRI's Find a Doctor tool before making any referrals for BCBSRI members. Stop referring to Total Toxicology, U.S. Lab & Radiology Inc., and Quest laboratories. Update referral protocols to require network verification for all services including DME, radiology, behavioral health, and lab services. Train staff to use the Find a Doctor tool for all BCBSRI referrals to avoid claim denials and member coverage issues.