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Hints for HEDIS® (and more)
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +1 more·Physician
Effective date
Mar 1, 2021
We identified it
Jun 19, 2026
Summary
BCBSRI has updated their HEDIS quality improvement guidelines focusing on colorectal cancer screening for members aged 51-75. The policy provides detailed billing guidance for various screening methods including colonoscopy, FIT tests, and Cologuard, along with exclusion criteria and recommended frequencies.
Action Required
Review HEDIS colorectal cancer screening requirements for members 51-75 years old. Ensure proper documentation of exclusions including colorectal cancer diagnosis, total colectomy history, hospice care, and long-term care facility residence. Contact Quality Concierge Team at QualityHEDIS@bcbsri.org or (401) 459-1005 for gap in care report assistance and HEDIS support.