Medicare AdvantagePrior AuthHigh impact
Prior authorization changes effective December 1
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Dec 1, 2020
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island is temporarily suspending prior authorization requirements for urgent/emergent inpatient care, long-term acute care, acute inpatient rehabilitation, and skilled nursing services due to COVID-19, effective December 1-31, 2020. However, notification requirements within 48 hours of admission and discharge still apply to ensure proper reimbursement.
Action Required
Immediately: Continue submitting admission notifications via BCBSRI portal within 48 hours of admission and discharge notifications within 48 hours of discharge for all inpatient stays, even though prior authorization is temporarily suspended. For skilled nursing facilities, notify within 3 days of admission by faxing to 401-459-1623. Elective hospital procedures still require prior authorization. Failure to notify may result in claim reimbursement issues.