CommercialPrior AuthHigh impact
COVID-19 Authorization Changes
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jul 8, 2020
We identified it
Jun 19, 2026
Summary
BCBSRI is resuming prior authorization requirements for inpatient care, skilled nursing, and rehabilitation services effective July 8, 2020, but COVID-19 related cases remain exempt from prior auth. Hospitals must now obtain prior authorization for post-acute care placements, and COVID-19 admissions still require notification within 48 hours.
Action Required
Immediately: Billing team must update system to require prior authorization for all urgent/emergent inpatient admissions, skilled nursing services, acute inpatient rehabilitation, and long-term acute care unless COVID-19 related. Continue entering all admissions via BCBSRI portal within 48 hours. For COVID-19 cases, ensure discharge notification is sent within 48 hours of discharge (fax Prospect members to 401-429-6377). Coordinate with discharge planning to ensure they obtain prior auth for post-acute care transfers.