Medicare AdvantagePrior AuthMedium impact
Temporary Medicare Advantage referral Requirement Waiver
Blue Cross Blue Shield of Rhode Island·RI·Physician
Effective date
Mar 1, 2020
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island is temporarily waiving referral requirements for Medicare Advantage plans retroactively from March 1, 2020 due to COVID-19. Claims previously denied for missing referrals will be automatically adjusted by the insurer. Commercial plans are not affected and still require referrals.
Action Required
Immediately: Billing team should resubmit any BCBS RI Medicare Advantage claims denied for missing referrals with dates of service March 1, 2020 or later. Monitor for automatic adjustments from BCBS RI on previously denied claims. Continue obtaining referrals for all commercial BCBS RI members as usual.