All PlansAdministrativeMedium impact
Radiology components reminder
Blue Cross Blue Shield of Rhode Island·RI · Radiology, Diagnostic Imaging, Orthopedics +1 more·Physician / Facility
Effective date
Apr 1, 2020
We identified it
Jun 19, 2026
Summary
When the same radiology procedure is performed multiple times on the same day by different providers/facilities, the second claim submitted will be automatically denied. Providers must appeal these denials with documentation proving the member was legitimately seen at their facility.
Action Required
Immediately: Billing team must establish appeal process for radiology claims denied due to same-day duplicate procedures. When radiology claims are denied for duplicate services, prepare appeals with documentation showing patient was legitimately seen at your facility. Monitor radiology claim denials closely and respond promptly with supporting documentation.