CommercialAdministrativeMedium impact
Cross-border notification reminder
Blue Cross Blue Shield of Rhode Island·RI·Physician
Effective date
Mar 1, 2020
We identified it
Jun 19, 2026
Summary
BCBSRI updated cross-border notification requirements for NEHP and State of Rhode Island members when seeing specialists outside of Rhode Island. Different workflows apply depending on member's plan type, PCP location, and specialist location within the New England region.
Action Required
Immediately: Billing team and providers must implement cross-border notification workflow for BCBSRI NEHP and State of RI members. For RI members seeing out-of-state specialists in New England region, enter cross-border notification on bcbsri.com before appointments. For members with New England PCPs, follow the New England cross-border notification workflow through the PCP's local plan. Update scheduling staff to verify member plan type and provider locations before booking specialist appointments.