CommercialAdministrativeMedium impact
NEHP & State of Rhode Island Cross Border Notification Guide
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Feb 1, 2020
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island has updated their cross border notification guide for NEHP and State of RI plan members, specifying different referral workflows based on whether members see specialists within Rhode Island, elsewhere in New England, or have PCPs in different states. The policy clarifies when to use Health Trio for referrals versus cross border notification workflows through bcbsri.com or the PCP's local plan.
Action Required
Immediately: Billing and front desk staff must verify member plan type (NEHP vs State of RI) and PCP location before scheduling specialist appointments. For RI members with RI PCPs seeing out-of-state specialists, obtain cross border notification via bcbsri.com. For members with New England PCPs, follow the PCP's local plan cross border workflow. Update scheduling protocols to check specialty referral requirements in Health Trio system.