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Medicare AdvantageAdministrativeMedium impact

New PPO Medicare Plan for 2020 – HealthMate for Medicare

Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Jan 1, 2020
We identified it
Jun 19, 2026
Days to comply

Summary

BCBSRI launched a new Medicare Advantage PPO plan called HealthMate for Medicare effective January 2020. This plan allows out-of-network access nationwide and reimburses out-of-area services at BCBSRI contractual MA rates instead of potentially lower rates.

Action Required

Action needed
Immediately: Billing team must verify patient eligibility through BCBSRI's secure provider portal before each encounter to confirm if patients selected the new HealthMate PPO plan for 2020. Update workflow to check plan type during registration to ensure proper billing and reimbursement rates for out-of-area services.