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CommercialPrior AuthHigh impact

New membership effective January 1, 2020

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 is welcoming two new large employer accounts effective January 1, 2020: The State of Rhode Island and Lifespan. Prior authorizations are required per plan benefits and must be verified before scheduling services, with previous carrier authorizations being transferred to BCBSRI's system.

Action Required

Action needed
Immediately: Billing team must verify BCBSRI prior authorization requirements before scheduling services for members with prefixes RIS, R2I, and L7S. Call (401) 274-4848 or 1-800-230-9050 to confirm authorizations on file as they won't be visible in the provider portal. Front desk staff must enter referrals in Health Trio for State of Rhode Island Anchor plans to ensure lower copayments. Failure to obtain proper authorizations or referrals will result in claim denials or higher member copayments.