CommercialAdministrativeHigh impact
Split billing
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Jan 1, 2020
We identified it
Jun 19, 2026
Summary
BCBSRI now requires all services performed by the same provider on the same date to be billed on a single claim. Split billing across multiple claims is prohibited and will result in pre-pay/post-pay audits and recoveries.
Action Required
Immediately: Billing team must update workflows to ensure all services by the same provider on the same date are submitted on a single claim. Update billing software to flag potential split billing scenarios. Train staff to identify procedures with 0-, 10-, or 90-day global periods that must be billed with E&M services using modifier 25 on the same claim. Review current claims processes to prevent inappropriate fragmentation that could trigger audits and recoveries.