CommercialCoverageMedium impact
NEHP tiered network
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +1 more·Provider Update
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Summary
Blue Cross & Blue Shield of Rhode Island is launching Network Blue New England Options on October 1, 2019, a tiered network product where providers are assigned to Standard or Enhanced benefit levels based on cost and quality metrics. Members will have different cost-sharing depending on which tier their provider is assigned to.
Action Required
Before October 1, 2019: Billing team must verify provider tier assignments (Standard vs Enhanced) in the Network Blue New England Options network. Update patient eligibility verification process to identify member benefit levels. Monitor periodic updates to provider tier assignments as BCBSRI will update these lists based on new cost and quality data.