CommercialPrior AuthMedium impact
Artificial Pancreas Device System
Blue Cross Blue Shield of Rhode Island·RI · Endocrinology, Family Medicine, Internal Medicine +1 more·Physician / Facility
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Summary
BCBSRI is updating medical criteria for prior authorization requirements for Artificial Pancreas Device Systems, effective October 1, 2019. The billing team needs to review the updated prior authorization criteria to ensure compliance when billing for these devices.
Action Required
By October 1, 2019: Billing team must review the updated prior authorization medical criteria for Artificial Pancreas Device Systems at the provided policy link. Update billing workflows to ensure prior authorization is obtained according to the new criteria before submitting claims. Claims without proper prior authorization will be denied.