CommercialAdministrativeHigh impact
MHK implementation
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Sep 1, 2019
We identified it
Jun 20, 2026
Summary
BCBSRI is implementing a new prior authorization platform called MHK (formerly MedHOK) in September 2019, replacing the current Clear Coverage platform for outpatient services and direct portal entry for hospitals. All prior authorization requests for outpatient services and acute inpatient level of care must be submitted through this new system.
Action Required
By September 2019: All staff must transition from Clear Coverage platform to new MHK system for BCBSRI prior authorization requests. Ensure access to bcbsri.com provider portal (contact ProviderRelations@bcbsri.org if needed). Attend mandatory training sessions and provide training preference feedback to ProviderRelationsSeminars@bcbsri.org by August 2019. Update workflow procedures for both outpatient and inpatient prior authorization submissions.