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 in September 2019, replacing the current Clear Coverage platform for outpatient services and the direct portal entry system for hospitals. All prior authorization requests for outpatient services and acute inpatient level of care will need to be submitted through this new system.
Action Required
By September 2019: Billing and authorization staff must transition from Clear Coverage platform to new MHK system for all BCBSRI prior authorization requests. Ensure staff have access to bcbsri.com provider portal (contact ProviderRelations@bcbsri.org if needed). Attend mandatory training sessions scheduled by Provider Relations team. Send training preference (office visit, Your Blue Store location, or webinar) to ProviderRelationsSeminars@bcbsri.org in August. Failure to transition will prevent submission of prior authorization requests.