CommercialAdministrativeMedium impact
Reminder: Claims adjustments vs. appeals
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
We identified it
Jun 20, 2026
Summary
BCBSRI clarifies the distinction between claims adjustments and appeals processes. Claims adjustments (retractions, corrections, medical records) must be sent to the claims department using the Physician/Provider Claim Adjustment Request Form, while appeals must use the separate Appeal Request Form and go to the Grievance & Appeals Unit.
Action Required
Immediately: Billing team must ensure all claims adjustments (retractions, corrections, medical records submissions) are sent to the claims department using the Physician/Provider Claim Adjustment Request Form at the address on the form. Use the separate Physician/Provider Appeal Request Form only for true appeals and send to the Grievance & Appeals Unit. For timely filing denials due to retractions from other plans, include copy of other plan's retracted RA with adjudication date.