CommercialPrior AuthHigh impact
New skilled nursing facility admission request process
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice·Physician
Effective date
Apr 1, 2019
We identified it
Jun 20, 2026
Summary
BCBSRI has streamlined the prior authorization process for skilled nursing facility (SNF) admissions. Providers must now obtain authorization before admitting patients to SNFs, with authorization valid for 72 hours, and all parties will be notified of determination decisions.
Action Required
Immediately: Providers must obtain prior authorization from BCBSRI before admitting any patient to a skilled nursing facility. Access the new request form in the Provider Portal under Coordination of Patient Care section. Do not admit patients until authorization number is received. If patient is not admitted within 72 hours of authorization, submit a new request. Failure to obtain prior authorization will likely result in coverage denial.