CommercialAdministrativeMedium impact
Reminder: Claim filing across states for telemedicine services
Blue Cross Blue Shield of Rhode Island·RI·Physician / Behavioral Health
We identified it
Jun 20, 2026
Summary
BCBSRI has clarified claim filing rules for telemedicine services provided across state lines. When BCBSRI providers treat BCBSRI members in contiguous out-of-state areas, claims go to BCBSRI; for non-BCBSRI Blues members in those areas, claims go to the state where services were rendered.
Action Required
Immediately: Billing team must verify member plan type and service location for all telemedicine claims. For BCBSRI members receiving services in contiguous out-of-state areas (Attleboro, Fall River, Swansea), submit claims to BCBSRI. For non-BCBSRI Blues members in these areas, submit claims to the Blue plan in the state where services were rendered. For BCBSRI NEHP members (RIA, RIS, RIN) seeing Massachusetts PCPs, submit claims to Blue Cross & Blue Shield of Massachusetts.