CommercialAdministrativeHigh impact
April 2017
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +1 more·Provider Update
Effective date
Jan 1, 2017
We identified it
Jun 20, 2026
Summary
BCBSRI now requires primary care providers to submit referrals through a web-based referral management tool (effective January 1, 2017) for BlueCHiP Commercial, BlueCHiP for Medicare Advance, and NEHP products. Claims may be denied if services are rendered without proper web-based referrals being entered.
Action Required
Immediately: Primary care providers must use BCBSRI's web-based referral management tool for all BlueCHiP Commercial, BlueCHiP for Medicare Advance, and NEHP referrals. Specialists must verify referrals are in place before rendering services. Update workflow to check referral status via the secure Provider site Patient Eligibility section. Contact Physician & Provider Service Center at (401) 274-4848 with questions. Claims will be denied if services are rendered without proper web-based referrals.