CommercialAdministrativeHigh impact
February 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 all primary care providers to use their web-based referral management tool for specialist referrals instead of paper processes, effective January 1, 2017. Claims for specialist services without proper web-based referrals may be denied for BlueCHiP Commercial, BlueCHiP for Medicare Advance, and New England Health Plan products.
Action Required
Immediately: Primary care providers must submit all specialist referrals through BCBSRI's web-based referral management tool for dates of service on or after January 1, 2017. Specialists must verify referrals are in place before rendering services. Update workflow to use web portal instead of paper/fax for BlueCHiP Commercial, BlueCHiP for Medicare Advance, and NEHP products. Claims without proper web-based referrals will be denied.