Bcbsri com providers phone number Find an eye doctor. BCBSRI is your contact for claims payment, problem BCBSRI to Introduce Provider Web PIN Self Service As previously communicated, we have introduced a web personal identification number (PIN) self-service capability. Simon@bcbsri. 4. 3 days ago · *$20 preferred insulin copay (30-day supply) or $50 (90-day) for preferred insulins on Tier 3. We do this to ensure personalized service for every member. This type of coordinated care makes it easier for you to find your way through the healthcare system so you can focus on getting or staying healthy. A customer service representative will respond to your request within one With your member ID card, you have access to thousands of providers across the country. Use My Health Toolkit ®. org prior to the meeting. Mail: Blue Cross & Blue Shield of Rhode Island. BCBSRI. Please continue to use your BCBSRI payer ID when submitting electronic claims. com provider portal to request prior authorizations beginning October 1, 2019. edi. Does every provider in my group need to take the training and attest? Yes. for a conference call with the Provider Relations team, who will provide important updates and reminders We encourage you to submit any questions you would like addressed during the call related to the topics above, or to other topics, to ProviderRelationsSeminars@bcbsri In the BCBSRI MHK Provider Portal, providers will now have the ability to add a six-digit extension to their contact phone number. This list is current as of July 1, 2024, and is subject to change. Refer to the phone number on the back of your card. To help providers with completing the training, we are offering multiple sessions for providers to join a live training and we will attest for the provider. We recommend that this notice be attention to Provider Relations. Medicare Advantage See all your options, compare plans, and enroll. Oct 1, 2021 · Medicare Advantage See all your options, compare plans, and enroll. Providers and doctors call these Blue Cross & Blue Shield Rhode Island phone numbers for eligibility and other questions. com or call our Customer Service Department at 1-800-267-0439, October 1 - Type of Provider There are approximately 1,359 Primary Care Physicians (PCP Dec 1, 2024 · Effective January 1, 2025, BCBSRI will move from facility contracting and billing and will start credentialing licensed chemical dependency professionals (LCDPs) individually. com or if you need assistance with MHK, please contact our Provider Relations team at ProviderRelations@bcbsri. When you arrive at a participating doctor's office or hospital, simply present your plan ID card. m. Back to Provider Update Nov 1, 2024 · We encourage you to submit any questions you would like addressed during the call to ProviderRelationsSeminars@bcbsri. Following the call, we will post a summary of topics covered to our Provider Conference Info page on our secure provider portal. Jun 1, 2022 · If you do not know who your administrator is, contact your Provider Relations representative. Providence, Rhode Island 02903. org. . All PCP visits (including sick visits) will now have a $0 copay for dates of services on or after January 1, 2025. Log on to the provider portal of BCBSRI. 2 High-Value Provider network consists of Care New England, Oak Street Health, and Prospect CharterCARE primary care provider (PCP) groups. Habla usted español? Online. Rhode Island Help Center: Important contact information for Blue Cross & Blue Shield of Rhode Island. NOTE: If you don’t take action before December 31, 2024, you will lose your prescription drug coverage and only be covered by Original Medicare (Parts A and B—hospital and medical) starting January 1, 2025. org Nov 18, 2024 · Medicare Advantage See all your options, compare plans, and enroll. 3 days ago · Medicare Advantage See all your options, compare plans, and enroll. This new, more efficient process eliminates the need to mail or fax a Health care providers, find a Blue Cross NC phone number for info on eligibility, benefits and claims status, plus medical policies, contract updates and more. D. 500 Exchange Street. For dates of service on or after October 1, 2019 providers must access EviCore by accessing the bcbsri. You can also use the Find a Doctor tool at bcbsri. All Practitioner Change Forms can be faxed to 401-459-2099 or emailed to ProvDB@bcbsri. Paper claims. You can contact us online anytime day or night with Secure Messaging. Already a BCBSRI Medicare Advantage member? If your practice is interested in converting your systems, and wishes to move from paper to electronic claims submission, visit the HIPAA section of the BCBSRI. All categories BCBSRI update Provider Relations Physician & Provider Call Center Quality Behavioral health Pharmacy Products & benefits Claims Policies Archive Show me Nov 1, 2024 · PCP $0 cost sharing. Oct 7, 2024 · As a reminder, you are required as a participating provider in the D-SNP network to complete the annual D-SNP training by March 31, 2025. BCBSRI Behavioral Health Case Management Program is staffed by experienced mental health and substance use professionals who can provide education and support, assist with coordination of care, and help to close gaps related to social determinants of Dec 1, 2024 · To refer a patient to the BCBSRI BH Case Management Program, please call 1-800-274-2958 or email traige_group@bcbsri. for a conference call with the Provider Relations team, who will provide updates and reminders on the following topics: Medicare copay for telemedicine correction reminder ; New vs existing patient audit ; Last live D-SNP training dates; Policy Update – Laparoscopically Your primary care provider (PCP) can coordinate your care with specialists, labs, hospitals, and any other providers you might need. You can also find our telephone numbers and hours of operation on the Contact Us page. To obtain access to bcbsri. If you are a Preferred Provider Organization (PPO) member, the doctor will recognize the PPO Suitcase logo, which will ensure you will get the PPO level of benefits. Click on Case Management Dec 1, 2024 · All plans offer this payment option and participation is voluntary. A few highlights of your plan: $0 for many preventive services, such as your annual physical, when you see a network provider; Predictable copays for many services; Lower costs for seeing in-network providers; Access to an extensive national network; View See the end of this page for our phone number and other ways to speak with us. Call us if you’d like an orientation at your office about provider publications or: Online preauthorization requests – This is a convenient way to submit preservice or aftercare authorization requests. Click on Case Management Medicare Advantage See all your options, compare plans, and enroll. Failing to provide direct contact information may delay the provider's enrollment request. Policy@bcbsri. See what BlueCare Connect can do for you. 23. You also can view a quick summary of benefits below: 2025. 2024 Participating Dental Provider Administrative Manual; Electronic funds transfer (EFT) enrollment; Dental policies; Claims filing Electronic claims. Nov 1, 2024 · All plans offer this payment option and participation is voluntary. If you already have dental coverage with BCBSRI, you can find everything you need to know about your plan, including covered services and claims, through the Dental Benefits section of your online account. 6067 Fax: (401) 459-2287 Please contact your account executive or call our main number at (401) 459-1000 or 1-800-637-3718 outside Rhode Island. Nov 14, 2023 · BCBSRI when a provider is no longer going to be practicing for your group. Tier 4 formulary insulins will have a $35 (30-day supply) or $105 (90-day) copay. Following the alphabetical list are listings by location and specialty, and by the type of provider. Apr 23, 2024 · In order to make the appeals process more efficient, please ensure you provide a valid name and phone number on your appeal requests for the person who will schedule peer-to-peer discussions. com by following these easy steps: 1. If you Nov 1, 2024 · To refer a patient to the BCBSRI BH Case Management program, please call 1-800-274-2958 or email triage_group@bcbsri. The 2023 PQIP booklet and future updates can be found on the BCBSRI Provider Portal under Quality > PQIP. Aug 1, 2024 · We encourage you to submit any questions you would like addressed during the call to ProviderRelationsSeminars@bcbsri. Tiering of ASC/OP hospital cost sharing Why choose BCBSRI? Network coverage; Pharmacy & prescriptions; What's included in all plans; Your Blue Store; contact: Physician and Provider Service (401) 274-4848 BCBSRI’s BH staff will be in touch with you within 3 business days to provide your authorization number needed for claims processing. If you are not sure who your Provider Relations representative is you can reach out to Provider. Dec 1, 2024 · Medicare Advantage See all your options, compare plans, and enroll. Oct 1, 2021 · Looking for a Medicare Advantage plan? Talk to our Medicare Sales team 1-800-505-BLUE (2583) (TTY: 711) Or request a sales call. With a single log-in or phone call, you can access health and wellness apps, plan information, care management, and customer service—and get personalized health support from Care Guides, nurses, and coaches. Connect with member customer service or find the right support resources, including your local Blue Cross and Blue Shield (BCBS) company, general FAQs and media relations contacts. Please Contact Physician and Provider Service Center: (401) 274-4848 to your local Blue plan — BCBSRI. To attend the session online, please join using Microsoft Teams. Dec 1, 2024 · For additional information or to find a Headway provider, please visit: Headway | Find Therapists Covered by Your Insurance or contact BCBSRI Behavioral Health Care Management by phone at 1-800-274-2958 or triage_group@bcbsri. com > Providers > Forms. ; Medicare Supplement Help cover costs with a Plan 65 option. 3. If the provider does not attend the training, will BCBSRI follow up? Yes, BCBSRI will follow up with the individual provider after the Q1 deadline. And mark your calendar for our next conference call on Tuesday, January 14, 2025 from 10am-11am. Mar 1, 2024 · BCBSRI invites providers to join us on Tuesday, March 12 from 10-11 a. As a BCBSRI-contracted provider, it is your obligation to coordinate member care with contracted, in-network providers, for all BCBSRI plans and products. Payment Errors You can see what is on the site at Provider Portal Enhancements. Send paper claims to: Dental Claims A specific customer service center supports each member. Practitioner Change Forms are located on bcbsri. org Personalized Trainings: Kathleen. How do you find BlueCHiP for Medicare’s providers in your area? You may look up a provider by last name in the alphabetical physician/provider listing starting on Page 1 of this directory. 137 drugs moving from Preferred Generic to Generic On January 1, BlueCare Connect will replace myBCBSRI. For other language assistance or translation services, please call the customer service number for your local Blue Cross and Blue Shield company. Relations@bcbsri. Printed Materials and Plan Specifics: ProviderRelations@bcbsri. Dec 1, 2024 · If you have any questions regarding this call, please contact ProviderRelations@bcbsri. Nutrition plays a critical role in maintaining optimal health—and we want to help! BCBSRI offers our Medicare Advantage members a meal delivery program through ILS Meals by Independent Living Systems. Dental Direct Basic; Dental Direct Standard; Dental Direct Plus; Dental Direct Elite Oct 1, 2024 · The notice shall be sent by certified mail, return receipt requested, postage prepaid. The codes included in this booklet are the most commonly used, but are not exhaustive. This Medicare Prescription Payment Plan fact sheet has helpful information about the program and will be sent to all BCBSRI Medicare Part D members. BCBSRI will require that all LCDPs are individually credentialing by February 1, 2025. If you have 150 providers in your group, all 150 will need to take the training and fill out the attestation form. Previously limited to four digits, this extension option allows for more accurate contact information, making communication with our UM team easier for those who have extensions more than four digits long. Prior authorizations can be requested using the phone 1-888-233-8158 beginning on September 23, 2019 for dates of service October 1, 2019 and beyond. Healthy choices earn rewards You and your employees can earn with Wellness Premium Reward. to 4:30 p. Out-of-state: 1-800-676-2583 Physician and Provider Service Center (401) 274-4848 or 1-800-230-9050 Complex claims inquiries, policies and procedures, business practice change requests, and Web access information Hours: Monday through Friday, 8:00 a. Practitioner Change Forms are locations at bcbsri. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. org Nov 1, 2023 · BCBSRI’s PQIP booklet contains acceptable codes for each of the PQIP measures. All Practitioner Change Forms can be faxed to Oct 1, 2024 · BCBSRI has seen an increase in claims processed by out-of-network providers or laboratories which were referred by a participating BCBSRI provider. BCBSRI members rated us #1 in member satisfaction among commercial health plans in the Northeast region - J. Please call the Customer Service telephone number on the back of your Member ID card. Facility Call Center (401) 274-3103 or 1-800-637-3718, ext. ; Extra Help Plans Medicare + Medicaid and the new Access plans. To contact the Information Assurance team for more information, please call (401) 459-1970 or send an e-mail to hipaa. See slide above for Provider Portal verification information. support@bcbsri. You can contact us in a couple of ways: Check the back of your membership card for your specific customer service phone number . Call the toll-free number on the back of your member ID card for BCBS customer service. When you can’t see your doctor in-person, Doctors Online is a great option. Click on Tools and Resources. com Nov 1, 2024 · Medicare Advantage See all your options, compare plans, and enroll. Please note this information would not be shared outside of BCBSRI. Members can opt in to this program if they are actively enrolled in a Medicare Part D plan. Sign in to your Blue Cross Blue Shield of Rhode Island account. Use the Find a Doctor tool if your vision exam is covered under your medical plan. If you have Blue Cross Vision, use this option for routine eye exams, glasses, and contacts. com. According to RI State regulations, BCBSRI will make two attempts to schedule a peer-to-peer for appeals denied for medical necessity. Power. This includes services such as durable Apr 1, 2024 · BCBSRI invites providers to join us on Tuesday, April 9 from 10-11 a. Self-guided Study: Complete the 2025 Provider Attestation form CMS Annual Requirement for ALL providers, cannot be delegated. Nov 1, 2024 · For more information, you may contact the BCBSRI BH Case Management Program at 1-800-274-2958. Members are able to elect into this program if they are actively enrolled in a Medicare Part D plan. Tiering of ASC/OP hospital cost sharing Dec 1, 2024 · Email: Medical. com Nov 1, 2024 · Tiering and formulary updates for Medicare members: 470 drugs moving off formulary ; 936 drugs moving to Higher Tiers; Tiering changes. If you Dec 1, 2024 · PCP $0 cost sharing. Dec 1, 2024 · Read Provider Update This monthly newsletter delivers updates on policies, changes to benefits, and other news you need to know. 2. You must provide 60 days notice to BCBSRI when a provider is no longer going to be practicing for your group. Click on Forms. org Personalized Trainings: ProviderRelations@bcbsri. 22. Please note that as a participating provider, it is your responsibility to notify members about non-covered services prior to rendering them. You may also use our automated referral form at BCBSRI. Attention: Medical Policy, CPT Review. Nov 12, 2024 · for provider offices to contact BCBSRI when a provider is leaving your practice. Please note from time to time it may be necessary for our Medical Director or their designee to speak to the provider directly. Oct 1, 2021 · $0 meal delivery after an inpatient hospital stay. If you have any questions about changes to our standard fee schedule, please contact provider relations at 1-844-707-5627 or email ProviderRelations@bcbsri. Access provider publications including: Participating Provider Administrative Manual; BCBSRI Practice Guidelines; Orientation visits. com provider website. BCBSRI participating providers will be able to obtain their PIN electronically when registering on bcbsri. Don’t see your provider on the BCBSRI portal? Please note that only your office administrator can add providers to your BCBSRI. ehflymv kglf xnqlx czohd dcl uusx ihvctjt gfagn erdq myqsuv
Bcbsri com providers phone number. Providence, Rhode Island 02903.
