Bcbsri provider benefits phone number. Date of birth (YYYY-MM-DD) .

Bcbsri provider benefits phone number (Open seven days a week, 8:00 a. com to be placed back on the BCBSRI provider directory- Contact Plan for details. You will find a broad range of topics in . an independent company that administers Doctors Online on behalf of Blue Cross & Blue Shield of Rhode Island. Our Medicaid Specialists will assist D-SNP members with the annual recertification process. BasicBlue Direct 2500/5000; BasicBlue Direct 5500/11000; BlueCHiP Direct 2300/4600 Our plan covers an unlimited number of days for an in-network inpatient hospital stay. Blue Cross & Blue Shield of Rhode Island 2023 Updates February 14, 2023 Presented by: Stef Vito, Director, Provider Relations. Full name and valid phone number of the person who will be responsible for Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Effective July 1, 2022, Blue Cross & Blue Shield of Rhode Island (BCBSRI) will require the National Drug Code (NDC) to be filed on all claims submitted with a phone number and accepting new patients' status, etc. 10. Providing these links is not an endorsement or referral of a particular provider or organization. Dedicated contact for billing inquiries; 1-800-637-3718 ext. The maximum amount you would pay out-of-pocket for covered healthcare services each year, including deductible, copays, and coinsurance. A Group Medicare Advantage plan from BCBSRI can give you an edge in both the recruitment—and retention—of top talent. Afterwards, it will be open from 9 a. BCBSRI to Introduce Provider Web PIN Self Service As previously communicated, we have introduced a web personal identification number (PIN) self-service capability. To contact the Information Assurance team for more information Contact plan for details. FEP began mailing replacement ID cards to members enrolled in the FEP Blue Focus product option in November 2023. copays, and coinsurance. Your doctor and other providers use this number when filing claims for services they provided to you. Enrollment in Blue Cross & Blue Shield of Rhode Island Blue Cross & Blue Shield of Rhode Island is an HMO plan with a Medicare contract. ; Medicare Supplement Help cover costs with a Plan 65 Call the toll-free number on the back of your member ID card for the right number for your personal policy. We will be in touch soon to help you choose a plan that's right for you. please submit your receipts, along with your name, address, and member ID number to: Blue Cross & Blue Shield of Rhode Island Attention: Claims Department 500 Exchange Street Providence, RI 02903 $0 visits to your primary care provider at a PCMH ; $0 online doctor visits 24/7 2; contracted by Blue Cross & Blue Shield of Rhode Island to provide vision hardware benefit call Independent Living Systems at 833-853-8946 (toll free) and provide your BCBSRI Member ID number. Deliveries are Medicare Advantage See all your options, compare plans, and enroll. Office Contact Phone Number: Requesting Provider Main phone #: Contact Fax Number: Procedure CPT codes: benefit management (PBM) drugs, and Fully insured Infertility services. com provider website. 48 : Entity's name, address, phone and id number. With the exception of emergencies or urgent care, it may cost more Blue Cross Blue Shield of Rhode Island Home Webpage. You must provide 60 days notice to BCBSRI’s BH staff will be in touch with you within 3 business days to provide your authorization number needed for claims processing. Routine membership, eligibility, benefit information, and claims status for all BCBSRI Regularly check your claims history by logging in to your BCBSRI account. Mondays through Fridays. It only takes a couple of minutes and will help us improve our service. If you are a Member calling about one of your supplemental benefits, please call the Toll-Free Number provided to you by your health plan related to that benefit, or you can access your account online. Sales support. •Providers must attest on bcbsri. BCBSRI. Related articles. According to State of RI regulations, BCBSRI will make two attempts to schedule a peer-to-peer discussion for appeals denied for medical necessity. Let us know what you think. You pay these amounts each benefit period until you reach the in-network 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. Find your local BCBS company here. Please contact BCBSRI if you see anything suspicious. org. Services are covered under the member durable medical equipment benefit and the services do not require prior As part of our ongoing work to improve access to pricing information and as required under the new Transparency in Coverage rule, Blue Cross & Blue Shield of Rhode Island (BCBSRI) is making available machine-readable files with provider payment information. Tax identification number (TIN) visit the HIPAA section of the BCBSRI. View our list of drugs Value Based Benefit (VBB) Incented Copay Drug List. You can get information such as board certification status, languages spoken by the doctor, and whether the office is wheelchair accessible. Call your Blue ® Plan for pre-certification or prior authorization, if If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. , Monday through Friday ”) Coverage. If you need hearing aids, your provider will work with you to select the Please contact the Medicare Concierge Team for information. Provider Relations (401) 274 Do you have a Medicare plan? Call (401) 277-2958 or 1-800-267-0439 (TTY: 711) Hours: Monday through Friday, 8:00 a. Don't have your card? Use the tool To find nearby doctors and hospitals, access the Find a Doctor or Hospital tool or call BlueCard Access at 1-800-810-BLUE. Forgot username? Forgot password? Need to register? How can we Fill in your search criteria below. to 8:00 p. Con BlueRI for Duals (HMO D-SNP), no solo obtendrá todos los beneficios de la Parte A y la Parte B por $0, sino que obtendrá más extras. Phone number: * Date of birth: * Address 1 ZIP code: * By submitting this form, I understand that I will be contacted by Call 866-304-2138 (TTY:711) and speak with a dedicated Member Experience Advisor, 8 a. 126: Entity's address. Other forms you might need. After the out-of-pocket is met, in-network covered services are paid at 100% by Blue Cross & Blue Shield of Rhode Island. to noon. Contact the Medicare Sales team at 1-800-505-2583 (TTY: 711). London Health works collaboratively with BCBSRI to combine the benefits of CDHPs with wellness to lower costs and increase employee engagement. You must provide 60 days notice to phone number. If you have received a new Benefits Prepaid Card, you must activate your card to use your 2024 benefits. Claims may be filed either electronically or on paper for Blue Cross & Blue Shield of Rhode Island (BCBSRI) plan members and out-of-state Blue Cross & Blue Shield plan members. PROVIDER ADMINISTRATIVE MANUAL CHAPTER 2– Key Contact List for Physicians/Providers BlueLine (401) 272-1590 or 1-800-327-6712 . For more information, contact (800) 945-4355. BCBSRI vision plans offer: Access – a nationwide network of more than 115,000 eye care providers and top eyewear retailers, including LensCrafters®, Pearle Vision®, and Target Optical® Affordability – competitive rates for individual and family plans; Convenience – no need to submit receipts for in-network services Provider Portal. Blue Cross & Blue Shield of Rhode Island 500 Exchange Street Providence, RI 02903-2699 Not a Member? To learn more about our healthcare coverage options, please visit View Benefits, or if appropriate, Providers, Medicare Advantage See all your options, compare plans, and enroll. We created this manual for dentists and their office managers in the Blue Cross & Blue . phone number and accepting new patients' status, etc. Thank you. . Section . X. com in the Preauthorization Requests section. All Practitioner Change Forms can be faxed to Please press *6 to unmute and we will call on you by your phone number. New card will have new Rx phone number. We will be in touch soon to help you choose a Every BCBSRI plan includes 100% in-network coverage for your annual physical, flu shot, and recommended tests and screenings. This is the customer service number for questions about your health insurance coverage, benefits or treatment. Deliveries are Value Based Benefit (VBB) Incented Copay Drug List. If you have any questions about this agreement, providers, or benefits please contact our Customer Service Department before you obtain services. PPO products also include an out-of-network transportation benefit. Y0146_web_2022 Blue Cross & Blue Shield of Rhode Island is an HMO and PPO plan with a Medicare contract. Type 2 group NPI number Please note this information would not be shared outside of BCBSRI. Or you may email ProviderRelations@bcbsri. Enter in office Phone Number, and Fax number to ensure proper correspondence to office. com Flexible Benefit Card, gym membership, and other benefits Start here. Need care? If it’s not an emergency, but your doctor’s office is closed Learn about this year’s plans, hear what other people are Wide network with more than 12,000 providers; $0 copays for primary care provider (PCP) visits Medicare approved Blue Cross & Blue Shield of Rhode Island to provide these benefits and Blue Cross & Blue Shield of Rhode Island is an HMO and PPO plan with a Medicare contract. 125: Entity's name. o Will BCBSRI support Medicaid recertification? Yes. BCBSRI. Hours: Monday through Friday, 8:00 a. – 8 p. If you or your spouse receive benefits from a current or former employer or union, call the employer/union benefits administrator or BCBSRI Customer Service if you have any questions about your employer/union benefits, plan premiums, or the open enrollment Medicare Advantage See all your options, compare plans, and enroll. 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 The center can be reached at 833-918-6603. The BCBSRI formulary is divided into five tiers. Find a provider. Over the last several months, we’ve shared information in each issue of Provider Update to help our provider community become more familiar with Prime. Office Contact Phone Number: Requesting Provider Main phone #: Contact Fax Number: 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 Blue Cross & Blue Shield of Rhode Island 2024 Updates February 13, 2024 Presented by: Stef Vito Director, Provider Relations. Reference your Evidence of Coverage (EOC) for more information. 1 of 9 VantageBlue Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: See below Plan Type: PPO Questions: Call 1-800-639-2227 or (401) 459-5000 or TDD 1-888-252-5051 or visit us at www. ) It shows how much your provider will charge you when they send you an actual bill—and how much you saved by using the BCBSRI network. Note: Prior to entering any requests into MHK, benefit and code requirements should be verified Enroll now in a medical plan for 2023. that it’s a CMS requirement and a contractual obligation under your Blue Cross & Blue Shield of Rhode Island (BCBSRI) provider agreement. You can contact us at: Blue Cross & Blue Shield of Rhode Island 500 Exchange Street Providence, RI 02903; or We’ll explain everything you need to know about the $0 benefits that come with our BlueCHiP for Medicare (HMO-POS) plans and the extra benefits you could get if you qualify for Extra Help or Medicare + Medicaid. Blue Cross & Blue Shield of Rhode Island 2022 Updates December 13, 2022 Presented by: Stef Vito, Director, Provider Relations. Check patient eligibility to verify effective dates of coverage, copays, deductibles, and other information. Call BCBSRI Customer Service at 1-800-639-2227 for help. wish to participate in the BCBSRI provider network have BCBSMA directly to determine member eligibility and benefit information. An independent licensee of the Blue Cross and Blue Shield Association. Date of birth (YYYY-MM-DD) Blue Cross & Blue Shield of Rhode Island is an independent licensee This number, which appears on your BCBSRI member ID card, is used by the Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees Medicare. Check status of all claims submitted with your National Provider Identifier (NPI). (Some insurance companies call it an Explanation of Benefits. Medicare approved Blue Cross & Blue Shield of Rhode Island to provide these benefits and lower copayments as part of the Value-Based Insurance Design program. Blue Cross Dental . from the BCBSRI provider directory- Find a Doctor Tool The quarterly data attestation includes confirming practice location, phone number and accepting new patients' status, etc. Don’t see your provider on the BCBSRI portal? Please note that only your office administrator can add providers to your BCBSRI. Services are covered under the member durable medical equipment benefit and the services do not require prior Blue Cross & Blue Shield of Rhode Island 2021 Updates May 25, 2021 Presented by: Stef Vito, Practitioner Change Forms are locations at bcbsri. Effective March 1, 2024, eviCore will be transitioning their authorization portal. ; Saturday, 8:00 a. Your employees can access all their health plan benefits—and get the extra help they need—in one convenient place. ; Medicare Supplement Help cover costs with a Plan 65 option. When you emulate the account, you will see Phone hours: Monday through Friday, 8:00 a. On the provider results page (see Step Check claims status and patient eligibility, view remittances, and review the Provider Administrative Manual. By Phone. Prescription medications that you can order by phone or online and have them delivered to your door. 2025. We can help you choose. Blue Cross & Blue Shield of Rhode Island (BCBSRI) and our network of providers can the Subscriber Agreement or contact the number on your member ID card. Failing to provide direct contact information may delay the provider's enrollment request. a specified/preferred time—they can combine their BCBSRI benefit with their SNAP benefit with Millonzi. Provide Feedback. Enrollment in Blue Cross & Blue Shield of Rhode Island depends on Member discounts on wellness and lifestyle brands – Blue365® offers discounts for all BCBSRI members. In the credentialing process, there may be a question or concern in which the committee needs to reach out to the provider but without an updated phone number, terminating the provider may be the only option. Phone number: * Company name: * Company size: Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association. Effective March 1, 2024, eviCore has transitioned their authorization portal to Carecore National. Teams based group instruction beginning in Q4 through Q1 of Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association. Medicare Advantage See all your options, compare plans, and enroll. com to be placed back on the BCBSRI provider directory- Find a What number can providers call for assistance? Note: this phone number is not available until the week of 5/28. Appeals Request Effective July 1, 2022, Blue Cross & Blue Shield of Rhode Island (BCBSRI) began requiring the National Drug Code (NDC) to be filed on all claims submitted phone number and accepting new patients' status, etc. Last name. If you gave information to someone you believe was a scam caller, please call the Blue Cross & Blue Shield of Rhode Island Anti-Fraud Hotline at 1-800-830-1444 or email SIU@bcbsri. Underwritten by Blue Cross & Blue Shield of Rhode Island An independent licensee of the Blue Cross and Blue Shield Association by plan To locate a meacal proviaer ror urgent care outside of RI Phone varies by plan Providers verify' eligibility' & benefits Phone Number will vary by plan Pharmacist: PROVIDER. Summary of Benefits. Read More on The Rhode Ahead. For a list of all providers in this network, use the Find a Doctor tool. Overview; Shop; contracted by Blue Cross & Blue Shield of Rhode Island (BCBSRI) to provide wellness services. Our plan covers an unlimited number of days for an in-network inpatient hospital stay. Find a Your Blue Store near you or call (401) 324-2535. You can also emulate the web account. Q: As a BCBSRI provider seeing BlueChip for Medicare BCBSRI Update PBF As of January 1, 2017, BCBSRI completed the transition of its pharmacy benefits manager (PBM) to Prime Therapeutics, LLC. CO 119 Denial Code – Benefit maximum for this time period or occurrence has been reached or exhausted; Place of Service Codes. Provider email address. m Blue Cross & Blue Shield of Rhode Island October 2024 Provider Monthly Conference Call October 1, 2024 Presented by: Stef Vito been excluded from the BCBSRI provider directory- Find a Doctor Tool. Jul 8, 2022. 2 The deductible and out-of- pocket limits are separate for the Preferred Network, National Blue Cross This is a summary of benefits. Overview; Shop; Blue Cross & Blue Shield of Rhode Island PO Box 1057 Providence, RI 02901. Please visit our Provider Contact Us page to find the correct point of contact. com to be placed back on the BCBSRI provider directory-Find a Medicare Advantage See all your options, compare plans, and enroll. 128: Entity's tax id. Overview; Shop; contracted by Blue Cross & Blue Shield of Rhode Island (BCBSRI) to provide pharmacy benefit management services. . Deliveries are Phone: (401) 462-3000 8:30 a. Our Provider Directory also contains a listing of participating providers. Flexible Benefit Card, gym membership, and other benefits Start here. Get rewarded with wellness You can use our wellness program online or on your phone to help you feel better, have fun, and earn up to $500 per household. 127: Entity's Communication Number. Authorization Blue Cross & Blue Shield of Rhode Island (BCBSRI) and our network of providers can Agreement or contact the number on your member ID card. Deliveries are made Monday BCBSRI uses eviCore for high-end radiology and cardiology prior authorizations and spine surgery for Medicare Advantage members. 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. We will be in touch soon. Inquiry@bcbsri. $4,800 annually for services you receive from in-network providers. to 4:30 p. Contact Plan for details. To obtain access to bcbsri. BLUE CROSS & BLUE SHIELD OF RHODE ISLAND (BCBSRI) FEDERAL EMPLOYEE PLAN MAY_2012 / Page 1 of 2 Frequently Asked Questions What is FEP? The Federal Employee Plan (FEP) is a health benefit plan offered to all federal employees. 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. Or you may email via Teams or in-person. Shield of Rhode Island (BCBSRI) dental network. Understand your medical benefits A quick look at your benefits. 270/271 Health Care Eligibility Benefit Inquiry and Response Companion Guide (Real-Time and Batch) HIPAA version 5010 . for a conference call with the Provider Relations team, who will provide important 2024 . This 834 Health Care Benefit Enrollment and Maintenance Companion Guide is designed for use in conjunction with the ANSI ASC X12N 834 ( 005010X220A1) Health Care Benefit Enrollment and Maintenance 5010 Technical Report Type 3 (TR3). Or, on Saturday, December 7, you can submit your application in person at one of the following locations. 47 : Internal review/audit - partial payment made. Once you’ve taken your hearing test, your provider will review the results of your hearing test with you. For benefit year 2024, the OOP maximums are changing for the FEP Blue Focus product option. $7,500 annually for services you receive from out-of-network providers. Save on prescriptions Call the toll-free number on the back of your member ID card for the right number for your personal policy. Medicare Advantage Plans with Part D Prescription Drug Coverage. Blue Cross & Blue Shield of Rhode Island (BCBSRI) requires all our participating providers to attest to their provider level and practice location information each quarter using the “update practice info” feature on the BCBSRI. this document, such as key contacts and an overview of the dental provider services Flexible Benefit Card, gym membership, and other benefits Start here. $10,000 annually for services you receive from out-of-network providers. Call Monday through Friday 8:00 a. BCBSRI Blue Cross & Blue Shield of Rhode Island 500 Exchange Street Providence, RI 02903-2699 LG-COC/SOB-3-2023-BX 1 Healthmate Coast-to-Coast Deductible/Maximum Out-of-Pocket Expense Deductible; Maximum Out-of-Pocket Expense Network Providers Non-network A primary care provider (PCP) who is your "regular" doctor and provides referrals for specialists, tests, and some other services; A limited network that includes 500+ PCPs, 1,800+ specialists, Blue Cross & Blue Shield of Rhode Island 2022 Updates October 11, 2022 Presented by: Stef Vito, Director, Provider Relations. MPDP ID number is the FEP Member ID; FEP will begin mailing a replacement ID card to members enrolled in the FEP Blue Focus product option in November 2023. Dec 1, 2024. Find out which doctors and hospitals are part of the extensive Blue Cross network. BCBSRI members have a $0 copay for a 90-day supply of many common medications BlueRI for Duals. (POS) benefit and may use non-network providers for specified covered services. There is not enough time for mail, so please complete an application online or call us at (401) 351-2583 (TTY: 711). The MPDP ID number is the FEP Member ID. This information is available for free in other languages. If you need help finding a primary care provider, other doctor, or a hospital/facility, you can use the find a doctor tool or call Customer Service at (401) 459-5000 or 1-800-639-2227 (outside RI). – 8:00 p. For details about coverage, including any limits and exclusions not noted here, please call (401) 429-2102 or 1 London Health is an innovative third-party administrator with expertise in administering consumer-directed health plans for employers while helping them lower employee benefit and human resources expenses. Specialized programs In addition to your traditional benefits, BCBSRI has partnered with community BCBSRI. ; Medicare Supplement Help cover costs with a Plan 65 Flexible Benefit Card, gym membership, and other in your appeal request to ensure BCBSRI will be able to schedule the peer-to-peer with the Medical Director at BCBSRI. Let's talk Phone number: * How can we help you? * Submit. NationsBenefits. For information call the BCBSRI Provider Call Center, at (401) 274-4848. First name. Blue Cross & Blue Shield of Rhode Island (BCBSRI) will begin offering a dual special needs plan, or D-SNP, For information call the BCBSRI Provider Call Center, at (401) 274-4848. Get money-saving benefits like these from ALL BlueCHiP for A: BCBSRI covers and separately reimburses for code E0445 when billed/provided by a professional provider e. com > Providers > Forms. A: BCBSRI covers and separately reimburses for code E0445 when billed/provided by a professional provider e. Relations@bcbsri. Please ensure your office is utilizing the new forms effective immediately. You can also click the links below to be redirected to the forms. physicians and Durable Medical Equipment providers when medically necessary and ordered by a physician/provider. Please activate the card by visiting MyBenefits. BCBSRI cannot guarantee the accuracy of the information in the links provided and shall not be liable for any losses, damages, or uncovered the Consolidated Appropriations Act, which became effective on January 1, 2022. com; You will not Medicare Advantage See all your options, compare plans, and enroll. com under provider forms. 1-800-882-1178, option #3. Overview; Shop; Search for providers. com or if you need assistance with MHK, please contact our Provider Relations team at ProviderRelations@bcbsri. m Medicare Advantage See all your options, compare plans, and enroll. c. In the BCBSRI MHK Provider Portal, providers will now have the ability to add a six-digit extension to their contact phone number. to 6:00 p. Call the dedicated pharmacy program phone number listed on your member ID card. Out-of-state: 1-800-676-2583 Patient benefit and eligibility information, referral questions, and claims inquiries specific to FEP members. Small-Group New cards will have the new Rx phone number. Provider tax ID number; Specific date(s) of service; Please contact Blue Cross & Blue Shield of Rhode Island (BCBSRI) or access their suite of helpful resources if you have questions regarding your medical coverage or your Blue Cross & Blue Shield of Rhode Island November 2024 Provider Monthly Conference Call November 12, 2024 Please continue to check member benefits to see if their plan now is part of a tiered cost for provider offices to contact BCBSRI when a provider is leaving your practice. Please contact your dedicated Account Executive. Effective January 1, 2025, BCBSRI will remove the non-skilled benefit for all Medicare Advantage pla P F . Sales. It is not a contract. ; Extra Help Plans Medicare + Medicaid and the new Access plans. local time, who will schedule your hearing test with no out-of-pocket cost with a local hearing provider. to Already a BCBSRI Medicare Advantage member? Looking for Medicare + Medicaid? Already a BlueRI for Duals member? Sometimes it’s easier to ask your questions face-to-face. Phone: 1-866-745-1783 Secure fax: 1-866-303-5749. com; You will not need a PIN to use your card. 2 – ListofNetworkProviders If you have received a new Benefits Prepaid Card, you must activate your card to use your 2024 benefits. on Sunday. Feedback By providing my phone number/email address, I give Blue Cross & Blue Shield of Rhode Island permission to contact me. o For questions related to the status of an existing prior authorization, call BCBSRI Provider Services at (401) 274-4848 or 1-800-230-9050. Over-the-counter (OTC) Blue Cross & Blue Shield of Rhode Island 2024 Updates March 12, 2024 Presented by: Stef Vito Director, Provider Relations. Credit and collections (401) 459-5821 Credit&Collection@bcbsri. g. A Summary of Benefits shows the key benefits of your plan. Your PCP is the main doctor, nurse practitioner, or physician’s For benefit information: Type of service, procedure code, place of service, please contact our Provider and Physician Call Center at (401) 274-4848 or 1-800-230-9050 for out-of-state providers. Small Group contacts Existing Sales. Enrollment in Blue Cross & Blue Shield of Rhode Island depends on contract renewal. com or by calling the Provider Service Center at 401-274-4848 or 1-800-230-9050. Mar 20, 2019. Patient benefit and eligibility information, referral questions, and claims inquiries specific to FEP members. 22 Blue Cross & Blue Shield of Rhode Island is an HMO and PPO plan with a Medicare contract. Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association. (Open seven days a Call the toll-free number on the back of your member ID card for BCBS customer service. Any provider removed from the Provider Directory for failure phone number and accepting new patients' status, etc. com to be placed back on the BCBSRI provider directory- Find a Medicare Advantage See all your options, compare plans, and enroll. Provider Relations (401) 274-4848 or 1-800-230-9050 Fax: (401) 459-5531 Physician/provider education, responsibilities, and policies and procedures Providers and doctors call these Blue Cross & Blue Shield Rhode Island phone numbers for eligibility and other questions. Access provider publications including: Participating Provider Administrative Manual; BCBSRI Practice Guidelines; Orientation visits QHP 2023 Benefit Changes; QHP 2024 Benefit Changes; QHP 2025 Benefit Changes; Drug Lists. 2024. We look forward to workin 31 BlueRI for Duals (HMO D-SNP) Summary of Benefits January 1, 2025 - December 31, 2025 Includes $0 copays for a number of services and prescription drugs; $0 telehealth visits. Contact Customer Service at the number listed on your ID card. • Providers must attest on bcbsri. org for scheduling. Only members with certain conditions are eligible for these benefits. Deliveries Blue Cross & Blue Shield of Rhode Island 2023 Updates December 12, 2023 Presented by: Stef Vito Director, Provider Relations. You must provide 60 days notice to New card will have new Rx phone number; MPDP ID number is the FEP Member ID; FEP will begin mailing a replacement ID card to members enrolled in the FEP Blue Focus product option in November 2023. we ask that you verify BCBSRI member benefits and eligibility by logging on to the secure provider for provider offices to contact BCBSRI when a provider is leaving your practice. For other language assistance or translation services, please call the customer service number for Please contact Blue Cross & Blue Shield of Rhode Island (BCBSRI) or access their suite of helpful resources if you have questions regarding your medical coverage or your health savings account (HSA): Call the State of Rhode A specific customer service center supports each member. to 4:00 p. We do this to ensure personalized service for every member. com provider account under Enroll now in a dental plan for 2021. m. for provider offices to contact BCBSRI when a provider is leaving your practice. , October 1 – March 31. The number is . Phone number: * Company name: * Company size: * Enter a brief description of how we can help you: * Submit. Phone number. Your PCP. WINFertility update. Value prop: How it works: Medicare Advantage See all your options, compare plans, and enroll. We offer many different plans, so please see your subscriber agreement/benefit booklet for details on your plan’s specific benefits. 45 : Awaiting benefit determination. The information presented in this member handbook is applicable for all health plans unless otherwise noted. Monthly Plan Premium $38 per month Value (HMO - POS) BlueCHiP for Medicare Copays for hospital benefits Our Grievance and Appeals Unit (GAU) has been working hard to update the appeals request form and the claims adjustment form. With your Benefits Prepaid Card, you can purchase eligible items across all of your spending allowance benefits. It will be open until 8 p. BCBSRI uses eviCore for high-end radiology and cardiology prior authorizations and spine surgery for Medicare Advantage members. You can still submit your Medicare application, however, the application must be received by Saturday, December 7. Providers must give BCBSRI a 60-day notification of any provider or practice changes. until 9 p. We are pleased you have chosen us. Enroll now in a medical plan for 2023. You can contact the number on the back of their card for their benefits and eligibility. 46 : Internal review/audit. Blue Cross & Blue Shield of Rhode Island 2021 Updates December 14, 2021 Presented by: Stef Vito, Director, Provider Relations. •New card will have new Rx phone number •MPDP ID number is the FEP Member ID. Thank you for sending Find a provider. 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. You can contact us in a couple of ways: Check the back of your membership card for your specific customer service 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. Version 1. 129: Entity's Blue Cross provider id. Subscriber Agreement LG-COC-3-2015-BX WELCOME Welcome to Blue Cross & Blue Cross Blue Shield of Rhode Island (BCBSRI). Like $3,000 for dental care $300 for eyeglasses an over-the-counter benefit free grocery delivery. • We need your help! See how BlueRI for Duals (HMO D-SNP) gives you so many extra benefits —at no extra cost to you. 6 11. please ensure you provide a valid name and phone number P B . Not right now. Underwriting. On these Fridays, we’re open only for benefits and eligibility requests: July 26, August 30, September 13, October 11, November 8, and December 13, New cards will have the new Rx phone number. If you would like a copy of your members that are currently receiving any of the medications listed above, please contact Provider Relations at Blue Cross & Blue Shield of Rhode Island is an independent Dr. Primary care visit. Enter in Contact Name, and Phone Number of the person submitting the request. Overview; Your doctor and other providers use this number when filing claims for services they provided to you. Title: Blue Cross & Blue Shield of Rhode Island Blue Cross & Blue Shield of Rhode Island is an HMO and PPO plan with a Medicare contract. We will be in touch This is the agreement used by us to administer benefits and process claims. and services available to you as a Blue Cross & Blue Shield of Rhode Island (BCBSRI) member. 130: Flexible Benefit Card, gym membership, and other benefits Start here. com to be placed back on the BCBSRI provider directory- Find a Adding retiree benefits, like a 5-Star Medicare plan from Blue Cross & Blue Shield of Rhode Island (BCBSRI), could be the solution. Out-of-network 20% coinsurance Copays for hospital benefits are based on per admission/per stay. Please take a moment to review your practice information in our Find a Doctor tool, focusing on the following areas: Blue Cross & Blue Shield of Rhode Island 2023 Updates May 9, 2023 Presented by: Stef Vito Director, Provider Relations. 1700 North University Drive Plantation, FL 33322 If you are a Member calling about one of your supplemental benefits, please call the Toll-Free Number provided to you by your health plan related to that benefit, or you can access your account online. Jun 1, 2024. Deliveries are Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association. If you do not know who your administrator is, contact your Provider Relations representative. Phone number: * How can we help you? * Submit. These files will be created internally, updated monthly, and posted to bcbsri. Did you know that Blue Cross & Blue Shield of Rhode Island (BCBSRI) members with certain chronic health conditions can If you have questions about the coordination of benefits process, please contact us at (401) 4534700, or 1- - 800-831-2400 (outside Rhode Island), Monday – Friday; 8:00 a. Please contact the BCBSRI Welcome to Blue Cross & Blue Shield of Rhode Island’s . call Independent Living Systems at 833-853-8946 (toll free) and provide your BCBSRI Member ID number. Date of birth (YYYY-MM-DD) Blue Cross & Blue Shield of Rhode Island is an independent licensee Flexible Benefit Card, gym membership, and other benefits Start here. This month, we are recapping the new features we’ve Flexible Benefit Card, gym membership, and other in your appeal request to ensure BCBSRI will be able to schedule the peer-to-peer with the Medical Director at BCBSRI. com Medicare Advantage See all your options, compare plans, and enroll. It combines a personalized digital experience (online or on the app) with one-on-one support from Care Guides, registered nurses, and health coaches. Web experience that manages all steps of the process to Contact Us . All demographic provider information should self-populate. PROVIDENCE, RI (August 11, 2020) – Blue Cross & Blue Shield of Rhode Island (BCBSRI), the leading choice for Medicare eligible adults in Rhode Island, has taken additional steps to help Medicare Advantage members access the care they need during the COVID-19 Flexible Benefit Card, gym membership, and other in your appeal request to ensure BCBSRI will be able to schedule the peer-to-peer with the Medical Director at BCBSRI. You or your doctor must call the GAU at (401) 459 During the COVID-19 pandemic, you also temporarily have telemedicine benefits for select other providers at the same cost share you’d pay for an in-person visit. Thank you for attending, see you next month! Medicare Advantage See all your options, compare plans, and enroll. Please call the Customer Service telephone number on the back of your Member ID card. You can contact us in a couple of ways: Check the back of your Claim Filing Information(Massachusetts Providers) Blue Benefit Administrators of MA Provider Manual; Mailing Address (claims and correspondence): Suite 1300, Boston, MA 02199-7611 Blue Cross & Blue Shield of Rhode Island . Deliveries are Blue Cross & Blue Shield of Rhode Island 2024 Updates June 11, 2024 Presented by: Stef Vito Director, Provider Relations. Services provided to GRID members are reimbursed according to the Blue Cross & Blue Shield of Rhode Island dental fee schedule. Specialized programs In addition Blue Cross & Blue Shield of Rhode Island 2021 Updates July 20, 2021 Presented by: Stef Vito, • Quarterly Verification can be done on your existing bcbsri. New Sales (401) 734-2409. Overview; Shop; Ordering Provider NPI Number Requirement Upload date. The new forms can be found on bcbsri. Deliveries are made Monday When you visit a doctor, lab, or hospital and you have to pay part of the cost, we will send you a Healthcare Services Summary (HSS) in the mail. Due to this change, a new ID card will be required. Rides available within our service area for HMO & HMO-POS plans only. You must provide 60 days notice to Enrollment in Blue Cross & Blue Shield of Rhode Island depends on contract renewal. BlueCare Connect is BCBSRI’s enhanced member service and support model. com provider account. Blue Cross & Blue Shield of Rhode Island is an HMO and PPO plan with a Medicare contract. com to be placed back on the BCBSRI provider directory- Find a If so, we can help you make the most of your benefits—and possibly save you money! Simply complete this form and mail to: Attn: OCL Department (A) - 00119 Blue Cross & Blue Shield of Rhode Island 500 Exchange Street Providence, RI 02903-2699. 0 We are pleased to announce that you are now able to verify the member’s benefits and eligibility on bcbsri. BlueCHiP for Medicare Value (HMO -POS) HealthMate for Medicare (PPO) Blue Cross & Blue Shield of Rhode Island On May 19, 2016, after a comprehensive national search to find a new president and CEO, the board of directors of Blue Cross & Blue Shield of If you have any questions about this agreement, providers, or benefits please contact our Customer Service Department before you obtain services. ) You can use our automated answering system outside of these hours. o What happens if a member loses eligibility? Blue Cross & Blue Shield of Rhode Island 2023 Updates February 14, 2023 Presented by: Stef Vito, Director, Provider Relations. Thank you for sending us your information. Benefits, eligibility, & claims Medical providers. The specifications contained within this Companion Guide define current functions and provide supplemental information specific to Blue This number, which appears on your BCBSRI member ID card, is used by the Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees Medicare. Fax the completed form along with clinical information to Utilization Management at 401-272-8885 Blue Cross & Blue Shield of Rhode Island 2021 Updates November 16, 2021 Presented by: Stef Vito, please contact Provider Relations at ProviderRelations@bcbsri. Q: As a BCBSRI provider seeing BlueChip for Medicare clients, are we able to see Medicare HealthMate patients also? from in-network providers. 6064 EmployerSupport@bcbsri. Contact ProviderRelations@bcbsri. Richer benefits attract top talent. Purchased your plan directly through BCBSRI. o What happens if a member loses eligibility? Find a provider. If you are unsure of the spelling of the Provider's name, enter only a portion of the name. • Members who qualify for BlueRI for Duals or BlueCHiP for Medicare Value ACCESS also qualify for SNAP; BCBSRI can help process the member’s SNAP application if they do not currently have SNAP benefits. Frequently Asked Questions from BCBSRI Provider Conference Calls January 12th call Q: PPE supply code 99072 – BCBSRI does not cover this code at the committee needs to reach out to the provider but without an updated phone number, terminating the provider may be the only option. Each tier has a corresponding copay, depending on your health plan: Tier 1 – Lowest cost generic drugs; Tier 2 – Low-cost generic drugs Medicare Advantage See all your options, compare plans, and enroll. Your employees will have access to a high-quality provider network at the Rhode Island and New England level, and you could see real savings over a national network option. Charges pending provider audit. Benefits can be viewed as a reward for years of company service; Employees and retirees recognize value in plans offered by BCBSRI; Employees of all ages value wellness and preventive care wish to participate in the BCBSRI provider network have BCBSMA directly to determine member eligibility and benefit information. for provider offices to contact BCBSRI when a provider is Membership in a health plan from Blue Cross & Blue Shield of Rhode Island brings you many perks beyond insurance: Lower prices for healthcare We work with doctors and other BCBSRI invites our participating providers to join us on Tuesday, November 12 from 10-11 am. For information about your BCBSRI benefits, call us at the number on the back of your member ID card. Browse dozens of wellness and lifestyle deals and save money on your favorite BCBSRI. These A specific customer service center supports each member. MD PCP PHONE: 401-555-1212 Blue Cross & Blue Shield of Rhode Island Attn: Medicare Advantage Membership Department 500 Exchange Street Providence, RI 02903-2699 Contact Social Security to find out about eligibility and enrollment. Call Monday through Friday 8:00 Medicare approved Blue Cross & Blue Shield of Rhode Island to provide these benefits and lower co-payments as part of the Value-Based Insurance Design program. Full name and valid phone number of the person who will be responsible for Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Flexible Benefit Card, gym membership, and other benefits Start here. Please contact our Customer Service number at 1-800-267-0439 (TTY/TDD users should call 711). please refer to the Subscriber Agreement or contact the number on your member ID card. To verify the BCBSRI providers have two options : Option 1 [Option 1 is the preferred option for providers may contact OptumRx at the following numbers: Medicare: 866-235-1793, ext Contact Us. View PDF. The links below will take you directly to the Summary of Benefits for your plan. See what BlueCare Using the links on the left, you can view the details of member, employer, and provider web accounts. participating providers. com. Thank you! Here's your guide! RIGHT BY YOU. You can contact us at: Blue Cross Note: You may request an expedited (faster) review of denied services if the circumstances are urgent or if you are in an inpatient setting . Manocchia also spoke on the importance of BCBSRI needing updated contact information for participating providers. If you are not sure who your Provider Relations representative is you can reach out to Provider. As with other drugs covered under the medical benefit, the drugs below will be eligible for buy and bill effective April 1, 2021. Place of Service 02; Place of Service 11; If you are designating PCP(s) via Workterra, the State's online enrollment system, you will need to obtain their 10-digit National Provider Identifier (NPI). wldwk krco zspvkst jokns ncnwg bsfesfq qsrmao cdbzb zpfbd fxcafkz