Gira os seus planos

The following information is provided to help you with the kinds of business-oriented questions we are frequently asked.

General questions

ACH, or automated clearing house, is a network that coordinates payments and automated money transfers. This option is for Large Group only. Send ACH requests to your account manager.

Other groups can find electronic funds transfer (EFT) forms here.

Rx BIN/RxPCN 610455/BCRI RxGrp BCRI

Members can print a temporary ID card through their online account. Once they log in, they can use the “Request Member ID card" section of the menu. Or you can copy this link and send it to them.

They can follow these three simple steps:

  1. Go to VirginPulse.com or download the app*.
  2. Choose Blue Cross & Blue Shield of Rhode Island as the sponsor.
  3. Connect a Fitbit® or other wearable device to track and sync steps with the app.

*Aplicam-se as tarifas padrão da operadora móvel e uso de dados. O download e o uso da aplicação móvel Virgin Pulse estão sujeitos aos termos e condições da aplicação e das lojas online das quais foi descarregada. Virgin Pulse® is an independent wellness company, contracted by Blue Cross & Blue Shield of Rhode Island (BCBSRI) to provide wellness services.

A member may have two ID cards because the family members on the medical and dental plans are not the same. Additionally, some employer groups have separate medical and dental groups.

Use this link to log in to your Employer portal. Once you have logged in, click “Reports," then “Monthly Statements," then “Group Billing Subscriber details," then “Date." Click on the Excel-formatted report.

No, ID card ordering occurs outside of the Electronic Enrollment tool. A group can order a member ID card by logging in to the Employer portal and clicking on “Change Address/Request Member ID Card" on the left side of the page. Or you can copy this link and send it to your employees.

Any completed transaction done via Electronic Enrollment creates a “Thank You" page with a transaction number. If an account user clicks on the “Change Address/Request Member ID Card" option without entering Electronic Enrollment, it won't produce a “Thank You" page

No, vision ID cards are not issued and are not required. Providers use the EyeMed website and member information to verify benefits.

Yes, you can access the guide by clicking “Electronic Enrollment Guide" on the lower left of the Electronic Enrollment home page.

Large Groups: Fully Insured

You can find this information on the Employer portal. Log in to view your reports (you must be authorized to access this section). Select “Monthly Statements" then “Core Reports." These provide a running 12-month report on claims.

You can access this information on the Employer portal. Log in to view your reports (you must be authorized to access this section). Select “Financial Performance," then “Loss Ratio." This report provides a running 12-month report of income versus claims. It does not factor in administrative costs.

You can view an executive summary, which provides a quick look at results, a population overview, geographic distribution, and demographic information.

There’s also an informative financial overview, which includes inpatient, outpatient, physician, and pharmacy cost per member, as well top 10 diagnosis categories and number and percentage of claims by dollar ranges.

Yes, you can see this type of information, which includes hospital data (days and admissions/1,000) and physician services (PCP, specialist, urgent care, and ER visits per member or per 1,000). It also features pharmacy information, including generic/brand use, Rx’s per year, and cost per Rx. Top 10 generic and brand information is also supplied as well as specialty drug information and HEDIS (quality) measurements.

Sim. Enrollment reports provide sortable, account level enrollment information for use by accounts to prepare 1094 and 1095 reports.

Large Groups: ASC or Self-funded

You can find this information on the Employer portal. Log in to view your reports (you must be authorized to access this section). Select “Weekly" or “Monthly" statements, then “Consolidated Claims Billing." These reports provide detailed information regarding billed claims.

You can find this information on the Employer portal. Log in to view your reports (you must be authorized to access this section). Select “Monthly Statements" then “Core Reports." These provide a running 12-month report on claims.

You can find this information on the Employer portal. Log in to view your reports (you must be authorized to access this section). Select “Monthly Statements." Depending on the coverage you offer, there are a variety of reports that you can view: utilization by product, Rx specific utilization, deductible utilization, and dental utilization.