As healthcare providers, your time and efficiency are crucial when it comes to managing medical or behavioral health prior authorizations. The BCBSRI MHK provider portal is a valuable tool that helps streamline the prior authorization process, and we want to provide you with some tips, reminders, and updates to optimize your experience.

1. Searching for requesting or servicing providers: When searching for a requesting or servicing provider on the portal, it’s important to note that providers who are participating with the member’s plan will appear first in the search results. Participating providers should always be selecting a “Par" address. This prioritization ensures that the correct provider status is used for participating providers and prevents any delays in processing your authorizations.
2. Performing InterQual reviews: Completing an InterQual review may be required for some prior authorizations, but performing multiple InterQual reviews back-to-back may cause a decrease in performance in the portal. When submitting several authorizations, we recommend intermittently logging out, closing your browser, and then logging back in to refresh your portal session. This simple step ensures optimal performance and prevents any slowness or time-outs which could cause a delay in processing the authorization.

Portal enhancements coming with MHK upgrade

We are pleased to announce that the BCBSRI MHK provider portal will soon be upgraded to the latest version, introducing new enhancements to further improve usability and efficiency. Our MHK system is set to be upgraded by 20 de agosto23. Here are some notable changes to portal features:

1. Member ID and date of birth (DOB) on “View Authorizations" screen: To improve searchability in the provider portal, the upgraded “View Authorizations" screen will display the member ID and DOB in the “Prior Authorization Request Status" grid. This enhancement offers quick access to essential patient information, ensuring quick and accurate identification.

2. Refreshed “View Authorizations" screen with discharge date: When entering a discharge date for an authorization on the “View Authorizations" screen, the “Prior Authorization Request Status" will now automatically refresh with the updated information. This enhancement provides confirmation the discharge date has been received and is reflected in our system.

We are committed to continuously improving the BCBSRI MHK provider portal to meet your evolving needs and simplify the medical prior authorization process. These upcoming enhancements are a small step to enhance usability, increase efficiency, and promote seamless communication between providers and payers.

Remember, the portal is a valuable resource that can save you time and effort. By staying up-to-date with the latest tips and using the upcoming enhancements, you can maximize your productivity by limiting administrative tasks and spend more time providing care to your patients.

If you have any questions or require any assistance, please reach out to our Provider Relations team at ProviderRelations@bcbsri.org. Thank you for your continued partnership and commitment to delivering high-quality healthcare services to our members.