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1 Nov, 2019

Hospital privileges and affiliations

To help make the BCBSRI Provider Directory as up-to-date as possible, the Provider Directory team has made changes to provider’s individual data displayed to members, including hospital affiliations and/or privileges. It is a credentialing requirement that all providers must have admitting privileges to at least one BCBSRI-contracted hospital, unless they meet the specified exceptions. These exceptions include a primary care physician or specialist who has demonstrated the ability to provide continuity of care in a practice devoted to ambulatory care, and has established an effective mechanism of providing care for hospitalized patients (e.g., has an arrangement with a physician(s) who will provide care for his/her patients in a BCBSRI-contracted inpatient setting). The practitioner(s) providing such coverage must also be contracted and credentialed by the BCBSRI Credentialing Committee. If the provider’s specialty does not typically require admitting privileges (e.g., allergy, anesthesiology, dental, dermatology, pathology, podiatry, psychiatry, radiology, oral surgery, and chiropractic) they are also exempt from this requirement.

The Provider Directory team has been outreaching to participating providers to confirm their hospital privileges or affiliations. Please take time to review your hospital affiliations listed in the BCBSRI Find a Doctor tool. If these affiliations are incorrect you may contact providerdirectory@bcbsri.org to update your information. The hospital privileges form can be found here and can be filled out and submitted to update your affiliation. This form can be used for the provider affiliation or plan of action for hospital admittance of a patient, not just admitting privileges.