Effective 1 de janeiro, 2024, notification and prior authorization will no longer be required for home health services for all products. As of 1 de janeiro, 2024, home care agencies will no longer have to use the MHK provider portal to submit requests. Any retrospective home healthcare delivered prior to 1 de janeiro, 2024 can be faxed into BCBSRI’s utilization management team at (401) 459-1623 or to Prospect’s utilization management team at 1-844-762-9230.

If your agency has any authorization inquiries, please contact BCBSRI’s utilization management team at (401) 272-5670, option 4 or Prospect’s utilization management team at 1-844-762-9231.

1 de janeiro, 2024 updates PBF

• Mental health counselors and marriage and family therapists will be allowed to render services to Medicare members. 
• All Medicare Advantage Plans, BlueCHiP Direct, BlueCHiP Direct Advance, BlueCHiP w/ Flex, Network Blue New England, Network Blue New England Options and Blue Choice New England products will not require a referral for Physical and Occupational Services.
• Our Access product will now be open to Prospect PCPs. 
• EyeMed – Hardware claims:
  • If a provider is participating with EyeMed, they will file the member’s hardware claim to EyeMed for reimbursement. 
  • If a provider is not participating with Eye Med, the member will need to file their hardware claim to EyeMed for reimbursement.