At BCBSRI we continue to improve our members’ health and peace of mind by facilitating their access to affordable and high-quality healthcare.
We are pleased to announce the implementation of the Primary Care Physician (PCP) burden reduction initiative that will go into effect on 15 de maio, 2025. This initiative aims to streamline processes and reduce the administrative processes on PCPs by exempting them from submitting prior authorization requests for certain services.
Providers who are credentialed as an eligible PCP will no longer need to submit prior authorization requests for 62 CPT codes related to radiology, cardiology, and sleep studies. This change is expected to simplify workflows, reduce delays in patient care, and improve overall provider satisfaction.
Educational sessions will be conducted to
- Ensure PCPs understand the new processes and requirements Specialists will need to encounter
- Address how PCP’s will check if their NPI is eligible for the waiver by entering their NPI, the code in question and the date of the order.
- How specialists will identify if the ordering physician is an eligible PCP to allow the code to be waived of the prior authorization requirement.
There will be a new process within the provider portal to find this information which will be presented in these sessions.
We have a few sessions that your offices can join. If you are unable to join, we will post the training material on our authorizations page on bcbsri.com as well.
Wednesday, 7 de maioth
12:00pm-12:30pm
Friday, 9 de maioth
1:00pm-1:30pm
Monday, 12 de maioth
8:00am-8:30am
Wednesday 14 de maioth
12:00pm-12:30pm
We will also present the training at our monthly conference call on Tuesday, 13 de maioth
Click this link to join the meeting.
If you have any additional questions about these changes or trainings, please contact Provider Relations at 1-844-707-5627 or ProviderRelations@bcbsri.org.