As a reminder, when a BCBSRI participating provider renders services to a BCBSRI Blue plan member in a city or town outside of Rhode Island that is within the contiguous county (e.g. Attleboro, Fall River, Swansea, etc.), claims should be submitted directly to BCBSRI as you are a participating provider with BCBSRI.
If a BCBSRI participating provider renders services to a non-BCBSRI Blues member in a city or town outside of Rhode Island that is within the contiguous county (e.g. Attleboro, Fall River, Swansea, etc.), claims should be filed directly to the Blue plan state where services were rendered.
If the member is a BCBSRI NEHP member (RIA, RIS, RIN) seeing their PCP who is a Massachusetts PCP, the claim should be filed to Blue Cross & Blue Shield of Massachusetts as the member's care is managed by BCBSMA.