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1 Set, 2018

Reminder: Utilizing the correct form for claim adjustment requests

BCBSRI wants all practices to have their administrative issues resolved accurately and timely. This is why it is so important to ensure that the appropriate form is filled out and submitted correctly, as well as sent to the appropriate department.

As such, please remember that the Grievance & Appeals Unit (GAU) does not process claims adjustments. GAU is BCBSRI’s internal review team for grievances and appeals and is not responsible for claim adjustments or processing.

If you are sending in a claim retraction, claim correction, or medical record, please use the Physician/Provider Claim Adjustment Request form. This form must be mailed to our claims department at the following address, which is also listed on the bottom of the claim adjustment form:

Blue Cross & Blue Shield of Rhode Island
A/C: Basic Claims Administration – Inquiry Unit 00066
500 Exchange Street
Providence, RI 02903-2699

Please note that any claims submissions that are incorrectly sent to GAU to process of any kind may be returned, and you will be asked to submit the proper form to the proper BCBSRI department.

If you are looking to submit an appeal, please use the Physician/Provider Appeal Request form. If you have any questions regarding which form to use or the appropriate BCBSRI department to submit claim adjustments to, we welcome you to email ProviderRelations@bcbsri.org.