- Bcbsri pay bill Locations. Coding: Unless specified in a specific payment policy, BCBSRI follows correct coding and payment guidelines published We are currently unable to print bills. If the amount of your payment changes as a result of a plan or benefit level change A: Yes, you can check out with approved and unapproved items. NOTE: The effective date of this policy relates to the date BCBSRI created documentation to reflect reimbursement processes that have been already established and does not indicate a change in the payment process. Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage Y0146_2025EOCblueRI_C OMB Approval 0938-1051 (Expires: August 31, 2026) January 1 – December 31, 2025. RELATIONSHIP TO OTHER CODES: (for payment purposes) PER ADA CDT 2020 This dental policy is made available to you for informational purposes only. As you know, BCBSRI’s temporary payment policy for telemedicine/telephone services is in effect until the end of this year. (Eastern). Go to BCBSRI. Dental Connections. 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 PAYMENT COVERAGE POLICY | 4 (401) 274-4848 WWW. COM Monoclonal Antibodies Q0239 Injection, bamlanivimab-xxxx, 700 mg Per CMS billing guidelines, submit to Original Medicare Do Not Bill to BCBSRI No reimbursement for claims submitted to BCBSRI for products health care providers receive at no cost Q0243 Injection, casirivimab and imdevimab, 2400 mg To keep your health insurance coverage active, you must pay your premium each month. Please select a premium payment option: ☐Receive a monthly bill ☐Receive a quarterly bill Section 4 – Payment Options. ; Extra Help Plans Medicare + Medicaid and the new Access plans. If you have questions, as always you can speak with your account representative. , from October 1 - March 31. • Click YOUR HSA in the left tool bar. effective date: 10 |15 2007 policy last reviewed: Providers and doctors call these Blue Cross & Blue Shield Rhode Island phone numbers for eligibility and other questions. Pay online or with the Xfinity app, or discover even more ways to pay with Quick Collect If you have to pay a Part D-Income Related Monthly Adjustment Amount (Part D-IRMAA), you must pay this extra amount in addition to your plan premium. Get Started. If you want to pay the provider, click Pay Provider. Here’s what you can do with myBCBSRI • Use one login for website and app • Use Face or Touch ID • View your BCBSRI medical, dental, and pharmacy benefits • Check your copays if you have them • View claims • Find doctors and labs in your health network • Compare costs for 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 PAYMENT POLICY | 1 (401) 274-4848 WWW. If you qualify for Extra Help with your Medicare prescription drug coverage costs, Medicare will pay all or part of your plan premium. , employees of veterinary hospitals, animal control officers) are considered a contract exclusion. Please submit the bill to: Blue Cross & Blue Shield of Rhode Island Attn: Claims Department 500 Exchange Street Providence, RI Submit electronically to BCBSRI or mail paper claims to 500 Exchange Street Providence, RI 02903. To learn more about the costs you may have to pay, log in to your online account. The funds will A portion of the cost you pay when you get healthcare. The provider and BCBSRI’s audit designee should make every effort to resolve billing and/or coding inquiries directly. It is not a guarantee of payment Coding and Payment Guidelines/Modifiers This policy was updated on January 19, 2022 to include Split (or shared) E/M visits and the applicable informational only modifiers: -FQ, -FR, -FS, -FT. • Review. Blue Cross & Blue Shield of Rhode Island. Member ID Number (9 Digits) information A B C The BCBSRI formulary is divided into five tiers. MEDICAL CRITERIA Deductible – What you pay for certain services before BCBSRI pays for them; Coinsurance – The percentage you pay for specific services, such as 20%; Your healthcare provider(s) may bill you this amount and you must pay the provider(s) directly. DRG Validation and Provider Bill Audit Program Timetable and Workflow . to 8:00 p. Yes. If you want to change your plan, and you purchased your current plan directly from BCBSRI, we can help you. To learn more about our fully integrated BlueSolutions for HSA health plans, please talk to your BCBSRI account representative or broker. Claims submitted after the time limit will be You pay $0 for services received through BCBSRI Doctors Online, which provides access to top-rated, board-certified doctors via smartphone, tablet, or computer. payment , BCBSRI . Locations where you can talk to our customer service team face-to-face, pay bills, take exercise classes like yoga and salsa, and attend seminars on BCBSRI pays each service based on how the provider is paid by FFS Medicare. We have built our reputation with an excellent medical staff, diverse services and dedication 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. HSA funds roll over from one year to the next, and the balance earns interest. ; In Your Blue Store: Visit us at any Your Blue Store location to enroll with help in person. So if the total bill is $100, the coinsurance would be $20. To authorize BCBSRI to withdraw your monthly payment from your checking or savings account, simply follow these steps: 1. Manage all your bills, get payment due date reminders and schedule automatic payments from a single app. ) Talk with family, friends, and doctors about your options, but remember that their situations may not be the same as yours. The member's physician/provider may bill BCBSRI and receive payment for the substitute physician/provider’s services as though the member's regular physician/provider performed them when these procedures are followed. Pay the lowest available price AND have covered Rx purchases applied to your deductible. effective date: 01|01|2021 policy last updated: NO BILL PROV LAST/ORG NM . This information will show you how to use your online account placement. BCBSRI will only pay for an assistant surgeon for those procedures with an indicator 2 (assistant surgeon This policy is intended to define BCBSRI payment policies and criteria for reimbursement for telemedicine and telephone only services. 837 and 835 How To Conduct Partner Testing. . com. Consumer-Driven Health Medicare Advantage See all your options, compare plans, and enroll. Dental Direct Basic; Dental Direct Standard; Dental Direct Plus; Dental Direct Elite Assistant Surgeon Payment Rules . com and log in. LCDPs who render services in a contracted facility may be eligible for reimbursement in accordance with the facility’s agreement with BCBSRI. Dental Connections - Fall 2024; Dental Connections - Spring 2024; Dental Connections - Fall 2023; Dental Connections - Spring 2023; Dental 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. Billing Provider Entity Type is 1 (person) and Billing Provider First Name is missing : P, D . The Electronic Payment Option Plan is easy to set up. Learn more. Using the links on the left, you can view the details of member, employer, and provider web accounts. BCBSRI has updated our system to reflect the new CMS Hospital Bill Type/Class (087) that becomes effective 1/1/2021. (Or call BCBSRI. Representatives are available to help Monday through Friday from 8:30 a. (Some insurance companies call it an Explanation of Benefits. Make an immediate payment To make an immediate payment, contact BCBSRI Credit & Collections at (401) 459-5821. You will pay less if you use a provider in the plan’s network. prescription drugs (instead of paying the pharmacy). You will pay the most if you use an out-of-network provider, and you might appealed. If the member is not active in BCBSRI’s system at the time of entry, they will not be found. The funds will be withdrawn When it’s time to pay for your doctor’s visit or health care procedure, there are a few balances that may need to be paid by you instead of your insurance: the deductible, coinsurance, and copay. In the timeframe, the provider does not have a denial and cannot bill the member until the claim is released for payment or the claim has denied for termination of coverage; Back to (401) 274-4848 WWW. ) call your doctor or BCBSRI Customer Service at the number on the back of your card or (401) 459-5000 or 1-800-639-2227 (outside RI). • To finalize payment, click Submit on the following page. If Medicare pays only a portion of this premium, we will bill you for the amount that Medicare doesn’t cover. As part of our ongoing work to improve access to pricing information and as required under the new Transparency in Coverage rule, Blue Cross & Blue Shield of Rhode Island (BCBSRI) is making available machine-readable files with provider payment information. Save on prescriptions The hospital administering the injections should bill Blue Cross and Blue Shield of Rhode Island (BCBSRI) directly for the drug. Each tier has a corresponding copay, depending on your health plan: Tier 1 – Lowest cost generic drugs; Tier 2 – Low-cost generic drugs; Tier 3 – Higher cost generic and preferred brand name drugs; Tier 4 – Highest cost generic and non-preferred brand name drugs; Tier 5 – Specialty drugs. (401) 274-4848 WWW. ID number (if payment is to be made to the doula), and all member information e. On January 1, BlueCare Connect will replace myBCBSRI. 6064 or 1-800-637-3718 ext. uploaded by BCBSRI. Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage To pay as a guest, fill out the policy holder's information below. For COVID-19 vaccine coverage, please refer to the separate policy for COVID-19 Vaccinations. If you want. • To finalize. 500 Exchange Street Providence, RI 02903 -2699 COVERAGE CODING (401) 274-4848 WWW. A participating dentist may not bill the member. Telemedicine is a broad term used to describe an array of electronic communications between medical personnel and patients at different locations. 1000 ext. EFFECTIVE DATE: 01|01|2024 POLICY LAST REVIEWED:09 |0 4202. Register Now. We made changes to our telemedicine/telephone services policy in March of this year to expand coverage and waive members’ cost share for telemedicine services, to help them get the care they needed from home during the COVID-19 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 PAYMENT COVERAGE POLICY | 1 (401) 274-4848 WWW. 13 Take 5 For You Find easy-to-use ideas to help manage However, because of the nationwide outage, Doctors Online cannot immediately verify any insurance benefits. 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 PAYMENT COVERAGE POLICY | 1 (401) 274-4848 WWW. • More ways to pay. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference The percentage of the total medical bill that you have to pay after you’ve met your deductible. This subscriber agreement replaces any previous subscriber agreement issued for this type of coverage. bills, viewing transaction activity, and scheduling contributions, can all be done through bcbsri. “Out-of-network” de scribes providers a nd facilities t hat haven’t signed a contract wit h yo ur health plan. Assistant Surgeon Payment Rules . A deductible is the amount you’ll have to Frequently Asked Questions from BCBSRI COVID-19 provider call Q: Many other payers (UHC and Cigna) (G2012), are we allowed to bill for and receive payment for the most appropriate CPT codes 99441-99443? A: All BCBSRI normal coding and policy rules would apply. Call To enroll in Plan65, dental, or prescription drug coverage. , full name, address, member ID number, date of birth, so that BCBSRI has adequate information to process the Contracted doulas with BCBSRI shall not bill BCBSRI members for these services. Use one of the methods below to determine your copayments amounts: Access your plan information in Member Self-Service BCBSRI in conjunction with the Blue Cross and Blue Shield Association. Non-Covered: Rabies vaccinations, as a requirement for school or employment or related to an employment exposure, (e. EFFECTIVE DATE:02|15|2011 POLICY LAST REVIEWED:01 |17 2024. BCBSRI offers our Medicare Advantage members a meal delivery program through ILS Meals by Independent Living Systems. Out-of-state: 1-800-676-2583 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. BCBSRI Medicare Advantage Non-Skilled Home Health Care Benefit – FAQ. On the phone: Call our enrollment line at 1-877-969-2583 (TTY: 711). Rhode Island (BCBSRI) has determined that the services outlined in this policy are medically appropriate to either be provided via telemedicine or telephone only. 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 PAYMENT COVERAGE POLICY | 5 Just show your BCBSRI member ID card; Full coverage for programs to stop smoking, lose weight, and manage conditions like asthma and diabetes *MedsYourWay is not insurance. Post Registration You can pay using an electronic check, Bill Me Later®, or credit/debit card (VISA®, MasterCard®, Discover® or American on the check. Every BCBSRI plan includes 100% in-network coverage for your annual physical, flu shot, and recommended tests and screenings. You can also check out our virtual events and classes, and tell us how you want to hear from us. Call our customer service team 7 days a week: (401) 459-5000 or 1-800-639-2227 (TTY/TDD: 711) I am willing to pay more of my medical bills out of my own pocket when I receive care if it means I could pay lower monthly premiums. Power. In all cases the participating physicians/providers are responsible for compliance under their contract. Y0146_2025EOCvalue_C OMB Approval 0938-1051 (Expires: August 31, 2026) January 1 – December 31, 2025. Complete the EFT Form. COM PAYMENT POLICY | 4 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 PAYMENT COVERAGE POLICY | 4 (401) 274-4848 WWW. DO NOT SEND CASH. What are my copayment amounts? Copayment amounts differ from plan to plan. BCBSRI does not credential Licensed Chemical Dependency Professionals (LCDP). We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. PROVIDER TRAINING, ANNUAL CMS REQUIREMENT D-SNP Training | Blue Cross & Blue Shield of Rhode Island (bcbsri. com to manage your finances and payments. The payment for face-to -face services • Make a monthly premium payment • Review claim details, and • Connect directly with customer service. Now you can get help signing up for specialty drug copay assistance programs (like manufacturers coupons). BCBSRI may amend the terms and conditions of this Agreement, except . 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 MEDICAL COVERAGE POLICY | 2 (401) 274-4848 WWW. m. com effective date: 11|11|2011 policy last updated: 11 |3 2016 overview For more information on the meals program, call Independent Living Systems at 833-853-8946 (toll free) and provide your BCBSRI Member ID number. after January 1, 2013, BCBSRI allows providers to file with a modifier “TU” Special Payment Rate, Overtime 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 MEDICAL COVERAGE POLICY | 3 (401) 274-4848 WWW. C413 : BILL PROV ADDR MISSING . Effective for dates of service on or after 8/1/2019, BCBSRI requires any services provided by a provider (physician or midlevel practitioner) that is credentialed as a Primary Care Physician or Dual Provider to bill their services on a CMS-1500 using their Type 1 NPI number and appropriate Evaluation and Management Let us know what you think. This policy is applicable to Commercial Products. If your health insurance has a 10% coinsurance, you would pay the doctor $10 and your insurance would pay the doctor $90. Please submit the bill to: Blue Cross & Blue Shield of Rhode Island Attn: Claims Department 500 Exchange Street Providence, RI Access your Amazon credit card account on amazon. com This policy is intended to define BCBSRI payment policies and criteria for reimbursement for telemedicine and telephone only services. EFFECTIVE DATE: 10|15|2007 POLICY LAST UPDATED: 04|21|2021 . Fill out the information below: You have five ways to enroll in a Blue Chip for Medicare plan. EFT is easy to set up. Out-of-network providers may be This policy is intended to define BCBSRI payment policies and criteria for reimbursement for telemedicine and telephone only services. We’re happy to help. Get rewarded with wellness You can use our wellness program online or on your phone to help you feel better, have fun, and earn up to $500 per household. These high-deductible health plans offer employers some of our lowest monthly premiums, while providing the comprehensive pay the entire bill if yo u see a provider o r visit a health care fac ility that isn’t in your health plan’s network. Contact the Medicare Sales Team at (401) 351-2583 or 1-800-505-BLUE (2583) TTY: 711. 835 HIPAA 5010 Health Care Claim Payment/Advice Companion Guide. 500 Exchange Street . This plan uses a provider network. BCBSRI will only pay for an assistant surgeon for those procedures with an indicator 2 (assistant surgeon Blue Cross & Blue Shield of Rhode Island (BCBSRI) offers health plans to meet different needs and budgets. to 6:00 p. Read your newsletter for highlights of changes and news about Blue Cross Dental. Please note, you pay for any services not covered by Medicare A & B or Plan 65 Medicare Supplement Plan PCPs will need to change the “As of” date from the date of entry to January 1, 2025 as that is when the new product will be active for the member. Group’s failure to pay the Service Fee will not subject Group to termination for non-payment of premium. COM Please note cost share can vary depending on whether the service is obtained from BCBSRI’s designated web-based telemedicine service provider or a BCBSRI or BlueCard network provider. For FEP policies, please call (401) 272-5670. Completed Application Requirements . com or call 1-800-639-2227 or (401) 459-5000 for a list of network providers. Make a secure payment in four easy steps. The indicators are 0, 1, 2, and 9. Note: Electronic check and Bill Me Later® require pre-registration by logging on to BCBSRI. Twitter. NEW PROVIDER CREDENTIALING PROCESS . Doctors Online will submit a claim to BCBSRI after your visit is completed and then will bill you for any copay you might owe once your insurance benefits are applied. We Your Flexible Benefit Card makes it easy to pay for the products and services you need the most. HQ Address. Pay without signing in 1 of 4. bcbsri. You also can view a quick summary of benefits below: 2025. to 4:30 p. COM The members of the NUBC endorsed 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 (401) 274-4848 WWW. Please submit the bill to: Blue Cross & Blue Shield of Rhode Island Attn: Claims Department 500 Exchange Street Providence, RI The percentage of the total medical bill that you have to pay after you’ve met your deductible. Let us know what you think. COM. • Flexibility and security. You saved 29% by using BCBSRI network discounts! Plan Benefit Period: 01/01/2023 - 12/31/2023. Do you have a preferred language other than English? ☐Spanish ☐Portuguese 2. If required for the audit, the provider will submit to BCBSRI’s audit designee a final, itemized bill within 30 calendar days of request. ) If a non-contracted provider submits a bill directly to you, you should not pay the bill. FlexAccess™ We know specialty drugs can be very expensive. (Open seven days a week, 8:00 a. Elimination of BCBSRI does not credential Licensed Chemical Dependency Professionals (LCDP). Call Monday through Friday 8:00 a. Description: An interim bill is one that is submitted and paid at agreed-upon (normally 30 day) intervals during the course of Medicare Advantage See all your options, compare plans, and enroll. BCBSRI. With every choice, remember that we're always happy to help. The policies below exclude Federal Employee Program® (FEP) products. If you're a renewing member, continue using your current card. Behavioral Health Authorization Request Form (Non Portal Users) Payment Policy | Hospital Laboratory Pass-Through Billing sad . 274-4848 WWW. "This is not a bill" or hospital and you have to pay part of the cost, we will send you a Healthcare Services Summary (HSS) in the mail. Written Correspondence. Coinsurance, or the amount of the bill not covered by your insurance, will kick in after Payment Plan, you’ll get a letter from your plan with information about how to pay your bill. Have your BCBSRI member ID handy. org. Example: A doctor might charge $100 for a visit. Complete the Electronic Payment Option form. Plan 65 Select F (01/20) - COC/SOB 3 Summary of Benefits Medicare Part A helps pay for health care in hospitals, skilled nursing facilities, hospice care, and some home health care services. If you don’t pay your bill by the date listed in that reminder, you’ll be removed from the Medicare Prescription Payment Plan. Listed below are the application requirements that need to be submitted at the time the application is (401) 274-4848 WWW. If you still owe a balance, you’re required to pay the amount you owe, even though you’re no longer participating in this payment option. ) It shows how much your provider will charge you when they send you an actual bill—and how much you saved by using the BCBSRI network. your HSA debit card (provided with your account), ACH, online bill-pay, check, or you can pay out-of-pocket and then reimburse yourself from your HSA (as long as the HSA was open at the time you made the purchase). Talk with your employer about available group coverage. If we cash a late premium payment you send us, it does not automatically constitute acceptance of the premium by us. This policy documents payment and claims filing guidelines for immunizations and vaccinations provided for pediatric and adult members. and/or dental coverage directly with BCBSRI. com) Online pharmacy directory - most up to date; 2024 PDF version of the pharmacy directory - to print or email; 2024 PDF version of the pharmacy directory - to print or email; You may save money when you use one of these preferred pharmacies; You may save money when you use one of these preferred pharmacies *Please note that the directories are subject to Present your BCBSRI member ID card. Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage WHEREAS Broker and Group have requested that BCBSRI bill Group for the Service Fee on the Broker’s behalf; and . Search, view, and print our current medical coverage and payment policies. The Summary of Benefits is intended to give you a general understanding of benefits available under this plan. Log in . Plan 65 F (01/20) - COC/SOB 1 SUMMARY OF BENEFITS This is your subscriber agreement for Plan 65 Medicare Supplement Plan F. You can choose to pay your balance all at once or be billed monthly. Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Don’t have an account? We comply with applicable Federal civil rights laws and do not Find online bill pay for Blue Cross Blue Shield of Michigan and Blue Care Network here. The Form CMS-1500 is the standard paper claim form used by health care professionals and suppliers to bill Medicare Carriers or Part A/B and Durable Medical Equipment Medicare Administrative Contractors. Providence, RI 02903. EFFECTIVE DATE: 01|01|2024. After you receive the explanation of benefits (EOB), send the information with a new bill to BCBSRI for secondary payment. A specific dollar amount you pay when you get healthcare. Shield of Rhode Island (BCBSRI). 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 PAYMENT COVERAGE POLICY | 5 • Pay medical bills directly from their HSA or with an HSA debit card. Coding: Unless specified in a specific payment policy, BCBSRI fo llows correct coding and payment guidelines published 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 PAYMENT COVERAGE POLICY | 4 (401) 274-4848 WWW. What happens if I don’t pay my bill? You’ll get a reminder from your health or drug plan if you miss a payment. eBill functionality consolidates your insured Blue Cross Blue Shield of Massachusetts invoices in one place and lets you pay with the click of the mouse. View your monthly premium or pay your bill to maintain coverage. C414 : BILL PROV CITY MISSING . CODING Commercials Products Medicare Advantage Plans . Please refer to the payment policy for additional details by clicking here. Will you pay less if you use a network provider? Yes. We will inform you when we have reinstated normal processes. Pay your Blue Cross & Blue Shield of Rhode Island bill with doxo bcbsri. syf. 2024 BCBSRI Duals Special Needs Plan (D-SNP) Model of Care (MOC) BlueRI for Duals Provider FAQ you as a provider cannot bill the member for this type of plan but can bill to Medicaid for payment with a copy of the RA denial. When ready to pay the claim, click Next. the claim information. You’ll Customer Service Welcome to the Customer Service Home Page. 1. You’ll pay the pharmacy directly for new out-of-pocket drug costs after you leave the Medicare Prescription Payment Plan. R4 Retrofit) BCBSRI system will be modified for the new Hospital Bill Class/Type, effective January 1, 2021, to treat the new code as Outpatient for the purpose of Claim/UM Matching If a non-contracted provider submits a bill directly to you, you should not pay the bill. Hours: Monday through Friday, 8:00 a. BCBSRI uses the assistance surgeon indicators on the Medicare Physician Fee Schedule (PFS RVU file) as a guideline to determine if we will pay for an assistant surgeon. applied to premiums due to BCBSRI. AMENDMENTS: a. Y0146_2025EOCacc_C OMB Approval 0938-1051 (Expires: August 31, 2026) January 1 – December 31, 2025. Deliveries are made Monday through Friday only. 6032 SUB A as amended). D. They can use their debit card or checks that are linked to the HSA to pay medical bills. 837 HIPAA 5010 Health Care Claim: Dental Companion Guide. U-verse® AT&T Pay your Xfinity bill anytime, on any device. Committed to Excellence! PrimaCare has become a recognized leader in medical care for southeastern New England communities. A deductible is the amount you’ll have to pay for most care before your health plan starts paying. Proof of payment will appear on your bank statement and your next month’s premium bill. The table below shows how much Medicare, this plan, and you pay for specific services. The payment determination is a contractual payment policy. Click Request Reimbursement for the specific claim you want. Billing Provider Street Address is missing : A . This policy is to document the general requirements for the timely filing of claims by providers. If you enrolled through HealthSource RI, please call 1-855-651-7873 for information about payment options. Register to get started on eBill today. ; Informational meeting: Come to one of our meetings to learn about your options and complete To ensure prompt payment from BCBSRI, please include as much information as possible. You can receive 24/7 care for common, non-emergency health concerns as well as pre-schedule virtual behavioral healthcare appointments with licensed therapists and psychiatrists. Do you prefer home delivery? When it’s time to pay for your doctor’s visit or health care procedure, there are a few balances that may need to be paid by you instead of your insurance: the deductible, coinsurance, and copay. 2. So at the time of the visit, you will not pay for the service. HSAs are a convenient and easy way to save for future medical expenses. can use this payment option. There are basic plans with traditional benefits, a local network plan with lower premiums, and another option that offers Use myBCBSRI to pay your bill, confirm coverage, track your deductible, review claims, access your HSA (if Look up Medical and Payment Policies. This policy is intended to define BCBSRI payment policies and criteria for reimbursement for telemedicine and telephone only services. COM testing/processing of the specimen to bill BCBSRI directly using a CMS 1500 claim form unless otherwise 500 exchange street, providence, ri 02903-2699 medical coverage policy | 1 (401) 274-4848 www. For example, BCBSRI’s Make a bill payment online without signing in! Just provide your account number or active AT&T phone number and easily pay your bill online. Although not submitted for payment purposes, encounter claims must also be received within the same timeframe. This policy documents payment using the CMS-1500 and UB-04 paper claim forms. The Blue Cross and Blue Shield Association is an • Pay your premium bill To do: Create your myBCBSRI account Go to myBCBSRI. When you visit a doctor, lab, or hospital and you have to pay part of the cost, we will send you a Healthcare Services Summary (HSS) in the mail. Pay by check As a Blue Cross & Blue Shield of Rhode Island (BCBSRI) member, you can choose to have your monthly premium payment deducted automatically from your checking or savings account. Please use your card for approved items (determined by point-of-sale technology) and pay for any uncovered items or remaining balance with another form of payment. If you want to pay yourself, click Pay Me. (Select “Pharmacy,” on the left hand side of your member homepage, and follow prompts BCBSRI members have a $0 copay for a 90-day supply of many common medications. Page 4 of 5 We try to accommodate a member’s preferred language to receive BCBSRI correspondence when possible. If another carrier is the primary payer and a Blue plan is secondary Bill the other carrier first. Bilateral Surgery BCBSRI has adopted CMS payment policies with respect to bilateral services. DON’T pay Blue Cross & Blue Shield of Rhode Island the Part D-IRMAA. Medicare Advantage See all your options, compare plans, and enroll. Y0146_2025EOCextra_C OMB Approval 0938-1051 (Expires: August 31, 2026) January 1 – December 31, 2025. Log in and View your claims and see how much you have spent on out-of-pocket expenses. Healthy choices earn rewards You and your employees can earn with Wellness Premium Reward. on the following page. 4. to pay the provider, click Pay Provider. Do I need to pay a copayment at the time of my visit? If your plan requires a copayment for certain services, you must pay it at the time of treatment. POLICY LAST REVIEWED: 09 |0 4202. COM If a Direct Pay member owes their premium to BCBSRI, their claims will be pended until a payment is received or BCBSRI terminates the member's membership. These files will be created internally, updated monthly, and posted to bcbsri. You can still see your billing information through your online account in the BCBSRI Employer Portal. For example, some plans have a 20% coinsurance charge for physical therapy. 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 PAYMENT COVERAGE POLICY | 5 Per our 2019 Provider Manual, for consumer-driven health (CDH) plans including HSAs, HRAs, and flexible spending accounts (FSAs), BCBSRI does not allow in-network participating providers to require payment for services that are applied toward the patient's health plan deductible or coinsurance benefit, at the point of service and before the claim is submitted Health will only be allowed to render and bill for behavioral health services. All plans offer this payment option and. payment, click Submit. House Bill No. Copay. When your payment arrives past the due date or is not in the full amount, you may lose your coverage. See www. It only takes a couple of minutes and will help us improve our service. As a provider you are required to bill BCBSRI if you were billing Medicare, and you must accept this payment as payment in full and must not balance bill the member. Send the claim to BCBSRI with the primary member ID first. Field Name of Field Information to Enter 1 Billing provider name, address and telephone number (phone # and fax # desirable) The name and service location of the provider submitting the bill. Contracts may differ and supersede this information. Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage • If the bill is mailed to you, you can call the provider to process your debit card payment over the phone, or you can write your debit card number on the medical bill and mail it back to the provider. com to create your account. 5. If you're new to BCBSRI, start by activating your card. POLICY BCBSRI pays each service based on how the provider is paid by FFS Medicare. If you already have dental coverage with BCBSRI, you can find everything you need to know about your plan, including covered services and claims, through the Dental Benefits section of your online account. You’ll get a Let us know what you think. • Review the claim information. Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage BCBSRI members rated us #1 in member satisfaction among commercial health plans in the Northeast region - J. View your health insurance bills, check previous payments, and make payments. 500 uploaded by BCBSRI. We update policies on a regular basis and they are subject to change. Click Request Reimbursement. Online bill pay •1. COM (508) 676-3292. Select a product. The fields identified with the blue type are mandatory. OVERVIEW . COM PAYMENT COVERAGE POLICY | 3 • Retail based clinic • Rehabilitation hospital If a non-contracted provider submits a bill directly to you, you should not pay the bill. ; Medicare Supplement Help cover costs with a Plan 65 option. For more information pertaining to the MA Payment Guide for Out-of-Network Payments, please click here. participation is voluntary. Locations where BCBSRI members can talk to customer service team face-to-face, pay bills, take exercise classes like yoga and salsa, and attend seminars on health, nutrition, and other topics. 6064 or email EmployerSupport@bcbsri. Option 1 - Electronic funds transfer (EFT) from your bank account each month. g. 70. C412 : NO BILL PROV FIRST NAME . For questions about your coverage, please refer to your subscriber agreement/benefit booklet or call Customer Service at (401) 459-5000 or 1-800-639-2227 (outside RI). Billing Provider Y0146_2024EOCBlueRI_C OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2024. New CMS Hospital Bill Type/Class (087) as Outpatient (5. If you select this payment option, each month you’ll continue to pay your plan premium (if you have one), and you’ll get a bill from your health or drug plan to pay for your . The claim will not automatically cross-over. You should submit it to us for processing and determination of your liability. Billing Provider Last/Organization Name is not present : A . If you don’t select a payment option, you will get a bill each month. To be considered for benefit payment, you must submit a clean claim within 180 days of the date of service or completion of an inpatient stay, or monthly in the case of an extended stay. for the specific claim you want. Participating physicians may not require members to pay a co-surgeon fee even if the members accept responsibility to do so, as this is charging outside of the approved amount. It is a drug discount program administered BCBSRI members may have a lower copay for a 90-day supply of many common medications. With a single log-in or phone call, you can access health and wellness apps, plan information, care management, and customer service—and get personalized health support from Care Guides, nurses, and coaches. View PDF. com effective date:01|01|2019 policy last updated: 07|02|2019 overview The percentage of the total medical bill that you have to pay after you’ve met your deductible. Payment . Please note this is not a complete listing. amxo ehvxv ovjygy uifm jikft box uodf ysvz wnwj wsddg