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Blue Cross and Blue Shield of Rhode Island Implementation Resources

Please download and read through the following material. Our goal is to make the change to EviCore by Evernorth as seamless and easy as possible and these documents will explain the process. There is contact information in the material if you have any questions.

Effective 3/1/2024,  the management of Blue Cross Blue Shield of Rhode Island (BCBSRI) prior authorizations through EviCore will transition from the MedSolutions portal platform to the CareCore National portal platform. The new portal will be used to request prior authorizations for the following: Commercial and  Medicare Advantage plans for radiology and cardiology and members who have the Medicare Advantage plan for spine surgery procedures.

Blue Cross & Blue Shield of Rhode Island has expanded its partnership with EviCore by Evernorth to manage an additional prior authorization service for the Spine Surgery program for BCBSRI's Medicare Advantage members. Prior authorizations will be required for dates of service on or after 2/1/2023 and requests will be accepted starting 1/24/2023.

Blue Cross & Blue Shield of Rhode Island has expanded its partnership with EviCore by Evernorth to manage an additional prior authorization service for the Cardiology program for BCBSRI’s Commercial and Medicare Advance/Medicare Advantage members. For dates of service on or after October 1, 2019 providers must access EviCore by accessing the bcbsri.com provider portal to request prior authorizations beginning October 1, 2019. Prior authorizations can be requested using the phone 1-888-233-8158 beginning on September 23, 2019 for dates of service October 1, 2019 and beyond.

Please download and read through the following material. Our goal is to make the change to EviCore healthcare as seamless and easy as possible and these documents will explain the process. There is contact information in the material if you have any questions.

BCBS RI and EviCore by Evernorth are announcing a Program Change for the current radiology management program:
Beginning with dates of service January 1, 2011, BCBS RI will no longer allow facilities to obtain preauthorization on behalf of the ordering physicians.

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EviCore highly recommends providers take full advantage of the online capabilities at https://www.evicore.com/provider

Here you can request prior authorization, review our nationally accepted evidence-based guidelines, and receive announcements about program updates. Access requires only your email address and a brief registration.

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