BCBSRI

BCBSRI resources | PAC-IM

Carelon Medical Benefits Management is excited to announce the partnership with Blue Cross Blue Shield of Rhode Island (BCBSRI) for management of in-patient post-acute care services for Medicare Advantage members in the state of Rhode Island effective March 15, 2025.

Please find important announcements, documents, and forms listed below for this delegation.

Current announcements

March 15, 2025 | Delegation information

Delegation:
Effective March 15, 2025, Carelon will begin managing in-patient post-acute care services for most Medicare Advantage plans in the state of Rhode Island. Delegated services include utilization management.

A copy of the provider notice can be found here.

Training sessions:
Training sessions will be available here starting February 15, 2025.

Contact:
Email us with questions related to this delegation.

Provider information form

PAC-IM Facilities (SNF, IRF, LTACH only): Please ensure you are registering for the portal under the “Post-Acute Facility” option. If your facility information is not available in the Carelon portal, please complete the “Provider information form” found online here.

Authorization program materials

Fax confirmation form: Online form providers use to confirm their fax numbers for authorization requests

Fax request forms

Initial and continued stay request fax forms can be found below by setting type:

Fax forms for Skilled Nursing Facilities (SNF):
SNF initial request form
SNF continued stay request form

Fax forms for inpatient rehabilitation facilities (IRF):
IRF initial request form
IRF continued stay request form

Fax forms for Long-Term Acute Care Hospitals (LTACH):
LTACH initial request form
LTACH continued stay request form