Rhode Island Prior Authorization Requirements

A guide to prior authorization rules, turnaround times, and laws for medical practices operating in Rhode Island (RI).

PA Turnaround Times

Standard Requests

14 calendar days

Urgent / Expedited

72 hours

Key Regulations

  • Standard PA turnaround of 14 calendar days
  • Urgent requests within 72 hours

Rhode Island Medicaid PA

Rhode Island Medicaid uses managed care. PA administered by MCOs.

Top Payers in Rhode Island

Blue Cross Blue Shield of Rhode IslandUnitedHealthcareTufts Health Plan

State Regulatory Body: Rhode Island Department of Business Regulation

File PA complaints or appeals through your state insurance department.

Automate PA in Rhode Island

Greenlight knows every payer's PA requirements in Rhode Island and checks them automatically before every appointment -- so your staff does not have to.

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