Oxygen and respiratory equipment 10121 BlueChoice HealthPlan South Carolina Medicaid 13554 BlueCross Medicare Advantage 11177 Bluegrass Family Health. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. To ensure the lowest cost to your patients, please send BlueCross and BlueChoice members testing to in-network laboratories only. Refer to the BlueChoice Radiology Utilization Matrix for specific procedures that require authorization. BlueChoice HealthPlan Log in to My Health Toolkit. With the My Health Toolkit app, you can: Find a doctor or hospital in your network. We also require prior authorization for lumbar and cervical spine surgery in an inpatient and/or outpatient location. Columbia, SC Blue Option It was also the first health plan in the state to receive accreditation from the National Committee for Quality Assurance (NCQA). Find your answers online in My Insurance ManagerSM! HealthMarkets Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, PPO and PPFS organizations and stand-alone prescription drug plans. Copyright 2023, BlueChoice HealthPlan. Avalon will promptly review your request and provide a timely, written decision. Because BlueChoice belongs to Blue Cross Blue Shield of South Carolina, members have access to some of the largest networks in the state. My Health Toolkit Access your digital ID card, check claims status, view plan Specialty medications often are covered under the medical benefit. Magellan manages precertification for advanced radiology, musculoskeletal care, radiation oncology and nuclear cardiology, as well as certain imaging services. Agent cannot provide tax or legal advice. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. Home speech therapy Durable Medical Equipment (DME) The centers of excellence are staffed by qualified clinical pathologists and genetic counselors prepared to answer your inquiries both before and after you perform testing. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. Log in to My Health Toolkit. Find the right care for you across our expansive network of doctors, hospitals and (These links lead to third party sites. Members may choose to take part in our Away From Home Care program which allows you to take your plan benefits with you if youre in- or out-of-area for at least 90 days. Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc. and First Care, Inc. are affiliate companies and also offer health benefit products and services on this site. P.O. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. Not all agents are licensed to sell all products. Health care is complicated. P.O. RadMD, one of the services NIA provides, allows contracting health care providers to enter authorization requests via the internet. Effective January 1, 2016, BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina require Avalon Healthcare Access your digital ID card, check claims status, view plan details and check your benefits. You can also view their radiology policies. You can also submit requests using the Prior Authorization for Services and Procedures Form. You can submit requests for prior authorizationby fax,phone or the web tool. Access your digital ID card, check claims status, view plan details and check your benefits. Box 6170 With BlueChoice HMO Open Access-High Option, your primary care provider (PCP) provides routine care and coordinates specialty care. Note that with this new program, certain lab procedures when performed in an office, outpatient or independent lab location will require prior authorization. See some of the benefits of being a member of BlueChoice HealthPlan. Use the "Ask Customer Service" feature to send a confidential email to the right person to help you. Create An Account. This precertification requirement is only applicable to BlueCross and BlueChoice Exchange members receiving nuclear cardiology services. Private duty nursing WebExplore tools to estimate and compare costs. The system is fast and easy to use and ensures accuracy. The Medical Form Resource Center (MFRC) is an online tool created to allow you to submit your precertification requests for some services electronically. Cost & Comparison Tools. If an out-of-network laboratory services you or you have outpatient testing performed by a hospital, your patients out-of-pocket cost may be significant. BlueChoice Health Plan was founded in 1984 and was the first HMO plan offered by BlueCross Blue Shield of South Carolina, sold under the name Companion HealthCare. Laboratory medicine is continuing to become increasingly complex. You can also call us at 800-868-2528 8:30 a.m. until 5 p.m. Eastern Time, Monday through Fridayor write us at: Do you need information about a patient's coverage, eligibility, claims, our network or other provider issues? View the Cardiac Services Checklist and Cardiac Services Tip Sheet to learn more about prior authorization requirements. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Each of the organizations we represent has a Medicare contract. ET, Monday through Friday. Hear better. We understand the unique insurance needs of individuals and families as well as small business owners and their employees. The Blue Cross and Blue Shield Names and Symbols are registered trademarks of the Blue Cross and Blue Shield Association. Call the Plans customer service phone number for more information. Beginning May 1, 2016, some groups will require National Imaging Associates (NIA) Magellan Healthcare Inc. precertification for interventional pain management spine services when performed and billed in an outpatient or office location. Copyright 2023 BlueChoice HealthPlan. WebBlueChoice HealthPlan is a wholly-owned subsidiary of Blue Cross and Blue Shield of South Carolina. There are also high deductible health plans (HDHPs) and flexible spending accounts (FSAs), and health reimbursement accounts (HRAs) for some health plan members. Do you have a question about QuickBillSM, QuickEnroll or other general questions about administering your company's BlueChoice HealthPlan coverage? Please use the Prior Authorization Request for Ancillary Services Form. January 1, 2016, we introduced a program that will improve the quality and reduce the cost of laboratory services our members receive. View a comprehensive list of the independent laboratories that are in-network. The company sells Like many insurance companies, BlueChoice HealthPlans product offerings include the following types of plans: HMO, EPO, and HDHP. Columbia, SC 29260-6170. is an independent licensee of the Blue Cross Blue Shield Association. Hematologists, oncologists, nephrologists and rheumatologists may continue to bill for these drugs under the medical benefit. We have the plans to fit your health care needs and budget. BlueChoice is simple. Our goal is to make the prior authorization process fast, easy and accurate. Visit RadMD, the secure webpage of National Imaging Associates (NIA). Since 2010, HealthMarkets has helped enroll Americans in more than 4 million insurance policies. ET, Monday through Friday. Kaiser Family Foundation (2019). Average Single Premium per Enrolled Employee For Employer-Based Health Insurance. Feel Health Tips & Tools. HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Hemophilia management NIA Magellan is an independent company that provides utilization management services on behalf of BlueChoice HealthPlan. BlueChoice HealthPlan CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., First Care, Inc., The Dental Network and CareFirst BlueChoice, Inc. are independent licensees of the Blue Cross and Blue Shield Association. All rights reserved. Any information we provide is limited to those plans we do offer in your area. Compare affordable BlueChoice HealthPlan health insurance plans and save money. iy_2023; im_07; id_01; ih_00; imh_21; i_epoch:1.68819609332E+12, py_2023; pm_06; pd_08; ph_10; pmh_00; p_epoch:1.68624363537E+12, link-block; link-block_link-block; bodystr, pn_tstr:Thu Jun 08 10:00:35 PST 2023; pn_epoch:1.68624363537E+12, https://www.healthmarkets.com/company/blue-choice-health-plan/. The drugs on the Self-Administered Drug Listmust be billed under the pharmacy benefit. Both are Independent Licensees of the Blue Cross and Blue Shield Our Or write us at: Brochure. Copyright 2023 BlueChoice HealthPlan. There are some exceptions. Certain self-administered drugs arent covered under the medical benefit. Blue365 gives you exclusive access to health information and more! WebBlueChoice HealthPlan offers Blue Option to individuals and families seeking health coverage in South Carolina. (If it's your first time, you'll have to create a simple profile first.) Other Logins. Visit with a doctor anytime, anywhere with Blue CareOnDemand. You will be required to provide proper documentation before your coverage becomes effective. Access your digital ID card, check claims status, view plan details and check your benefits. There are open access plans through BlueChoice Advantage and BlueChoice Advantage Plus, which allows members to visit doctors and specialists without a referral. P.O. Which Laboratories are In-network? 10121 BlueChoice HealthPlan South Carolina Medicaid 13554 BlueCross Medicare Advantage 11179 BMC HealthNet Plan 13151 Boon-Chapman Beneit Admin. WebFor log in problems: Please try the email address that you registered with as your user name. Drugs with a site-of-care requirement may only be approved in certain sites of care or if the patient is under 18 years of age. Your favorite features from the website are now available in a mobile app. For a more complete summary of your benefits, please see your 2018 Plan Information Booklet. We've put together some information to better serve you when requesting prior authorization. You can video chat with a doctor anytime, anywhere through Blue CareOnDemand. WebYou can call us at 800-868-2528 8:30 a.m. until 5 p.m. WebLearn all the ways you can save, just because you're a BlueChoice HealthPlan member! BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. We can only accomplish this if we effectively manage the network of laboratory providers and if your practice accesses the laboratories that have been accredited for participation in the health plan. BlueChoice HealthPlan. WebLaboratory Prior Authorization. Your Rights & Protections Against Surprise Medical Bills, Non-Discrimination Statement and Foreign Language Access. Access the user guide here. Box 6170. The company sells health insurance to individuals and families and has around 31 different plans through the Blue Option that includes bronze, silver, gold, and catastrophic coverage. Note: Some infused specialty medications commonly administered in the hospital setting can be safely provided at home, in a physicians office or in an infusion suite. Need information about our products, quotes or how to use My Business Manager? Its easy to get a free insurance quote now. WebBlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. Health Spending Account PDFs require Adobe Acrobat Reader to open. Contact your tax or legal professional to discuss details regarding your individual business circumstances. To find out which medical specialty drugs require prior authorization under the Specialty Medical Benefit Management (SMBM) program, view the Medical Drug List. We are dedicated to ensuring your patients receive the highest quality laboratory testing at the most reasonable cost. This information is not a complete description of benefits. The cost of health care is rising for everyone and we have an obligation to ensure that our members receive the highest quality of care at the most affordable cost. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. Note: Prior authorizations for medical specialty drugs have always been a requirement for BlueChoice HealthPlan members. Service and product availability varies by state. My Insurance Manager also has an "Ask Provider Services" feature, where you can send a secure message directly to our Provider Services department. Key plan changes. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1- 877-486-2048) 24 hours a day/ 7 days a week to get information on all of your options. No obligation to enroll. Please check this page frequently for new information. Januar PAYER ID PAYER NAME It is a part of the BlueCross BlueShield group rating of A+ received by A.M. Best Company. Want information about our Great Expectations for health programs? BlueChoice has considered this issue and has included specialty labs and centers of excellence within the network of laboratory providers. Get Healthy with the FOCUSfwd Wellness Incentive Program. WebBlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. Orthotics and prosthetics WebAbout BlueChoice HealthPlan From the mountains to the Midlands, across the state and down the coast, BlueChoice HealthPlan is truly South Carolina's health plan. Member & Guest Services Enrollment in any plan depends on contract renewal. Home occupational therapy This program will assist us in ensuring appropriate testing for our members at the lowest out-of-pocket cost. How Do You Contact Avalon? Member & Guest Services Non-Discrimination Statement and Foreign Language Access, Your Rights and Protections Against Surprise Medical Bills, Get connected to BlueChoice HealthPlan faster and easier with the, Stay on track to meet your goals with some help from of our. We do not offer every plan available in your area. How Does This Program Affect You? Non-Discrimination Statement and Foreign Language Access. Access your digital ID card, check claims status, view plan details and check your benefits. With thousands of plans to choose from nationwide and personal service at no additional cost to you, HealthMarkets is the smarter way to shop for insurance. BlueChoice HealthPlan is a health maintenance organization in South Carolina and an independent licensee of the Blue Cross and Blue Shield Association.
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