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. HealthMarkets Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, PPO and PPFS organizations and stand-alone prescription drug plans. WebWith BlueChoice HMO Open Access-High Option, your primary care provider (PCP) provides routine care and coordinates specialty care. 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. WebBlueChoice HealthPlan is a health maintenance organization in South Carolina and an independent licensee of the Blue Cross and Blue Shield Association. Find your answers online in My Insurance ManagerSM! Certain self-administered drugs arent covered under the medical benefit. 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. Blue Option | BlueChoice HealthPlan of South Carolina Providers | BlueChoice HealthPlan of South Carolina There are some exceptions. Thats why its important to review whether the use of these medications meets coverage criteria before a specialty drug is provided. Hematologists, oncologists, nephrologists and rheumatologists may continue to bill for these drugs under the medical benefit. Prior Authorization | BlueChoice HealthPlan of South Want information about our Great Expectations for health programs? ET, Monday through Friday. Contact | BlueChoice HealthPlan of South Carolina What Other Resources are Available to Assist Me in Learning More About Avalon? Each of the organizations we represent has a Medicare contract. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. PAYER ID PAYER NAME ENROLLMENT REQUIRED - ABILITY WebBlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. Private duty nursing Durable Medical Equipment (DME) WebBlueChoice HealthPlan of South Carolina. Visit with a doctor anytime, anywhere with Blue CareOnDemand. With Blue Option, you get more than just a great health plan. Health Spending Account Get Healthy with the FOCUSfwd Wellness Incentive Program. BlueChoice HealthPlan The program also includes requirements for self-administered drugs and site-of-care that may impact coverage, which is important to know if you provide these types of medications. Not all agents are licensed to sell all products. Agent cannot provide tax or legal advice. Let us help you understand the many options available so you can make the best choice. You can also use our Doctor & Hospital Finder to find participating labs. Summaries of benefits and coverage. Avalon will promptly review your request and provide a timely, written decision. You have access to comprehensive services such as after-hours care including 24-hour nurse advice line, video visits, convenience care clinics, and urgent care visits. Blue365 gives you access to exclusive health and wellness discounts. Which Laboratories are In-network? Open enrollment has ended. Additionally, some member benefit plans may be exempt. For a more complete summary of your benefits, please see your 2018 Plan Information Booklet. BlueCard lets you take your health care coverage wherever you go. To find out which medical specialty drugs require prior authorization under the Specialty Medical Benefit Management (SMBM) program, view the Medical Drug List. Non-Discrimination Statement and Foreign Language Access. Note that with this new program, certain lab procedures when performed in an office, outpatient or independent lab location will require prior authorization. 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. You can submit requests for prior authorizationby fax,phone or the web tool. Columbia, SC BlueChoice HealthPlan Explore BlueChoice HealthPlan with HealthMarkets today! Or write us at: Our quoting tool is provided for your information only. About Us | BlueChoice HealthPlan of South Carolina P.O. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. We've put together some information to better serve you when requesting prior authorization. Hospice. How Does This Program Affect You? Prior Authorization Request for Ancillary Services Form. Get rewarded for living a healthy lifestyle with the FOCUSfwd Wellness Incentive Program. We also require prior authorization for lumbar and cervical spine surgery in an inpatient and/or outpatient location. Web2023 Blue Option SM. Get a quote and enroll your clients! 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. You can call us at 800-868-2528 8:30 a.m. until 5 p.m. With the My Health Toolkit app, you can: Find a doctor or hospital in your network. BlueChoice HMO Open Access-High Option - CareFirst Blue365 gives you exclusive access to health information and more! All rights reserved. Other Logins. 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. Orthotics and prosthetics This change does not alter the available member benefits, but using these participating providers will result in a lower out-of-pocket cost for your BlueCross- and BlueChoice-covered patients. WebA proprietary health plan-specific indication of the type of provider being enrolled for EFT with spe-cific provider type description included by the health plan in its instruction and BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. You can video chat with a doctor anytime, anywhere through Blue CareOnDemand. Here are National Imaging Associates' reference materials about this radiation oncology program: Effective November1, 2016, BlueCross BlueShield of South Carolina and BlueChoiceHealthPlan require precertification for nuclear cardiology services through National Imaging Associates (NIA). Forgot Password? WebChoice by Select Health of South Carolina Humana Healthy Horizons@ in South Carolina Healthy Blue BlueChoice@ HealthPlan of SC 2023 HealthMarkets Insurance Agency. Refer to the BlueChoice Radiology Utilization Matrix for specific procedures that require authorization. View a comprehensive list of the independent laboratories that are in-network. MSK Group Prefixes Requiring NIA MSK Precertification, MSK Interventional Pain Management Checklist, MSK Interventional Pain Management Frequently Asked Questions, MSK Quick Reference Guide for Order Physicians/Surgeons, MSK Spine Surgeries Frequently Asked Questions, RadMD Pain Management Injection Quick Start Guide, RadMD Pain Management Surgery Quick Start Guide, Radiation Oncology Frequently Asked Questions (FAQ), Radiation Oncology Solutions Presentation, Radiation Therapy Treatment Notification Form, Avalon Claim Editor Frequently Asked Questions, Non-Discrimination Statement and Foreign Language Access, Your Rights and Protections Against Surprise Medical Bills. 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. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. What Physicians Need to Know About Avalon WebBlueChoice HealthPlan offers Blue Option to individuals and families seeking health coverage in South Carolina. Use the "Ask Customer Service" feature to send a confidential email to the right person to help you. BlueChoice has considered this issue and has included specialty labs and centers of excellence within the network of laboratory providers. ET, Monday through Friday. With BlueChoice HMO Open Access-High Option, your primary care provider (PCP) provides routine care and coordinates specialty care. Ancillary Services BlueChoiceHealthPlan directly manages prior authorizations, claims and network management processes for ancillary services, including: Why Did BlueChoice Make This Change? Thosecompaniesare solely responsible for the contents and privacy policies on their sites.). The drugs on the Self-Administered Drug Listmust be billed under the pharmacy benefit. Avalon is an independent company that provides benefit management services on behalf of BlueCross and BlueChoice. The company sells 10121 BlueChoice HealthPlan South Carolina Medicaid 13554 BlueCross Medicare Advantage 11179 BMC HealthNet Plan 13151 Boon-Chapman Beneit Admin. Sources: The Blue Cross and Blue Shield Names and Symbols are registered trademarks of the Blue Cross and Blue Shield Association. Box 6170 WebBlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. WebLaboratory Prior Authorization. Health Tips & Tools. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. As technology improves, the cost and utilization of these services increase. RadMD, one of the services NIA provides, allows contracting health care providers to enter authorization requests via the internet. NIA Magellan is an independent company that provides utilization management services on behalf of BlueChoice HealthPlan. Access your digital ID card, check claims status, view plan details and check your benefits. It is a part of the BlueCross BlueShield group rating of A+ received by A.M. Best Company. BlueChoice HealthPlan is a health maintenance organization in South Carolina and an independent licensee of the Blue Cross and Blue Shield Association. Blue Choice Option | Excellus BlueCross BlueShield Copyright 2023 BlueChoice HealthPlan. BlueChoice HealthPlan Oxygen and respiratory equipment My Health Toolkit Login | BlueCross BlueShield of South Carolina Find out what member discounts are available to you. There are open access plans through BlueChoice Advantage and BlueChoice Advantage Plus, which allows members to visit doctors and specialists without a referral. Copyright 2023 BlueChoice HealthPlan. P.O. WebFor log in problems: Please try the email address that you registered with as your user name. Effective January 1, 2016, BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina require Avalon Healthcare The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity, or religion. Need help with your coverage,claims, eligibility or benefits? | BlueChoice HealthPlan of South Carolina 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. 10121 BlueChoice HealthPlan South Carolina Medicaid 13554 BlueCross Medicare Advantage 11177 Bluegrass Family Health. 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. Service and product availability varies by state. Non-Discrimination Statement and Foreign Language Access, Your Rights and Protections Against Surprise Medical Bills. They can be costly for our members, and not all plans cover them the same way. 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. Its easy to get a free insurance quote now. ELECTRONIC FUND TRANSFER ENROLLMENT FORM To ensure the lowest cost to your patients, please send BlueCross and BlueChoice members testing to in-network laboratories only. My Health Toolkit Access your digital ID card, check claims status, view plan It was also the first health plan in the state to receive accreditation from the National Committee for Quality Assurance (NCQA). (These links lead to third party sites. Your favorite features from the website are now available in a mobile app. We are dedicated to ensuring your patients receive the highest quality laboratory testing at the most reasonable cost. Whether you know what coverage you need or want to explore your options, CareFirst offers a range of 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. WebExplore tools to estimate and compare costs. Log in to My Health Toolkit. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces. We have the plans to fit your health care needs and budget. 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. Log in to My Health Toolkit. Need information about our products, quotes or how to use My Business Manager? This plan allows members to visit specialists directly without referrals. Magellan manages precertification for advanced radiology, musculoskeletal care, radiation oncology and nuclear cardiology, as well as certain imaging services. Call the Plans customer service phone number for more information. BlueChoice HealthPlan of South Carolina Home infusion therapy Sometimes patients may need a specialized test. Download it free from the Adobe site. Copyright 2023 BlueChoice HealthPlan. Effective January 1, 2016, BlueCross BlueShield of South Carolina and BlueChoiceHealthPlan of South Carolinarequire Avalon Healthcare Solutions to precertify certain lab procedures when performed in an office, outpatient or independent lab location. All Rights Reserved. Copyright 2023, BlueChoice HealthPlan. View the Cardiac Services Checklist and Cardiac Services Tip Sheet to learn more about prior authorization requirements. Blue Choice Content - Get a Quote 2023 Blue Option. You can also view their radiology policies. CareFirst Member This precertification requirement is only applicable to BlueCross and BlueChoice Exchange members receiving nuclear cardiology services. Home occupational therapy Do you need information about or want to enroll in our Great Expectations for health programs? The Medical Form Resource Center (MFRC) is an online tool created to allow you to submit your precertification requests for some services electronically. WebMy Health Toolkit. Columbia, SC 29260-6170. Do you need information about a patient's coverage, eligibility, claims, our network or other provider issues? Here are reference materials about Avalon: BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue Shield Association. BlueChoice HealthPlan - Insurance from BlueChoice HealthPlan Find the right care for you across our expansive network of doctors, hospitals and This plan allows members to visit SM. Please use the Prior Authorization Request for Ancillary Services Form. Member & Guest Services BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue Shield Association. BlueChoice HealthPlan WebBlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. Blue Choice Option is a Medicaid Managed Care program sponsored by New York State. Plus, spending account resources that offer flexibility. Feel P.O. You can also submit requests using the Prior Authorization for Services and Procedures Form. Use the "Ask Customer Service" feature to send a confidential email to the right person to help you. Like many insurance companies, BlueChoice HealthPlans product offerings include the following types of plans: HMO, EPO, and HDHP. We do not offer every plan available in your area. You can still enroll for coverage if you have a qualifying life event that gives you a Special Enrollment Period. All rights reserved. Cost & Comparison Tools. 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. Note: Prior authorizations for medical specialty drugs have always been a requirement for BlueChoice HealthPlan members. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. Key plan changes. Prior Authorization for Services and Procedures Form. Please select "BlueChoice HealthPlan" followed by the study desired. Because BlueChoice belongs to Blue Cross Blue Shield of South Carolina, members have access to some of the largest networks in the state. Access your digital ID card, check claims status, view plan details and check your benefits. All quotes are estimates and are not final until consumer is enrolled. WebChoosing a health plan for yourselfor your familyis an important decision. Your Rights & Protections Against Surprise Medical Bills, Non-Discrimination Statement and Foreign Language Access. You will be required to provide proper documentation before your coverage becomes effective. Hear better. Member Information | CareFirst BlueCross BlueShield WebLearn all the ways you can save, just because you're a BlueChoice HealthPlan member! Today it serves around 200,000 people. Visit RadMD, the secure webpage of National Imaging Associates (NIA). Our The system is fast and easy to use and ensures accuracy. Forgot Username? is an independent licensee of the Blue Cross Blue Shield Association. Our goal is to make the prior authorization process fast, easy and accurate. Laboratory medicine is continuing to become increasingly complex. Individual & Family Health Insurance Plans in Maryland - CareFirst PDFs require Adobe Acrobat Reader to open. Copyright 2023 BlueChoice HealthPlan. Hemophilia management
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