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. Januar PAYER ID PAYER NAME With the My Health Toolkit app, you can: Find a doctor or hospital in your network. Oxygen and respiratory equipment Need help with your coverage,claims, eligibility or benefits? All Rights Reserved. Orthotics and prosthetics How Do You Contact Avalon? (These links lead to third party sites. Please check this page frequently for new information. PDFs require Adobe Acrobat Reader to open. Use the "Ask Customer Service" feature to send a confidential email to the right person to help you. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. Blue365 gives you access to exclusive health and wellness discounts. This precertification requirement is only applicable to BlueCross and BlueChoice Exchange members receiving nuclear cardiology services. WebChoosing a health plan for yourselfor your familyis an important decision. 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. To find out which medical specialty drugs require prior authorization under the Specialty Medical Benefit Management (SMBM) program, view the Medical Drug List. We do not offer every plan available in your area. Enrollment in any plan depends on contract renewal. Copyright 2023 BlueChoice HealthPlan. RadMD, one of the services NIA provides, allows contracting health care providers to enter authorization requests via the internet. Your favorite features from the website are now available in a mobile app. Effective January 1, 2016, BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina require Avalon Healthcare Home health services Hemophilia management You can call us at 800-868-2528 8:30 a.m. until 5 p.m. WebLaboratory Prior Authorization. Get rewarded for living a healthy lifestyle with the FOCUSfwd Wellness Incentive Program. Please call us toll free at 866-280-0766 or in Columbia at 803-382-5976. 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. Avalon is an independent company that provides benefit management services on behalf of BlueCross and BlueChoice. Call the Plans customer service phone number for more information. All quotes are estimates and are not final until consumer is enrolled. Thosecompaniesare solely responsible for the contents and privacy policies on their sites.). 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). Blue Option You can submit requests for prior authorizationby fax,phone or the web tool. The system is fast and easy to use and ensures accuracy. We understand the unique insurance needs of individuals and families as well as small business owners and their employees. Find your answers online in My Insurance ManagerSM! Prior Authorization Request for Ancillary Services Form. BlueChoice HealthPlan Non-Discrimination Statement and Foreign Language Access, Your Rights and Protections Against Surprise Medical Bills. BlueChoice has considered this issue and has included specialty labs and centers of excellence within the network of laboratory providers. Blue Option. Access your digital ID card, check claims status, view plan details and check your benefits. Member Center | BlueChoice HealthPlan of South Carolina Copyright 2023 BlueChoice HealthPlan. WebMy Health Toolkit. Here are NIA Magellan Healthcare Inc.s reference materials about this musculoskeletal (MSK) care management program: Beginning January 1, 2015, some groups will require National Imaging Associates (NIA) precertification for radiation oncology services when performed and billed in an outpatient or office location. 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 Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. 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. WebFor log in problems: Please try the email address that you registered with as your user name. Copyright 2023 BlueChoice HealthPlan. Copyright 2023, BlueChoice HealthPlan. ET, Monday through Friday. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. Other Logins. All rights reserved. Non-Discrimination Statement and Foreign Language Access, Your Rights and Protections Against Surprise Medical Bills. 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. Use the "Ask Customer Service" feature to send a confidential email to the right person to help you. If you have a headset, you can even talk to our provider service representatives online! BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Sources: About Us | BlueChoice HealthPlan of South Carolina is an independent licensee of the Blue Cross Blue Shield Association. 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. BlueChoice HealthPlan - Insurance from BlueChoice HealthPlan Compare affordable BlueChoice HealthPlan health insurance plans and save money. Find out what member discounts are available to you. It was also the first health plan in the state to receive accreditation from the National Committee for Quality Assurance (NCQA). Forgot Password? Avalon has developed a Lab Procedure Authorization matrix in an effort to help you determine when you need to contact Avalon for prior authorization. Visit with a doctor anytime, anywhere with Blue CareOnDemand. 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. 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. Access your digital ID card, check claims status, view plan details and check your benefits. Magellan manages precertification for advanced radiology, musculoskeletal care, radiation oncology and nuclear cardiology, as well as certain imaging services. Sales agents may be compensated based on a consumers enrollment in a health plan. Download it free from the Adobe site. P.O. P.O. Box 6170 Today it serves around 200,000 people. BlueChoice HealthPlan. There are also high deductible health plans (HDHPs) and flexible spending accounts (FSAs), and health reimbursement accounts (HRAs) for some health plan members. Or write us at: Member & Guest Services. Providers | BlueChoice HealthPlan of South Carolina They can be costly for our members, and not all plans cover them the same way. Home speech therapy Visit RadMD, the secure webpage of National Imaging Associates (NIA). WebBlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. WebYou can call us at 800-868-2528 8:30 a.m. until 5 p.m. Web2023 Blue Option SM. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. There are some exceptions. 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. Feel Do you have a question about your own personal claims, eligibility or benefits? This information is not a complete description of benefits. Not all agents are licensed to sell all products. Box 6170 Payer ID Payer Name Comments - ABILITY Network 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. Attention: This website is operated by HealthMarkets Insurance Agency and is not the Health Insurance Marketplace website. Our quoting tool is provided for your information only. What Physicians Need to Know About Avalon You can also submit requests using the Prior Authorization for Services and Procedures Form. PAYER ID PAYER NAME ENROLLMENT REQUIRED - ABILITY 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/. CareCore National Web Portal Let us help you understand the many options available so you can make the best choice. You can send prior authorization requests to Avalon by completing the Preauthorization Request Form, by calling 844-227-5769 or by faxing 888-791-2181. WebBlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. Learn about qualifying eventsto see if you qualify. Key plan changes. Open enrollment has ended. Hear better. Need to request a prior authorizationbut don't know where to start? BlueChoice HMO Open Access-High Option - CareFirst Blue Choice Content - Get a Quote Non-Discrimination Statement and Foreign Language Access. 10121 BlueChoice HealthPlan South Carolina Medicaid 13554 BlueCross Medicare Advantage 11179 BMC HealthNet Plan 13151 Boon-Chapman Beneit Admin. Healthy Connections Medicaid! We make changes to all of our drug lists from time to time. WebServing Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group WebBlueChoice HealthPlan of South Carolina. Refer to the BlueChoice Radiology Utilization Matrix for specific procedures that require authorization. Service and product availability varies by state. Agent cannot provide tax or legal advice. 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. Specialty medications often are covered under the medical benefit. Hospice. Columbia, SC 29260-6170. BlueChoice HealthPlan of South Carolina Home occupational therapy Access the user guide here. With Blue Option, you get more than just a great health plan. Home infusion therapy Blue Option SC See some of the benefits of being a member of BlueChoice HealthPlan. Do you need information about a patient's coverage, eligibility, claims, our network or other provider issues? Get a quote and enroll your clients! Access your digital ID card, check claims status, view plan details and check your benefits. My Health Toolkit Access your digital ID card, check claims status, view plan Get Healthy with the FOCUSfwd Wellness Incentive Program. 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. Access your digital ID card, check claims status, view plan details and check your benefits. Individual & Family Health Insurance Plans in Maryland - CareFirst Our goal is to make the prior authorization process fast, easy and accurate. WebBlueChoice HealthPlan is a health maintenance organization in South Carolina and an independent licensee of the Blue Cross and Blue Shield Association. Columbia, SC 29260-6170. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity, or religion. Since 2010, HealthMarkets has helped enroll Americans in more than 4 million insurance policies. Whether you know what coverage you need or want to explore your options, CareFirst offers a range of You can still enroll for coverage if you have a qualifying life event that gives you a Special Enrollment Period. 2023 Blue Option. Brochure. My Health Toolkit Login | BlueCross BlueShield of South Carolina Find the right care for you across our expansive network of doctors, hospitals and Prior Authorization for Services and Procedures Form. 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. Avalon will promptly review your request and provide a timely, written decision. For a more complete summary of your benefits, please see your 2018 Plan Information Booklet. As technology improves, the cost and utilization of these services increase. Precertification and Referral Guide Learn how to submit a referral or precertification request through My Insurance ManagerSM and determine which services we can automatically authorize. 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 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. Ancillary Services BlueChoiceHealthPlan directly manages prior authorizations, claims and network management processes for ancillary services, including: View a comprehensive list of the independent laboratories that are in-network. We are dedicated to ensuring your patients receive the highest quality laboratory testing at the most reasonable cost. 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. January 1, 2016, we introduced a program that will improve the quality and reduce the cost of laboratory services our members receive. 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. Its easy to get a free insurance quote now. Kaiser Family Foundation (2019). How Does This Program Affect You? To find providers in our individual Blue Option network, please visit www.BlueOptionSC.com. WebBlueChoice HealthPlan is a wholly-owned subsidiary of Blue Cross and Blue Shield of South Carolina. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces. Prior Authorization | BlueChoice HealthPlan of South Note that with this new program, certain lab procedures when performed in an office, outpatient or independent lab location will require prior authorization. | BlueChoice HealthPlan of South Carolina View the Cardiac Services Checklist and Cardiac Services Tip Sheet to learn more about prior authorization requirements. Log in to My Health Toolkit. (If it's your first time, you'll have to create a simple profile first.) Member & Guest Services Blue Option | BlueChoice HealthPlan of South Carolina