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Blue Choice

Manuals & Guides

Please refer to these helpful guides and manuals.

  • 2016 BlueCard® Program Manual - This manual provides you with an overview and describes the advantages of the program. It will also help you guide through eligibility verification, precertification and claims filing processes for out-of-area members. 
  • Healthier Moms and Babies - Our maternity health magazine gives information about our maternity managed care programs, informs you of helpful tools to engage your patients and provides you with resources to integrate your patient care with our services. There are articles about the Birth Outcomes Initiative, using the Screening, Brief Intervention and Referral to Treatment (SBIRT) process  in your practice, benefits of Centering Pregnancy and more. Centering Pregnancy is offered by Centering Healthcare Institute (CHI). CHI is an independent organization that provides care management on behalf of BlueChoice HealthPlan.
  • Improving Patient Satisfaction for Providers
  • 2016 Member Identification Card Reference Guide - This guide provides you with an overview of our various plans and associated networks.
  • 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.
  • Preventive Care Guide - This guide provides an outline of the services the Affordable Care Act approves as preventive for non-grandfathered plans.
  • Provider Reconsideration Process- Get instructions about the provider appeal process for medical necessity and billing/coding disputes. Also, learn when it is appropriate for a provider to file a reconsideration. 
  • View the latest edition of our Provider Office Administrative Manual.
  • Quick Reference Card - Use this table to identify the most efficient method to obtain benefit information and get preauthorization for certain services. 
  • Submit Clinical Attachments Online - Learn how to submit clinical attachments for pending precertification requests online.
  • Reference Guide for Provider Information and Contacts - This at-a-glance reference tool is perfect for locating contact information for our plans and service areas. It also includes BlueCard quick tips, electronic carrier codes and a county map of South Carolina that is color-coded according to the provider advocate.
  • What You Need to Know About Anesthesia - This guide gives an overview of anesthesia procedures, modifiers and filing guidelines. 
  • What You Need to Know About Claim Attachments - This guide provides you with an overview of the Claim Attachment feature in My Insurance ManagerSM. Use Claim Attachments to attach records or documents to claims that require additional documentation. 
  • What You Need to Know About Medical Specialty Drug Prior Authorizations - This guide provides you with an overview of the specialty medical drugs prior authorization requirements and the steps to get prior authorizations.
  • What You Need to Know about Skilled Nursing Facilities - This booklet gives an overview of procedures, authorization requirements and claims filing guidelines for skilled nursing facilities (SNFs).