BlueChoice HealthPlan

providers

Forms

We've gathered all our forms here in one place to make it easier for you to find the one you need.  

Signature sticky note

Physician Appeal Request Form

If you wish to appeal a claim, just download and complete this form.

 

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Doctor and nurse

Referral and Authorization Forms

We have a variety of referral and authorization forms to accommodate your patient's specific situation. You'll find them all here. Remember, you can also authorize referrals in My Insurance Manager!

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BlueChoice HealthPlan is a wholly owned subsidiary of BlueCross BlueShield of South Carolina. Both are independent licensees of the Blue Cross and Blue Shield Association.
® Registered Marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.
sm Service mark of BlueChoice HealthPlan of South Carolina, Inc.