BlueChoice HealthPlan

providers

Referral and Authorizations Forms

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Hospital Delivery Fax Log

Maternity Authorization Form

Referral Partner Authorization Form

Request for Extension of Rehabilitation Services

Request for Pre-Authorization of Benefits for Services/Procedures

Specialist Request for Extension of Visits/Services

providers

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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.
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