COVID-19: Prior Authorization Requirements

COVID-19: Prior Authorization Requirements

BlueCross BlueShield of South Carolina and BlueChoice HealthPlan continue to monitor the status of the COVID-19 virus to ensure our provider community remains informed of any changes in policy or procedure related to the care of your patients, our members.

Due to the recent surge in the number of COVID-19 cases leading to hospitalizations, effective Jan. 7, 2022, both plans temporarily modified the requirement for notification within 24 hours of emergency admission to 72 hours. Please note that this modification will remain in place until further notice and will continually be assessed throughout the pandemic.

Additionally, this modification will not remove the prior authorization requirement as a whole but will help ease the burden of the facilities impacted by the surge, while still allowing our plans to keep track of the patients being admitted. In turn, both plans remain in a position to help with transition of care when the patient is ready for discharge from the acute setting.

If you have any questions related to this bulletin, please contact Provider Education using the Provider Education Contact Form located on www.BlueChoiceSC.com.