Sept. 9, 2026
BlueCross BlueShield of South Carolina is committed to keeping you informed of updates that may impact your administrative processes. Please review the important information below regarding an upcoming change to prior authorization (PA) management.
Effective Nov. 1, 2026, BlueCross will transition PA management for musculoskeletal and joint surgery procedures to Evolent® for the following plans:
- Commercial, including BlueChoice® fully insured and ASO
- All other BlueCross full insured business
- Major Group and National Alliance ASO (for groups that elect the buy-up option)
- Healthy Blue℠ (Medicaid)
The procedure codes managed are not new; however, all requests require submission of clinical documentation for review when a PA is requested.
How to Submit Prior Authorization Requests
Beginning Nov. 1, 2026, submit applicable PA requests via:
- Evolent’s website: www.RadMD.com
- Phone: 866-500-7664 (BlueCross members), 888-642-9181 (BlueChoice members) or 855-569-6749 (Healthy Blue members)
We appreciate your continued partnership and cooperation during this transition. Additional resources and guidance will be shared as the effective date approaches.
If you have questions, please contact your Provider Relations Consultant.