Provider Training and FAQs

Provider Training and FAQs

Annual Provider Summits

To view past Annual Provider Summit presentations, click the links below:

BlueCross® BlueShield® of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.

Avalon Healthcare Solutions Benefits Management Program

Learn about our partnership with Avalon Healthcare Solutions for lab services. Avalon is an independent company that provides benefit management services on behalf of BlueChoice HealthPlan. Effective Jan. 1, 2016, BlueChoice® will require Avalon Healthcare Solutions to precertify certain lab procedures when performed in an office, outpatient or independent lab location. 

Avalon Healthcare Solutions Claim Editor and Claim Trial Tool

This Avalon Laboratory Network Education presentation discusses the Claim Editor and how it provides consistent application of our medical policy to lab tests being performed to ensure that our members are receiving the highest quality of care at the most affordable cost. You'll also learn about the Trial Claim Tool. 

Avalon Healthcare Solutions Clinical Webinar

This clinical webinar is for laboratory ordering physicians, practice clinicians, and the like. Learn information about the scientific laboratory medical policy development and adherence through prior authorization and claim editor technology, resources available such as the policy education video library, Trial Claim Advice Tool and more.

BlueCard® Program

Learn about how the BlueCard program works, how to identify members and how to use the alpha prefix, as well as how to file claims. 

Durable Medical Equipment

Learn about durable medical equipment claims filing procedures, precertification requirements and using our Web tools, as well as information on CPAPs and more. 

Maternity Initiatives

Learn about our maternity initiatives programs. We adopted these programs and efforts in order to reduce health disparities among newborns and improve the overall health of mothers and babies. Learn the benefits of these programs and how to receive additional reimbursement.

Mental Health Webinar

Learn about Companion Benefit Alternatives (CBA). CBA is a separate company that administers mental health and substance abuse benefits on behalf of BlueChoice. Also learn about the health coaching process, the benefits of this program and important mental health plan tools.

Musculoskeletal (MSK) Care Management Program

The MSK presentation outlines prior authorization for two components of non-emergent MSK care: outpatient, interventional spine pain management services, and inpatient and outpatient lumbar and cervical spine surgeries. 

Provider Enrollment

This presentation will give you an overview of the steps in the provider enrollment process to validate practitioners' qualifications.

Quality Initiatives

Learn about our quality initiatives. Learn about programs to improve birth outcomes, techniques to closing gaps in care and benefits of becoming a patient-centered medical home. You will also get information about the importance of patient satisfaction and HEDIS quality measures.

South Carolina Reporting & Identification Tracking System (SCRIPTS)

Learn more about SCRIPTS, a database providers use to help monitor inappropriate use of prescription drugs, particularly opioids. Learn why SCRIPTS should be a part of every patient’s initial evaluation and subsequent monitoring, and is considered a standard of care. 

Web Tools Presentation 

Learn about the web tools available to help you get the information you need faster.