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Health and Wellness Healthy Blue of South Carolina

Details: Health A to Z is an online health resource. It’s easy to use and provides information and answers on many health topics. You can also check your symptoms with our symptom checker and explore our interactive tools to help guide your health care decisions. Check Your Symptoms. Check out the Interactive Tools.

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Medicaid Benefits Healthy Blue of South Carolina

Details: Healthy Rewards is a no-cost, optional program for eligible members enrolled in our health plan. The program encourages you to get the care you need to create a healthy lifestyle. You can redeem these Healthy Rewards through the Benefit Reward Hub: $25 for childhood wellness visits; $25 for adolescent wellness visits; $50 for breast cancer

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Medicaid for South Carolina Healthy Blue of South Carolina

Details: BlueCross is the oldest and strongest health insurer in South Carolina. Free extra benefits on top of your regular Medicaid benefits. You’ll get benefits including no copays for urgent care and preventive visits, free car seats, and discounts on healthy lifestyle services like Jenny Craig® and Boys & Girls Club fees.

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Manage Your Condition Healthy Blue of South Carolina

Details: Get support from us to make health care choices with your health care providers. Ask about all DM-related treatment options (choices of ways to get better) mentioned in clinical guidelines (even if a treatment is not part of your health plan), and talk about options with treating health care providers.

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New Members Healthy Blue of South Carolina

Details: 5. Complete your Health Risk Assessment (HRA) As a new member, you’ll fill out a Health Risk Assessment (HRA). It’s a short questionnaire that will help us connect you to care and doctors that fit your needs. If you have questions, call us at 1-866-781-5094 (TTY 1-866-773-9634). Please take the time to answer the questions as best as you can.

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Medicaid Eligibility Healthy Blue of South Carolina

Details: Healthy Blue understands just how important it is to have quality health care. We are a health plan serving Healthy Connections Medicaid members in South Carolina. The South Carolina Department of Health and Human Services (SCDHHS) decides who’s eligible for Medicaid benefits.

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Healthy Blue Provider

Details: Behavioral health provider. We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts, and other resources to successfully meet the needs of members with mental health, substance use, and intellectual and developmental disabilities.

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Patient Care Overview

Details: Health education resources. We advocate a community approach to health education and outreach activities and have a proven record of collaborating with community and faith-based organizations, advocacy groups, and other community resources.

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Prior Authorization Requirements

Details: Behavioral health. Fax all requests for services that require prior authorization to 877-664-1499.. Services billed with the following revenue codes ALWAYS require prior authorization:

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MED.00110 Silver-based Products and Autologous Skin

Details: Outcome scores, except for SF-12 mental health, remained significantly improved in the injection and crossover participants at 2 years compared to baseline. The study was limited by its small size and limited follow-up with a crossover at 3 months. Further studies are needed to fully assess the safety and efficacy of BMAC therapy for any condition.

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Find a Doctor Healthy Blue of South Carolina

Details: Whether it’s 3 a.m. or a Sunday afternoon with the family, health issues happen at the most inconvenient times and places. Our 24-Hour Nurseline is a resource you call when life throws you a curve ball: 1-866-577-9710 (TTY 1-800-368-4424).

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Urgent Care, Emergency & More Healthy Blue of South Carolina

Details: Health issues can come up when you least expect them. Our toll-free 24-Hour Nurseline lets you talk with a registered nurse whenever you have health questions or need medical advice — day or night, holidays and weekends. 1-866-577-9710 (TTY 1-800-368-4424) Our nurses are here to: Advise you on where to go when you need care.

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Emergency Preparedness Healthy Blue of South Carolina

Details: A copy of your health insurance card A copy of your photo ID Cash. Source: www.DiabetesDisasterResponse.org * Health care professionals, visit our Provider page for more information and resources about the use of insulin products in an emergency situation. It’s easier than you think to be ready.

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Member Materials Healthy Blue of South Carolina

Details: Health Education Advisory Committee. To learn what matters to you, we just ask. Do you want to share your thoughts on how we can improve your health plan or member experience? Please join us for our next meeting! Call Healthy Blue at 1-803-382-5810 (TTY …

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Pregnancy Care Healthy Blue of South Carolina

Details: Step 2: Complete an OB health screener. This screener will help us customize the care and support we provide you throughout your pregnancy. Call 1-866-781-5094 to complete our OB health screener. Step 3: Call us to speak with an OB care manager. Call 1-866-781-5094 to learn more about our New Baby, New Life℠ program.

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Member Rights Healthy Blue of South Carolina

Details: The health plan’s duties for coordinating care in a timely manner. Know that Healthy Blue, your doctors and your other health care providers cannot treat you differently because of your: Age. Sex. Race. National origin. Gender. Gender identity. Sexual preference. Language needs. Degree of illness or health …

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Claims Submissions and Disputes

Details: Healthy Blue uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to health care professionals. Availity is an independent company that provides a secure portal on behalf of BlueChoice HealthPlan.

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Search Medical Policies and Clinical Guidelines

Details: Health plans or lines of business which determine there is not a need to adopt a clinical utilization management guideline may instead use the guideline for educational purposes or to review the medical necessity of services for any provider who has been notified that his or her claims will be reviewed due to billing practices or claims that

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Our Quality Standards Healthy Blue of South Carolina

Details: Start by asking your current PCP or behavioral health provider for a recommendation for a new adult PCP or behavioral health provider. We’re here to help, too. You can change your PCP or behavioral health provider at any time by calling the Customer Care …

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Join Our Network

Details: Joining our network is easy! We’re glad to hear you are interested in joining Healthy Blue. We have a diverse network of exceptional health care professionals who ensure our members have uninterrupted access to the health care they need. You make your patients' lives better. We'll do the same for you. Our prior authorizations, referrals

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How to Enroll Healthy Blue of South Carolina

Details: Healthy Connections Choices will automatically enroll your baby in the same health plan as you on the month of your child’s birth. If you are covered by a different health plan, and would like to choose Healthy Blue for your newborn, contact Healthy Connections Choices within 90 days of your newborn’s enrollment effective date to request a health plan transfer:

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Rights and Responsibilities

Details: Get health care services that are enough in amount, length of time given and scope to do what they should be able to do for the member’s health issue. Get family planning services from a provider not in their network. Get 24-hour-a-day, 7-day-a-week access to medical advice from their PCP, either in …

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Contact Us Healthy Blue of South Carolina

Details: Call the Customer Care Center at 1-866-781-5094 (TTY 1-866-773-9634). Healthy Blue. P.O. Box 100124. Columbia, SC 29202-3124. Our reps are here to help with: Changing your primary care provider. Getting your member ID card. Getting member handbooks. Understanding your benefits.

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Member Eligibility & Pharmacy

Details: Member eligibility, panel listings and member reports. Providers can access real-time member eligibility information, member reports and panel listings from the Availity Portal. Availity is an independent company that provides the secure portal on behalf of BlueChoice HealthPlan. To log-in or for more information, visit our Member Eligibility

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Healthcare Effectiveness Data and Information Set (HEDIS)

Details: The Healthcare Effectiveness Data and Information Set (HEDIS®) is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service. Altogether, HEDIS consists of 81 measures across five domains of care.

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Medicaid Renewal Healthy Blue of South Carolina

Details: You’ll get a Healthy Connections Annual Review form from the South Carolina Department of Health and Human Services (SCDHHS) when it’s time to renew your benefits. They’ll check to see if you still qualify for Medicaid. 2. Complete your form and gather documents. Completely fill out the form and gather any documents SCDHHS asks for. 3.

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Terms of Use Healthy Blue of South Carolina

Details: By health-related information, we mean the health-related, medical, and wellness information available through the Web Site that includes, but is not limited to, text, graphics, video, and images; information created by health information content providers, licensors, suppliers, and other third parties; advertisements; and any other material

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Zero Dollar Copay List

Details: Blood Pressure/Heart Health : BENAZEPRIL-HYDROCHLOROTHIAZIDE . BENAZEPRIL/HYDROCHLOROTHIAZIDE : Blood Pressure/Heart Health . BENICAR : OLMESARTAN MEDOXOMIL . Blood Pressure/Heart Health : Healthy Blue Zero Dollar Copay List Page 2 of 20 WEBMBSC-0334-20 BRAND NAME GENERIC DRUG NAME CATEGORY

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Learn about Availity

Details: Select the appropriate health plan. From the Payer Spaces home page, select the Resources tab. From the Resources tab, select Provider Online Reporting. If you don't see it on the list, select Next from the right-hand side at the bottom of the page. From the Provider …

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Healthy Blue Evidence of Coverage (EOC)

Details: harm your health. When you ask for a rush appeal, be sure to tell us that you think waiting 30 calendar days will harm your health and why. A medical director will review your request for a rush appeal. If the medical director thinks waiting 30 calendar days will harm your health, we’ll: • …

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Reimbursement Policy Definitions

Details: Facility-based provider: A hospital, nursing home, or other medical or health-related service facility that provides care for the sick, injured or disabled, or other care that may be a covered service in an insurance policy. Fee schedule: A list of pre-established allowances for specific services.

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Health Education

Details: Health education — helping our members. Healthy Blue advocates for a community approach to health education and outreach activities. We have a proven record of collaborating with community and faith-based organizations, advocacy groups and other community resources.

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Fraud, Waste, and Abuse Healthy Blue of South Carolina

Details: Health care fraud, waste and abuse affects everyone in the U.S. Let’s make sure you know what it is, how to spot it and how to help us prevent it. So, what is it exactly? Fraud is when someone purposely lies to a health insurance company, Medicaid or Medicare to get money. Waste is when someone overuses health services carelessly.

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CG-MED-23 Home Health

Details: Medically Necessary: Home health services are considered medically necessary when all of the following criteria A through D are met: . The individual is confined to the home: The individual’s overall physical/medical condition poses a serious and significant impediment to receiving intermittent or occasional, skilled, medically necessary services outside the home setting.

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2021 Clinical Practice Guidelines

Details: You may also call the South Carolina Department of Health and Human Services Fraud Hotline at 888-364-3224 or email [email protected] BSCPEC-1937-21 April 2021 2021 Clinical Practice Guidelines Date reviewed December 2020 Date adopted January 2021 Table of contents: Adult health Infectious disease Pediatric/adolescent health Substance use

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Appeals and Grievances Healthy Blue of South Carolina

Details: Why you aren’t happy with your health care services. Attach any papers that will help us look into your issue. After you complete the form or letter, mail it to: Healthy Blue Grievance Department P.O. Box 62429 Virginia Beach, VA 23466-2429. Fax: 866-216-3482

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Useful Health Apps Healthy Blue of South Carolina

Details: Managing your health on the go. Want help managing your health while you’re on the go? We’ve found some free apps we think you’ll find useful. MediSafe. Tells you when it's time to take your medicine. State of the Air. Check the air quality wherever you are. CaringBridge.

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Eligibility & Provider Reports

Details: Select the health plan. From the Payer Spaces homepage, select the Resources tab. From the Resources tab, select Provider Online Reporting. If you don’t see it in the list, select Next from the right-hand side at the bottom of the page. From the Provider Online Reporting page, select Member Reports. Registration for provider online reporting

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Coronavirus (COVID-19) Healthy Blue of South Carolina

Details: Good health habits can also help prevent and fight COVID-19. Here are some tips: Washing your hands is the best way to avoid getting sick: Wash often with soap and water for at least 20 seconds. If you can’t use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol.

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BlueBlast June 2021 Edition

Details: Aspire Health for Members in Need of Palliative Care Healthy Blue has contracted with Aspire Health to provide in-home and virtual palliative care services to our Medicaid members facing advanced illness. Aspire Health is an independent company providing in-home care services on …

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Precertification Request Form

Details: To report fraud, call our confidential Fraud Hotline at 877725- -2702. You may also call the South Carolina Department of Health and Human Services Fraud Hotline at 888-364 -3224 or email [email protected] BSCPEC-1430-19 July 2019 . To prevent a delay in processing your request, fill out the form in its entirety with all applicable information.

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Provider Appeal Request Form

Details: To report fraud, call our confidential Fraud Hotline at 877-725-2702. You may also call the South Carolina Department of Health and Human Services Fraud Hotline at 888-364-3224 or email [email protected] BSCPEC-1310-19 April 2019 Please use this form to appeal an action we have taken related to a claim or authorization for services.

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