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Provider News

  • New Healthy Blue Website, Same Valuable Healthy Blue Information

    July 15, 2019 –– We are pleased to unveil our new Healthy Blue public website — www.HealthyBlueSC.com. It’s our latest upgrade in communications and provides all of the same useful Healthy Blue content to which you are accustomed but with an all-new look and feel that will further enhance your provider experience.

  • BlueBlast – July 2019

    July 1, 2019 – July 2019 issue of BlueBlast. BlueBlast is sharing some insight for our providers and their office staff that we hope will help you reduce stress in your practices. We met Dennis McIntee at a conference in South Carolina several years ago. McIntee is a gifted keynote speaker and author who travels across...

  • Clinical Criteria Web Posting Q2 2019

    June 28, 2019 – On March 29, 2019, April 12, 2019, and May 1, 2019, the Pharmacy and Therapeutics (P&T) Committee approved the following Clinical Criteria applicable to the medical drug benefit for Healthy Blue. These policies were developed, revised or reviewed to support clinical coding edits.

  • January 2019 Medical Policies and Clinical Utilization Management Guidelines Update

    June 25, 2019 – The Medical Policies and Clinical Utilization Management (UM) Guidelines below were developed and/or revised to support clinical coding edits. Note that several policies and guidelines were revised to provide clarification only and are not included. Existing prior authorization requirements have not...

  • Disbursement Update Bulletin

    June 21, 2019 – Recently, Healthy Blue communicated a change in our provider remittances and payment disbursement processes due to the migration of a new system. This change went live on May 12, 2019.

  • BlueBlast - June 2019

    June 5, 2019 -- June 2019 issue of BlueBlast. On July 1, 2019, Healthy Blue will begin managing services provided in opioid treatment programs (OTP).

  • Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET) HEDIS measure

    June 3, 2019 -- IET is a HEDIS® measure that gauges how a plan performs linking members recently diagnosed with substance use disorder to treatment.

  • Missing notification/late notification process reminder

    June 3, 2019 -- Effective August 1, 2019, failure to obtain prior authorization or to notify Healthy Blue within the established guidelines as outlined below will result in an administrative denial.

  • Behavioral health implementation announcements

    June 1, 2019 -- Opioid treatment program implementation.