Services Requiring Prior Authorization
Providers are responsible for verifying eligibility and benefits before providing services to Healthy Connections members. Failure to obtain prior authorization (PA) for services provided may result in a denial of the reimbursement request except in the case of emergency services.
To view the Medical Policies and Utilization Management Guidelines, visit www.HealthyBlueSC.com and select Providers.
Note: Referral to an out-of-network provider and/or facility requires PA for all services.
Requesting Prior Authorization
To request PA, report a medical admission or ask questions regarding PA, contact our Utilization Management (UM) department at:
- Phone: 866-902-1689
- Fax: 800-823-5520
- Prior Authorization Forms
General Prior Authorization Forms
Forms for Specific Procedures/Items
- Universal Newborn Prior Authorization Form - Pediatric Offices *
- MCO Universal 17P/Makena Authorization Form *
- Universal Medication Prior Authorization Form *
Contact the UM intake department for any questions on PA at 866-902-1689 or fax 800-823-5520.
* These links lead to a third-party site. That organization is solely responsible for the contents and privacy policies on its site.
Need information about our claims process? You'll find it here!