Current News
Notice to South Carolina Providers: Inpatient Readmission Payment Policy Update
Claims | July 10, 2026
Effective Aug. 1, 2026, BlueCross will no longer separately reimburse potentially preventable inpatient readmissions within 30 days for related diagnoses.
Prior Authorization for DME and Home Health, Efftective Aug. 1, 2026
Prior Authorization | June 4, 2026
BlueCross BlueShield of South Carolina announces a collaboration with IHCS to coordinate DME and home health services for Commercial small group and ACA plans.
2026 May Medical Policy Updates
Medical Policies | May 29, 2026
Here are the latest medical policy updates.
Prior Authorization Transition from HealthHelp to Evolent — Effective July 1, 2026
Prior Authorization | May 12, 2026
Important transition details for plans going from prior authorization vendor HealthHelp to Evolent.
2026 April Medical Policy Updates
Medical Policies | April 29, 2026
Here are the latest medical policy updates for April.
2026 March Medical Policy Updates
Medical Policies | April 3, 2026
Here are the latest medical policy updates.
New Provider Coding Education Program, Provider Scope
Claims | April 3, 2026
Learn about the new, upcoming provider coding education program, Provider Scope.
Importance of Submitting Continued Stay Reviews Properly in Cohere Health
Prior Authorization | March 25, 2026
Review the importance of submitting Continued Stay Reviews in Cohere Health.
New Phase Added to ClaimsXten
Claims | March 9, 2026
Review the latest updates for ClaimsXten.
Updated MOON Notice and Requirement for Medicare Advantage
Medicare Advantage | March 25, 2026
Review details on the updated Medicare Outpatient Observation Notice for our Medicare Advantage plans.
Updates on Lupron Depot Injections for State Health Plan Members
Benefits | March 11, 2026
See an important update for our State Health Plan members regarding Lupron Depot injections.
Upcoming Post-payment Review Process Changes for Group and Individual Plans
Claims | March 9, 2026
Review the upcoming changes to the post-payment review process for our group and individual plans.
2026 February Medical Policy Updates
Medical Policies | March 4, 2026
Here are the latest medical policy updates.
Reminder: High Dollar Pre-payment Review Process
Claims | March 3, 2026
Review important details about the high dollar pre-payment review process.
Update to Pharmacy Benefit Drug Prior Authorization Process for Exchange Members
Pharmacy,Prior Authorization | February 5, 2026
Learn more about the upcoming changes to the pharmacy benefit drug prior authorization process for our Exchange plans.
2026 January Medical Policy Updates
Medical Policies | February 3, 2026
Here are the latest medical policy updates.
New Year, Same 90-Day Validation Requirements
Enrollment | January 6, 2026
Remember to complete your provider validations at least every 90 days.