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- Billing disputes
- Denial of coverage
- Denial of treatment as not medically necessary
- Partial payments on claims
- Unfair insurance practices
- False or misleading health care advertising
- Difficulty navigating the health insurance appeals process
The Attorney General’s Health Care Bureau was created to assist consumers with difficulties they encounter in obtaining health care services and insurance benefits through mediation, investigation and enforcement actions. The bureau also advocates for laws and policies that enhance the health care rights of consumers and educates consumers about those rights.
The Health Care Bureau’s toll-free hotline, 1-877-305-5145 (TTY 1-800-964-3013), operates to assist consumers with problems related to health care. Health Care Bureau mediators deal directly with the consumer to collect information regarding the complaint. The mediators then contact the health care provider or insurance company in an attempt to settle the dispute, in consultation with attorneys and a physician in the bureau.
BCBS SC - Authorized Rep Appeal Designation Form
BCBS SC - Authorization to Disclose HIPAA
BCBS SC - Pregnancy Notification Form
BCBS SC - Screening tool Pregnancy
BCBS SC - COB Federal Employee
Submit a Pre-certification Online
My Insurance ManagerSM features an automated authorization, precertification and referrals tool that allows you to request authorizations for many patient services online. With this function, called "Authorization/Precertification/Referral," you can submit requests for BlueCross and State Health Plan.
Go to My Insurance Manager to begin using this tool. Log in and select Authorization/Precertification/Referral to begin. If you are a new user, first select Create a New Profile to create your user account. If you are not registered yet, read more about creating a profile.
You can request an initial precertification or authorization in My Insurance Manager or check the status of existing requests. You can also use our STATchatSM feature to speak directly with a Health Care Services representative over the Internet if you wish to provide clinical information, request an appeal or extension, or update information on an existing authorization.
Receive Immediate Approval for the Majority of Requests
For certain services and procedures, you can receive immediate approval in most cases. There will be no need to contact us or submit additional information unless the member remains hospitalized beyond the approved days.
Our response to your request is not a guarantee of payment or reimbursement, or a guarantee of the member's eligibility for coverage. We will review all claims to verify that:
- The preauthorization request and the claim information you submit are consistent.
- The patient is eligible for benefits at the time of treatment.
- The patient's health plan covers the services he or she receives.
- The patient satisfied all health plan requirements (e.g., limitations, waiting periods, copayments, deductibles, network eligibility, etc.).