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Electronic Provider Access Capabilities for Providers

November 15, 2013

Blue Cross and Blue Shield Plans are launching a new tool on January 1, 2014, that will let you access out-of-area members’ Blue Plan (Home Plan) provider portals to conduct electronic pre-service review. The term “pre-service review” refers to pre-notification, pre-certification, pre-authorization and prior approval, among other pre-claim processes. You will be able to access our version of this tool through My Insurance ManagerSM.

Electronic Provider Access (EPA) will enable you to use My Insurance Manager to gain access to a BlueCard® member’s Home Plan provider portal through a secure routing mechanism. Once in the portal, you will have the same access to electronic pre-service review capabilities as you would with My Insurance Manager. A separate login is not required once you have been routed to the Home Plan landing page.

The availability of EPA on January 1 will vary depending on the capabilities of each Home Plan. Some Home Plans will be fully implemented and have electronic pre-service review for many services. Others will not yet have implemented electronic pre-service review capabilities.

Our tool will be available on January 1. As the information becomes available, we will provide more details about how to use our tool, as well as keep you updated on how other Plans are implementing their EPA tools.

If you have any questions on how to use the EPA tool or general questions about the process, please contact provider.education@bcbssc.com or call 803.264.4730.

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