Past Workshop Presentations

Benefit Update Meeting Presentations

Avalon Healthcare Solutions Clinical Webinar

This clinical webinar is for laboratory ordering physicians, practice clinicians, and the like. Learn information about the scientific laboratory medical policy development and adherence through prior authorization and claim editor technology, resources available such as the policy education video library, Trial Claim Advice Tool, and more.

Avalon Healthcare Solutions Benefits Management Program

Learn about our partnership with Avalon Healthcare Solutions for lab services. Avalon is an independent company that provides benefit management services on behalf of BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan. Effective Jan. 1, 2016, BlueCross and BlueChoice® will require Avalon Healthcare Solutions to precertify certain lab procedures when performed in an office, outpatient or independent lab location.

Avalon Healthcare Solutions Claim Editor and Claim Trial Tool

This Avalon Laboratory Network Education presentation discusses the Claim Editor and how it provides consistent application of our medical policy to lab tests being performed to ensure that our members are receiving the highest quality of care at the most affordable cost. You'll also learn about the Trial Claim Tool.

BlueCard® Program Webinar

Learn about how the BlueCard program works, how to identify members and how to use the prefix, as well as how to file claims.

ClaimsXten Implementation: Phase I Webinar

Learn about our upgrade to ClaimsXten, a robust claim-auditing software designed to ensure health insurance claims are coded properly. Get details about the claim coding rules and benefits of this upgrade. 
Posted: June 2019

Dental Webinar

We created this webinar especially for our dental providers. It describes our dental networks and gives you important dental plan updates. It also outlines the credentialing process and instructs you on how to effectively use My Insurance ManagerSM and My Remit Manager.

Durable Medical Equipment (DME)

Learn about DME claims filing procedures, precertification requirements and how to use our Web tools, as well as get information on CPAPs and more.

Health Insurance Marketplaces Webinar

Learn about our current plan offerings on the Federally Facilitated and private Marketplaces (Exchanges).

Medicare Advantage

Learn about our Medicare Advantage coverage benefit designs and how to identify Medicare Advantage patients.

Maternity Initiatives

Learn about our Maternity Initiatives. We adopted these programs and efforts in order to reduce health disparities among newborns and improve the overall health of mothers and babies. Learn the benefits of these programs and how to receive additional reimbursement. 

Mental Health Webinar

Learn about Companion Benefit Alternatives. CBA is a separate company that administers mental health and substance abuse benefits on behalf of BlueCross. Also learn about the health coaching process, the benefits of this program and important mental health plan tools.
Last Updated: May 2019

Musculoskeletal (MSK) Care Management Program

The MSK presentation outlines prior authorization for two components of non-emergent MSK care: outpatient, interventional spine pain management services, and inpatient and outpatient lumbar and cervical spine surgeries.

Provider Enrollment Process

This enrollment presentation will give you an overview of the steps in the enrollment process to validate practitioners' qualifications.
Last Updated: May 2019

Radiation Oncology

Learn about the radiation oncology program. This program requires National Imaging Associates (NIA) precertification for radiation oncology services provided in an outpatient or office setting. NIA is an independent company that provides precertification services for certain imaging services on behalf of BlueCross and BlueChoice.

Quality Initiatives

Learn about our quality initiatives. Learn about programs to improve birth outcomes, techniques to closing gaps in care and the benefits of becoming a patient-centered medical home. You will also get information about the importance of patient satisfaction surveys and Health Effectiveness Data and Information Set (HEDIS®) quality measures.

South Carolina Reporting & Identification Tracking System (SCRIPTS)

Learn more about SCRIPTS, a database providers use to help monitor inappropriate use of prescription drugs, particularly opioids. Learn why SCRIPTS should be a part of every patient’s initial evaluation and subsequent monitoring, and is considered a standard of care.

Specialty Drug Medical Benefit Management

Learn about the new specialty drug requirements for medical pharmacy benefits. This webinar provides an overview of the requirements as well as how to create a prior authorization through NovoLogix, CVS/caremark's medical prior authorization system, with single sign-on access through My Insurance ManagerSM. CVS/specialty is a division of CVS Health, an independent company that provides pharmacy services on behalf of our health plans.

Web Tools Presentation

Learn about the web tools resources and provider self-service tools available to help you get the information you need faster.

BlueChoice HealthPlan of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.