April 23, 2025

Beginning May 1, 2025, HealthHelp^® will manage the prior authorization (PA) requests for select procedures related to the following services:

• Cardiology
• Musculoskeletal care

HealthHelp will no longer manage the PA requests for surgical procedures, sleep studies and Zoll Life Vests. To get a PA for these services, you must go through the Cohere Health platform, which is accessible through My Insurance Manager℠. Requests submitted through Cohere are reviewed by BlueCross BlueShield of South Carolina’s clinical staff, ensuring consistency with the BlueCross medical policies and benefit guidelines.

This only applies to our Exchange (Affordable Care Act or Marketplace) plans with group numbers that start with 61, 62 or 65 except for our new Blue Direction plan (indicated by a ‘B’ in the fifth space of the group number).

The procedure codes managed by HealthHelp are not new. However, all codes require clinical documentation for review when a PA is requested.

If the request does not meet clinical criteria, providers can expect a call from a physician at HealthHelp to request a peer-to-peer review.

How to submit a PA request through HealthHelp:

A PA can be requested by:

• Web: www.HealthHelp.com 
• Phone: 833-715-2255
• Fax: 844-470-2466

HealthHelp is an independent company that provides utilization management services on behalf of BlueCross BlueShield of South Carolina.