May 12, 2026

BlueCross BlueShield of South Carolina is committed to keeping you informed of updates that may impact your administrative processes. Please review the important information below regarding an upcoming change to prior authorization (PA) management.

Effective July 1, 2026, BlueCross will transition PA management for select procedures from HealthHelp^® to Evolent^® for our Exchange (Affordable Care Act/Marketplace) plans.

Plans Affected
This change applies only to Exchange (ACA) plans with group numbers beginning with 61, 62, or 65, excluding the Blue Direction plan (identified by a “B” in the fifth position of the group number).

Services Managed by Evolent
Evolent will manage PA requests for select procedures related to the following service categories:

• Cardiology
• Musculoskeletal care (Joint Surgeries)

The procedure codes managed are not new; however, all requests require submission of clinical documentation for review when a PA is requested.

How to Submit Prior Authorization Requests
Beginning July 1, 2026, submit applicable PA requests to Evolent via:

• Online: www.RadMD.com 
• Phone: 866-500-7664

We appreciate your continued partnership and cooperation during this transition. Additional resources and guidance will be shared as the effective date approaches.
If you have questions, please contact your Provider Relations Consultant.