Overview
Starting January 2025, Cohere Health, a patient journey optimization company, is designated the preauthorization and utilization management vendor for a variety of Blue Cross Blue Shield of South Carolina’s outpatient and inpatient services.
A note to Blue Cross Blue Shield of South Carolina Providers:
The prior authorization requirements for Blue Cross Blue Shield of South Carolina have not changed, only the method to check prior authorization requirements and submit authorizations.
To determine whether a prior authorization is required for a specific service, we encourage you to enter the procedure details and code(s) into Cohere and the portal will let you know how to proceed with that authorization.
Cohere Health’s 2025 Scope of Management: Prior Authorization Lists for Impacted BlueCross BlueShield of South Carolina Plans