Financial and Provider Reconsideration

• Provider Reconsideration
• Open Negotiation Notice
  • Email the completed form to OPN_IDR_Requests@bcbssc.com.
• Overpayment Refund
• Notice of IDR Initiation
  • Email the completed form to OPN_IDR_Requests@bcbssc.com.

Other

• Authorization to Disclose Personal Health Information
• Designation to Authorize Representative
• Other Health Insurance
• Peer-to-Peer Request
• Pregnancy Notification
• Referral Authorization
• Screening, Brief Intervention and Referral to Treatment
• Subrogation