Please note, in addition to the procedure codes found on Prior Authorization Lists (PAL), other request criteria may impact submission requirements. |
Overview
As of January 2025, Cohere Health, in partnership with Blue Cross Blue Shield of South Carolina, supports the preauthorization and utilization management process for a variety of outpatient and inpatient services.
As of August 2025, Behavioral Health services can be submitted through Cohere.
Beginning December 2025, Medicare Advantage services can be submitted through Cohere.
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 whether an authorization is needed and how to proceed with that authorization.
Please note, in addition to the procedure codes, other request criteria may impact submission requirements.
Cohere Health’s 2025 Scope of Management: Prior Authorization