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Prior authorizations are required for: All inpatient admissions, including organ transplants. Durable medical equipment over $500. Elective surgeries.
Via a Clearinghouse Partnered with Sunflower Directly: Payer ID: 68069 Medical.
NaviNet is Americas leading healthcare provider portal connecting over 40 health plans and 60% of the nations physicians. It is an easy-to-use, free, web-based solution linking providers to Keystone First VIP Choice. Through NaviNet, you can access, submit, or verify: Eligibility information.
How do I get set up in NaviNet? If you are already a NaviNet user for your other health plans, go to .navinet.net Opens a new window or Opens a new window to request access to Select Health of South Carolina information on NaviNet.
Transition From NaviNet to Availity Starts October 2023. Highmark is replacing its existing provider portal, NaviNet, with Availity Essentials. Availity serves plans nationwide, including many Blue Cross Blue Shield Association licensees like us.
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You will log into NaviNet as usual, choose the authorization type and complete the Selection Form as you do currently. Authorization request screens may appear differently than they did previously.

sunflower health authorization