New Assistance for Providers From ProgenyHealth

Aug. 4, 2023

Beginning Oct. 9, 2023, BlueCross BlueShield of South Carolina will begin working with ProgenyHealth®. ProgenyHealth specializes in neonatal care management services, and their program will enhance services for our members.

With this program, ProgenyHealth’s neonatologists, pediatricians and neonatal nurse care managers will collaborate closely with our members, as well as attending physicians and nurses. This approach promotes healthy outcomes for BlueCross's premature and medically complex newborns.

Which plans are included:

  • This program will apply to BlueChoice® HealthPlan, fully insured businesses (major group, small group and individual plans) and some self-insured plans.
  • This program will not include state employees and retirees covered through PEBA’s State Health Plan or Medicare Advantage.

Benefits of working with ProgenyHealth include:

  • The support of a team who understands the complexity and stress of managing infants in the neonatal intensive care unit (NICU) and who will collaborate with you to achieve the best outcomes.
  • A collaborative and proactive approach to care management that supports timely and safe discharges home.
  • The resources of a company that believes in sharing best practices and works with NICUs nationwide to improve the health outcomes of our next generation.

In the program, families will have dedicated care managers who will provide support and education, while having access to an “on-call” staff member 24/7. For our hospitals, ProgenyHealth will serve as a liaison for BlueCross, providing inpatient review services and assisting with the discharge planning process to ensure a smooth transition to the home setting.

What you need to do:

The process for notifying BlueCross of infant admissions to the NICU or a special care nursery is not changing. Continue to follow the existing process if you plan to admit an infant to the NICU or a special care nursery.

If you have any questions regarding this bulletin, please contact Provider Education at Provider.Education@bcbssc.com or 803-264-4730.

 

BlueChoice® HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. 

ProgenyHealth is an independent company that provides neonatal and pediatric care management services on behalf of BlueCross BlueShield of South Carolina and BlueChoice HealthPlan.

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