For your convenience, here are mental health and substance abuse benefits forms for Companion Benefit Alternatives, Inc. (CBA). On behalf of BlueCross BlueShield of South Carolina, CBA administers mental health and substance abuse benefits. CBA is a separate company.
Outpatient Treatment Initiation Form Outpatient Treatment Continuation Form Network Outpatient Treatment Report South Carolina Non-Network Outpatient Treatment Report
Outpatient Substance Abuse Treatment Request Form Outpatient Substance Abuse Treatment Request Form: Continued Stay
Electroconvulsive Therapy Initiation Request Electroconvulsive Therapy Continuation Request Please note: Effective 01/01/2012, the State Health Plan provides Mental Health and Substance Abuse coverage through CBA.
