Learning Resources
Frequently Asked Questions
| Third Party Liability (TPL) |
Can MIVS track down where other payer’s money goes if you are not paid?No, but they can contact other payers to obtain payment information. | |
Can the HIIRF form be faxed?The HIIRF can be faxed to Medicaid Insurance Verification Services at (803) 252-0870. | |
Can you accept a member as just a private pay patient even if they have Medicaid?Yes, you just have to let them know before they receive any services. | |
Do we need to send an EOB?An Explanation of Benefits from a third party payer should be kept on file in the provider’s office, especially if the payer didn’t submit payment. | |
Do we send an EOB with claims?You do not send an EOB with claims, unless it is requested. | |
Do you have to ask MIVS to research TPL non-payment?No, they do this on their own to ensure payment. | |
Does the Medicaid card have all the information needed?No, you should further investigate eligibility using eligibility resources and the information provided on the card. | |
For HIPP referral, who should you contact?For HIPP referral, providers should contact the Medicaid Insurance Verification Services at 1-888-289-0709 option 5, option 4. The HIPP Fax is 803-462-2580. | |
How do patients learn updated information?Patients learn of updates at their enrollment anniversary dates, or you may share information with them. | |
How long do you have to request a hearing for an appeal?You have 30 days to request a hearing. | |