Saturday, April 20, 2024, 10:20 AM
Site: Healthy Connections Medicaid E-Learning
Course: Learning Resources (Learning Resources)
Glossary: Frequently Asked Questions
MED BASICS
If the beneficiary doesn’t have an ID number for the MCO, how do we obtain it?Contact the MCO. |
What do you do if a beneficiary is out of visit counts?When checking eligibility, you will see what visit counts they have left. You can request more from your representative or treat them as a self pay. |
What do you do if you contact a Primary Care Provider and they have no record of a patient?If this were to happen, you would need to contact the Managed Care Organization directly. |
What is the payment cycle?The payment cycle is: Wed-Mon, payments are processed on Tuesday, and payment is received as early as Friday. |
What should I do if one line does not pay on your claim?Correct and refile that one line. |
When would you use a void?You would use a void if you bill for something by mistake; accidental claim submission, for example. |
Where are your procedure codes located?Procedure codes are located in Section 4 of your manual and the DHHS website. |
Where can carrier codes be located?Carrier Codes can be located in Appendix 2 of the Provider Manual. |
Where can you find an out of state referral form?That form can be found on SCDHHS.gov. |
Where do you get the bulletins?You can sign up for e-bulletin on the SCDHHS.gov page. |