Monday, October 7, 2024, 5:01 AM
Site: Healthy Connections Medicaid E-Learning
Course: Learning Resources (Learning Resources)
Glossary: Frequently Asked Questions
REVALIDATION

I am a provider in a stand-alone dental office. Do I need to revalidate with South Carolina Healthy Connections Medicaid?

I am a provider with multiple NPIs attached to my Medicaid ID. I completed the provider revalidation application for my primary NPI. Why are my claims being rejected?

Within 30 days from the date on the revalidation notification letter, all other NPIs attached to your Medicaid ID will need to complete an electronic provider enrollment application. To access the online provider enrollment application, copy and paste https://providerservices.scdhhs.gov/ProviderEnrollmentWeb/ into your browser. If you did not complete an electronic provider enrollment application for all non-primary NPIs associated with your Medicaid ID and you wish to continue billing with those NPIs, claims for those NPIs will be rejected. You may resubmit claims once you have received confirmation that the electronic provider enrollment application is complete. Revalidation FAQs PDF

I am also a Medicare provider and I have paid the provider revalidation fee to Medicare. Do I need to pay the South Carolina Healthy Connections Medicaid provider revalidation fee?

No, not if you have paid your Medicare fee in the last 12 months. Revalidation FAQs PDF

I am an individual provider who is affiliated with or linked to multiple organizations. Do I need to revalidate for all of the organizations where I am affiliated or linked?

 

The provider revalidation application allows you to list multiple organizations that you may be affiliated with or linked to. You will need to include every group you are associated with currently. You do not need to complete a provider revalidation application for each group. The group provider is responsible for provider revalidation. Revalidation FAQs PDF

I am an out of state South Carolina Healthy Connections Medicaid provider who has paid the provider revalidation fee for the state where I practice. Do I need to pay the South Carolina Healthy Connections Medicaid provider revalidation fee?

No, not if you have paid your Medicare fee in the last 12 months. Revalidation FAQs PDF

I am an out of state South Carolina Healthy Connections Medicaid provider, and I have already revalidated with my state. Do I need to revalidate with South Carolina Healthy Connections Medicaid?

Yes, if you want to maintain your enrollment with South Carolina Healthy Connections Medicaid. Revalidation FAQs PDF

I am currently under review by Program Integrity. Do I need to complete the provider revalidation application?

I am under review by Program Integrity and I am required to have a site visit for the Program Integrity Process. Am I required to have a separate site visit for provider revalidation?

I enrolled after 12/03/2012. Am I required to go through the provider revalidation process?

You are not required to go through this current provider revalidation process. You will be notified of the next provider revalidation process when it begins. Revalidation FAQs PDF

I’m concerned about entering my payment information on the website. Is the website secure?

Yes, the website is secure. South Carolina Healthy Connections Medicaid uses the national standard in website security software to ensure that the information entered onto the site is secure. Revalidation FAQs PDF