Friday, April 19, 2024, 1:46 AM
Site: Healthy Connections Medicaid E-Learning
Course: Learning Resources (Learning Resources)
Glossary: Frequently Asked Questions
REVALIDATION

How will I know that I need to begin the provider revalidation process?

When it is time to revalidate your enrollment as a South Carolina Healthy Connections Medicaid provider, you will receive a revalidation notification letter in the mail. The revalidation letter will contain detailed instructions for the revalidation process and a revalidation reference number that is specific to each provider. You will use this information to access the provider revalidation application online. You will need to complete and submit the provider revalidation application in its entirety with all current information. Revalidation FAQs PDF

How will I know that my provider revalidation has been approved?

Once the provider revalidation application is approved, provider revalidation approval notification will be emailed to the email address entered on the provider revalidation application. Revalidation FAQs PDF

I am a group provider with multiple NPIs associated with my Medicaid ID. How do I complete the provider revalidation process?

Your revalidation notification letter will list all of the NPIs associated with your Medicaid ID. The revalidation notification letter will identify one NPI as being the primary NPI associated with your Medicaid ID.  Complete the provider revalidation application for the primary NPI following the standard procedure. Within 30 days from the date on the revalidation notification letter, all other NPIs attached to your Medicaid ID will need to complete an online provider enrollment application. To access the online provider enrollment application, copy and paste https://providerservices.scdhhs.gov/ProviderEnrollmentWeb/ into your browser. This ensures that the billing process continues uninterrupted. Revalidation FAQs PDF

I am a medical clinic and I see that other medical clinics are revalidating in June and July 2015. I haven’t received my revalidation notification letter yet. What should I do?

All medical clinics will revalidate within June, July or August 2015. If your clinic’s address information has changed recently and needs to be updated, please fax or mail a letter requesting an address change to MCCS Provider Enrollment on company letterhead. The Provider Enrollment fax number is (803) 870-9022. The address is Medicaid Provider Enrollment, P.O. Box 8809, Columbia, SC 29202-8809. The letter should include the provider’s legacy and NPI numbers, as well as the new address, along with the provider’s or an authorized person’s signature and a contact person’s name and telephone number in case there are any questions. Once the address information is updated and the revalidation notification letter is re-sent, the provider will still have 30 days from the date on the original revalidation notification letter to fully complete the provider revalidation process. If your clinic’s address information has not changed recently or has changed recently but the address change procedure was followed correctly, your revalidation notification letter will be mailed later in summer 2015. Revalidation FAQs PDF

I am a Medicare provider who has revalidated with Medicare. 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 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