Sunday, November 10, 2024, 2:04 PM
Site: Healthy Connections Medicaid E-Learning
Course: Learning Resources (Learning Resources)
Glossary: Frequently Asked Questions
REVALIDATION

I’m concerned about entering my social security number or other identifying information on the provider revalidation 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

If I do not receive the revalidation notification letter, what can I do?

Have you recently changed your mailing address? Was the proper procedure followed to inform SCDHHS of the change? To update your address, 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 remailed, the provider will still have 30 days from the date on the original revalidation notification letter to fully complete the provider revalidation process.

If you have not recently changed your mailing address, please remember that South Carolina Healthy Connections Medicaid provider revalidation will occur in phases beginning in June 2015 and ending in March 2016. Providers should not take any steps to revalidate until they receive their revalidation notification letters. If you have not received a revalidation notification letter and your contact information is current with SCDHHS that is a strong indication that your provider revalidation phase has not begun.

Revalidation FAQs PDF

If I think my revalidation notification letter is lost in the mail, can I call the Provider Service Center and have someone give me my revalidation reference number over the phone?

No. The only way to access your revalidation reference number is to have your revalidation notification letter remailed to you. Revalidation FAQs PDF

Is revalidating as a provider the same thing as recertifying or updating my provider credentials?

In South Carolina, no, provider revalidation is not the same thing as recertification. However, some states use terms such as “revalidating,” “recertifying” or “recredentialing” interchangeably.  South Carolina Healthy Connections Medicaid provider revalidation could possibly be different from other states’ recertification process and certification updates required for specific provider types. For example, a certified nurse practitioner who is also a Medicaid provider needs to ensure that they have completed the provider revalidation process with South Carolina Healthy Connections Medicaid and that they have been recertified by the American Academy of Nurse Practitioners. The two processes are separate. Revalidation FAQs PDF

Is this the same thing as the Durable Medical Equipment (DME) revalidation process?

The provider revalidation process for South Carolina Healthy Connections Medicaid providers and South Carolina Healthy Connections Medicaid DME suppliers is the same. The timeline is different. DME suppliers need to revalidate every three years. Revalidation FAQs PDF

On a hospital claim, if the pay-to provider has revalidated, but the line provider fails to revalidate, will the claim deny?

If MMIS validates the NPI of the rendering physician, then the claim will deny if the individual has not revalidated. Revalidation FAQs PDF

The bulletin references March 2016 as being the due date/last day for provider revalidation.

Is that the last day that I can submit my provider revalidation application? Is that the day I will receive provider revalidation confirmation from South Carolina Healthy Connections Medicaid?

South Carolina Healthy Connections Medicaid mailed revalidation notification letters for phase 1 of provider revalidation on June 4th, 2015. South Carolina Healthy Connections Medicaid provider revalidation will occur in phases from June 2015 to March 2016. 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. Revalidation FAQs PDF

To which address will the provider revalidation notification letter be mailed?

The provider revalidation notification letter will be mailed to the primary practice location address. Revalidation FAQs PDF

What do I need to do to prepare for a site visit?

You will receive a site visit form with this information after your site visit has been scheduled. Revalidation FAQs PDF

What do I need to do to prepare for revalidation?

It is highly recommended that you make sure your primary practice location address and provider type are current with South Carolina Healthy Connections Medicaid. It is your responsibility to ensure that your information is current.

To update your address, 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. To update info other than an address, please go to www.scdhhs.gov/Provider and select “FAQ Guide” for instructions on how to update information in your profile.

Revalidation FAQs PDF