How long does the enrollment process take?
Enrollment applications will be processed within thirty (30) business days from the date of receipt. The thirty (30) business day timeframe may be exceeded for enrollment applications that require: additional information, a site visit, a contractual agreement, or are submitted with sanction information.
Why did my enrollment application get rejected after I made the corrections I was told to?
A provider is notified about rejections via the Enrollment Rejection Letter. The rejection letter indicates the reason(s) for the rejection. For further assistance, contact the Provider Service Center at 1 (888) 289-0709, option 4.
How do I update the individual provider’s name?
SCDHHS requires the individual provider to send in a completed/signed W9 form with the individual’s name, SSN, address and signature. Providers are also required to complete the Disclosure of Ownership and Control Interest Statement Form.
Why can’t we update our enrollment profile over the phone?
SCDHHS requires updates to a provider’s file to be submitted in writing on business letterhead with the provider’s or an authorized signature. Submit any updated changes via Fax: (803) 870-9022 or Mail: Medicaid Provider Enrollment, PO Box 8809, Columbia, SC 29202-8809. Updates will be processed within ten (10) days of receipt.
How are MCO plans chosen for a beneficiary if they are auto-enrolled?
If a plan doesn’t cover family planning, do we bill to Medicaid and send the EOB?
If the beneficiary doesn’t have an ID number for the MCO, how do we obtain it?
Is the EFT form used for MCOs as well?
No, they have their own forms and billing systems.
What do you do if you contact a Primary Care Provider and they have no record of a patient?
Will MCO info be available via the Web Tool?