Saturday, May 18, 2024, 5:32 PM
Site: Healthy Connections Medicaid E-Learning
Course: Learning Resources (Learning Resources)
Glossary: Frequently Asked Questions

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

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

Do all providers need to go through the provider revalidation process?

All South Carolina Healthy Connections Medicaid providers will go through the provider revalidation process. The current process, however, is for all South Carolina Healthy Connections Medicaid providers who have an enrollment date 90 days prior to or on 12/03/2012. These providers are required to go through the provider revalidation process. Revalidation FAQs PDF

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

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

How do I complete the provider revalidation process?

The provider revalidation application is available exclusively online. When it is time to revalidate your enrollment as a provider, you will receive a revalidation notification letter. You have 30 days from the date on the revalidation notification letter to complete and submit the provider revalidation application in its entirety with all current information. Revalidation FAQs PDF

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