Frequently Asked Questions


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Frequently Asked Questions

 

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Third Party Liability (TPL)

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Can MIVS track down where other payer’s money goes if you are not paid?

No, but they can contact other payers to obtain payment information.
Entry link: Can MIVS track down where other payer’s money goes if you are not paid?

Can the HIIRF form be faxed?

The HIIRF can be faxed to Medicaid Insurance Verification Services at (803) 252-0870.

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Can you accept a beneficiary as just a private pay patient even if they have Medicaid?

Yes, you just have to let them know before they receive any services.
Entry link: Can you accept a beneficiary as just a private pay patient even if they have Medicaid?

Do we need to send an EOB?

An Explanation of Benefits from a third party payer should be kept on file in the provider’s office, especially if the payer didn’t submit payment.
Entry link: Do we need to send an EOB?

Do we send an EOB with claims?

You do not send an EOB with claims, unless it is requested.
Entry link: Do we send an EOB with claims?

Do you have to ask MIVS to research TPL non-payment?

No, they do this on their own to ensure payment.
Entry link: Do you have to ask MIVS to research TPL non-payment?

Does the Medicaid card have all the information needed?

No, you should further investigate eligibility using eligibility resources and the information provided on the card.
Entry link: Does the Medicaid card have all the information needed?

For HIPP referral, who should you contact?

For HIPP referral, providers should contact the Medicaid Insurance Verification Services at 1-888-289-0709 option 5, option 4. The HIPP Fax is 803-462-2580.

Entry link: For HIPP referral, who should you contact?

How do patients learn updated information?

Patients learn of updates at their enrollment anniversary dates, or you may share information with them.

Entry link: How do patients learn updated information?

How long do you have to request a hearing for an appeal?

You have 30 days to request a hearing.
Entry link: How long do you have to request a hearing for an appeal?


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