Learning Resources
Frequently Asked Questions
All categories |
MED BASICS |
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If the beneficiary doesn’t have an ID number for the MCO, how do we obtain it?Contact the MCO. | |
What do you do if a beneficiary is out of visit counts?When checking eligibility, you will see what visit counts they have left. You can request more from your representative or treat them as a self pay. | |
What do you do if you contact a Primary Care Provider and they have no record of a patient?If this were to happen, you would need to contact the Managed Care Organization directly. | |
What is the payment cycle?The payment cycle is: Wed-Mon, payments are processed on Tuesday, and payment is received as early as Friday. | |
What should I do if one line does not pay on your claim?Correct and refile that one line. | |
When would you use a void?You would use a void if you bill for something by mistake; accidental claim submission, for example. | |
Where are your procedure codes located?Procedure codes are located in Section 4 of your manual and the DHHS website. | |
Where can carrier codes be located?Carrier Codes can be located in Appendix 2 of the Provider Manual. | |
Where can you find an out of state referral form?That form can be found on SCDHHS.gov. | |
Where do you get the bulletins?You can sign up for e-bulletin on the SCDHHS.gov page. | |