Learning Resources
Frequently Asked Questions
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REVALIDATION |
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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. | |
What if I do not complete my provider revalidation within 30 days?If you do not fully complete the provider revalidation process within 30 days from the date on the notification letter, it is considered voluntary termination from South Carolina Healthy Connections Medicaid. You will need to enroll as a new provider. Revalidation FAQs PDF | |
What if my address is correct, but other information needs to be updated?If any information that you used for your provider enrollment has changed and you have not informed SCDHHS of the change, you will need to follow the standard procedure to update your information. Please go to www.scdhhs.gov/Provider and select “FAQ Guide” for instructions on how to update information in your profile. Revalidation FAQs PDF | |
What if my revalidation notification letter is returned due to an incorrect address?If the revalidation notification letter is returned to South Carolina Healthy Connections Medicaid as undeliverable mail, we will call you using the phone number on file in order to update your address. You will need to follow the standard procedure to update your address. 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 re-sent, 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 are unable to be reached using the phone number on file, your inability to complete the provider revalidation process means that you have voluntarily terminated as a South Carolina Healthy Connections Medicaid provider and will need to enroll as a new provider. | |
What if my revalidation reference number does not work on the website?If your revalidation reference number does not work on the website, ensure that the computer you are using meets the web application system requirements for the provider revalidation application. Please visit https://www.scdhhs.gov/ProviderRequirements and scroll to the section labeled “Web Application System Requirements” for more information. If you are still unable to use your revalidation reference number, please contact the Provider Service Center at (888) 289-0709, option 4. | |
What if there are NPIs associated with my Medicaid ID that I do not want to revalidate?If there are NPIs associated with your Medicaid ID that you do not want to revalidate, do not complete an enrollment application for them. No action is needed on your part. Revalidation FAQs PDF | |