Frequently Asked Questions

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What is the physical address to over-night a TAD?

The PO boxes and physical address are included in the Provider manual as well as on the mailing envelope.

For regular mail:

Medicaid Claims Receipt – NF Claims Section

Nursing Homes

P.O. Box 100122

Columbia, SC 29202-3122

Medicaid Claims Receipt – NF Claims Section

OSS/IPC/Hospice:

P.O. Box 67

Columbia, SC 29202

For UPS, FedEx, etc.

Medicaid Claims Receipt – NF Claims Section or CRCF Claims Section

8901 Farrow Road

Columbia, SC 29203

NOTE: Late change forms should be sent overnight or faxed, with all attachments, to (803) 870-9020. Forms should not be faxed unless they are sent past the deadline. Faxed corrections should be received no later than the third working day of each month for Nursing Home providers and the 17th day of the month for OSS providers.

Can you correct the 181/CRCF-01 form?

No. MCCS staff cannot make corrections to the DHHS Form 181 or CRCF 01 form.

I did not receive my TAD. Can you fax/mail a copy?

MCCS can send a copy of the TAD when requested.

Should claims returned on Form 017 or 017CI without processing be re-filed?

Yes. Once corrections are made, Medicaid claims should be re-billed using the CRCF-01 form for OSS and the DHHS 181 for NFs. Coinsurance claims can be submitted at any time of the month once corrections are made.

Why would a Nursing Facility provider receive a 951 rejection if the member had always been eligible for NF Medicaid since entering the facility?

A 951 Edit Code means the member was not eligible for Medicaid on the date of service. The member and/or responsible party for the member might not have completed the annual Medicaid eligibility review. Inform the nursing facility caller to contact the member’s eligibility caseworker.

What happens if my DHHS Form 181, CRCF 01 or IPC form is not received on time or is not received at all?

No changes will be made regarding beneficiaries’ income, IPC/CRCF status, etc., for the current billing month if change forms are not received by MCCS. However, changes can be made during the next month’s billing process.

Will every Nursing Facility or Intermediate Care Facility (ICF) / Mental Retardation (MR) have the same rate?

No.

Will the hospice agency receive a copy of the DHHS Form 181 when the recurring income changes?

Yes, they will receive a copy of the 181 to verify the income change. It is recommended that the NF or ICF/MR attach a copy of the most current 181 when invoicing the hospice. Recurring income is noted in Section III of DHHS Form 181. Medicaid Eligibility is responsible for determining recurring income.

Is the date of discharge for Nursing Facilities or Intermediate Care Facility (ICF) / Mental Retardation (MR) room and board Medicaid reimbursable?

Nursing Facilities and ICFs/MR are not reimbursed for the date of discharge.

Nursing Facilities and ICFs/MR should not invoice hospice agencies for the date of discharge. The date of hospice discharge for a reason other than death or transfer to another facility is billed to Medicaid.

For example: If the person was in an NF or ICF/MR facility from Feb. 1 to Feb. 23, 2013, and was enrolled in hospice from Feb. 1 to Feb. 14, 2013, the hospice would pay NF or ICF/MR the room and board for Feb. 1 to Feb. 13, 2013. Medicaid would pay the NF or ICF/MR for dates of service from Feb. 14 to Feb. 22, 2013.

Who is responsible for pharmaceutical costs as it relates to the terminal illness?

The hospice agency is responsible for pharmaceutical costs related to pain management and symptom control of the terminal illness.

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