Frequently Asked Questions


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Frequently Asked Questions

 

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Is the Web Tool updated daily?

Yes, the Web Tool is updated every night.


If I send a HIIRF, will I see anything saying it was received?

No, just wait a few days and check eligibility again.

How do patients learn updated information?

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


If a Health Insurance Information Referral Form (HIIRF) is completed with no documentation, will the member's TPL record be updated?

No, MIVS will further investigate and draft a letterhead showing steps taken.

What do you do if monies are sent to the patient?

Change them to self pay after or before service completion.

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.

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

You have 30 days to request a hearing.

If my third party has several addresses, which one do I choose?

You would contact the company to find out which address is for your service area.

What happens when Medicaid recoups for retro-health recovery and it is outside of the timely filing window?

Professional billers do not receive retro health letters. Medicaid contacts or solicits billing payments from the private health plan.

If a plan doesn’t cover family planning, do we bill to Medicaid and send the EOB?

Certain services are “carved out”, not covered, by the MCOs and MHNs. Those services can be billed directly to SC Medicaid. You do not need to bill to the managed care plan for a denial.


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