Learning Resources
Frequently Asked Questions
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Where are the carrier codes listed?Appendix 2 of your SCDHHS Provider Manual. | |
Will Web Tool list information auto-update for you as changes are made?No, it is not tied to another system. Updates are your responsibility. | |
If a member isn’t eligible, will the Web Tool show ineligible?Yes, information is listed in red. | |
When should eligibility be checked?You should check before providing services. | |
If providers aren’t getting remits, who can they contact?Provider Service Center/EDI | |
Can we find edit codes on the Web Tool?No, however the edit code listing is found in Appendix 1 of your provider manual. | |
Is the Web Tool claim ID number automatically entered?Yes. | |
In the Web Tool's status section, do claims purge based on batch ID?They purge based on the check date. | |
When a claim is in a denied status, can you do an adjustment?You must wait for the rejection, and then do a correction. An adjustment can only be made to a paid claim. | |