Learning Resources
Frequently Asked Questions
Currently sorted By creation date descending Sort chronologically: By last update | By creation date
How do I know that my credit balance report was received?Providers may send an e-mail request for Medicaid credit balance receipt confirmation to creditbalancemivs@bcbssc.com. For questions call 1-888-289-0709 option 5, option 1. | |
What is a credit balance?A credit balance is a positive amount that remains in a patient’s account which may have resulted from multiple reimbursements from several payers, adjustments to previously paid claims of a provider, duplicate payment, or subrogation events due to accidents and other injury cases. When another third party payer reimburses a provider for claims that Medicaid paid, either in part or in full, a refund is due to the Medicaid Program. | |
If you make an error and you submit the claim on the Web Tool, is there a way to cancel or make a correction that same day?Once a claim is submitted via the Web Tool, there is no way to cancel or make a correction to the submitted claim that same day. Once the claim has gone through the payment cycle, you will be able to see if the claim has been rejected, paid, or suspended. You will then be able to make corrections to the claim before resubmitting as a new claim. | |
Can Web Tool users in the same organization see each other’s claim information?Users in the same organization based on the provider’s NPI number will be able to see claim information entered by other users. | |
What is the Web Tool’s Non-Contractual box?The Non-Contractual box is to be selected/entered when the provider is not contracted with the beneficiary’s third party payer. | |
Can the HIIRF form be faxed?The HIIRF can be faxed to Medicaid Insurance Verification Services at (803) 252-0870. | |
What if a claim is created, but the beneficiary says that he/she no longer has the insurance on file?If a beneficiary no longer has the insurance policy that is seen on the Web Tool, the provider can refer the beneficiary to their eligibility counselor/worker, or complete the Health Insurance Information Referral Form (HIIRF) to update the beneficiary’s third party payer information. Making a change to a policy that already exists in the Medicaid Management Information System (MMIS) takes five days. The HIIRF Form can be faxed to 803-252-0870. | |
Do I have to request another Login and Password if more than one person wants to use the Web Tool?Yes, all users must have their own individual login ID and Password to access the Web Tool. If more than one user tries to login under the same login ID and Password, they will receive a denial message. | |
Do you have to put the last 4 digits of the zip code for Claims Entry?Yes; you can find zip codes on the US Postal Services website: www.usps.com. Click on Look Up a Zip Code™ | |