Learning Resources
Frequently Asked Questions
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Can you assist with Medicaid/bed hold billing procedures?An authorized SNF 181 along with a separate Medicare-to-Medicaid bed hold billing 181 is required. | |
Is an eligibility signature required for termination? (Nursing Home)No signature is required for terminations. | |
Can you add beneficiaries or other information to the TAD for me? | |
Is an adjustment only done when you have been paid?Yes, only paid claims can receive an overpayment or underpayment. | |
How do patients learn updated information?Patients learn of updates at their enrollment anniversary dates, or you may share information with them. | |
Where can you find an out of state referral form?That form can be found on SCDHHS.gov. | |
How can I obtain more information regarding the new provider screening and other enrollment requirements?A link to the Federal Register, Vol 76, No. 22, dated February 2, 2011, can be found on the SCDHHS website at SCDHHS.gov. | |
How can a provider check to see if the ordering/referring physician is enrolled with Medicaid?
On the SCDHHS website SCDHHS.gov, there is a searchable listing of Enrolled Providers under the For Providers tab. If the provider is not listed, then the provider is not currently enrolled with Medicaid. You may also contact the Provider Service Center at 1 (888) 289-0709, option 4 to verify the provider’s enrollment.
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Can a billing provider be an ordering or referring provider as well?Yes, as long as the provider is not designated as an ordering/referring provider exclusively. Future edits will prevent claims payment if an ordering/referring-only provider submits their NPI as a billing provider. | |
Where can I find the Medicaid Credit Balance Report forms?The Medicaid Credit Balance Report Certification Page and Claim Detail forms can be found under the For Providers menu option at SCDHHS.gov – see Credit Balance Forms. | |