Learning Resources
Frequently Asked Questions
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Will systems recognize a duplicate claim if it is denied?No, because it did not process. | |
Can batches be deleted after they are sent?No. Batches cannot be deleted at this time. | |
Can I check claim status on the Web Tool?Yes. Key in the NPI or provider ID number and the recipient ID number and press submit. | |
How do I file a replacement claim for a paid claim that is partly incorrect?Go to the Web Tool submission page. Log in; go to claims entry/history; click on the correct batch number; click on the correct claim number; copy; click the claim type on the left; click on batch, claim; edit; scroll down to claim submission reason code; select replacement. To complete this task, you must have the original Claim Control Number (CCN). | |
How can we get an enrollment status update?Contact the Provider Service Center (PSC) (888) 289-0709, option 4 for Provider Enrollment. Please have your Reference ID number available. | |
Why did my enrollment application get rejected after I made the corrections I was told to?A provider is notified about rejections via the Enrollment Rejection Letter. The rejection letter indicates the reason(s) for the rejection. For further assistance, contact the Provider Service Center at 1 (888) 289-0709, option 4. | |
Where do I list the individuals affiliated with our group on the enrollment application?During the online enrollment process, organizations cannot affiliate individuals to their group. It is the responsibility of the individual provider to affiliate with a group. The request must be on the business letterhead to include the Group’s Medicaid Legacy ID number and the provider’s NPI number with the provider’s or an authorized signature via Fax: (803) 870-9022 or Mail: Medicaid Provider Enrollment, PO Box 8809 Columbia, SC 29202-8809. Updates will be processed within ten (10) days of receipt. | |
Why is the group enrollment effective date before the date our individual provider joined the group?When an Individual provider is affiliated with a group, the original group enrollment date remains the same regardless of when the individual provider was affiliated. The individual provider does not receive a new enrollment date when affiliated with the group. | |
Why can’t we update our enrollment profile over the phone?SCDHHS requires updates to a provider’s file to be submitted in writing on business letterhead with the provider’s or an authorized signature. Submit any updated changes via Fax: (803) 870-9022 or Mail: Medicaid Provider Enrollment, PO Box 8809, Columbia, SC 29202-8809. Updates will be processed within ten (10) days of receipt. | |