Frequently Asked Questions


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Frequently Asked Questions

 

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How do I make sure that my address and other information are correct?

Contact the South Carolina Healthy Connections Medicaid Provider Service Center at 888-289-0709, option 4. It is your responsibility to ensure that your contact information is current. Customer Service Advocates cannot update your address information over the phone.

To update your address, please fax or mail a letter requesting an address change to MCCS Provider Enrollment on company letterhead. The Provider Enrollment fax number is (803) 870-9022. The address is Medicaid Provider Enrollment, P.O. Box 8809, Columbia, SC 29202-8809. The letter should include the provider’s legacy and NPI numbers, as well as the new address, along with the provider’s or an authorized person’s signature and a contact person’s name and telephone number in case there are any questions. Once the address information is updated and the revalidation notification letter is re-sent, the provider will still have 30 days from the date on the original revalidation notification letter to fully complete the provider revalidation process.

Revalidation FAQs PDF


How do I know if I am a moderate or high risk provider?

Refer to the Provider Type/ Specialty listing document. Go to www.scdhhs.gov/provider and select the link titled “Provider Type and Specialty Listing” in the Provider Lists subsection. Revalidation FAQs PDF


What do I need to do to prepare for revalidation?

It is highly recommended that you make sure your primary practice location address and provider type are current with South Carolina Healthy Connections Medicaid. It is your responsibility to ensure that your information is current.

To update your address, please fax or mail a letter requesting an address change to MCCS Provider Enrollment on company letterhead. The Provider Enrollment fax number is (803) 870-9022. The address is Medicaid Provider Enrollment, P.O. Box 8809, Columbia, SC 29202-8809. The letter should include the provider’s legacy and NPI numbers, as well as the new address, along with the provider’s or an authorized person’s signature and a contact person’s name and telephone number in case there are any questions. To update info other than an address, please go to www.scdhhs.gov/Provider and select “FAQ Guide” for instructions on how to update information in your profile.

Revalidation FAQs PDF


What information will the provider revalidation process require?

A checklist of the documentation that you will need for the provider revalidation process can be found by copying and pasting this link you’re your browser https://www.scdhhs.gov/sites/default/files/Online%20Enrollment%20Application%20Visual%20Guide.pdf or by visiting https://www.scdhhs.gov/Provider and selecting “Online Application Visual Guide” from the “Provider Enrollment Information” section. This is currently a link to the Provider Online Enrollment Application Visual Guide. The information needed for enrollment is very similar to the information needed for revalidation. Revalidation FAQs PDF


What if my address is correct, but other information needs to be updated?

If any information that you used for your provider enrollment has changed and you have not informed SCDHHS of the change, you will need to follow the standard procedure to update your information. Please go to www.scdhhs.gov/Provider and select “FAQ Guide” for instructions on how to update information in your profile. Revalidation FAQs PDF


I am a provider with multiple NPIs attached to my Medicaid ID. I completed the provider revalidation application for my primary NPI. Why are my claims being rejected?

Within 30 days from the date on the revalidation notification letter, all other NPIs attached to your Medicaid ID will need to complete an electronic provider enrollment application. To access the online provider enrollment application, copy and paste https://providerservices.scdhhs.gov/ProviderEnrollmentWeb/ into your browser. If you did not complete an electronic provider enrollment application for all non-primary NPIs associated with your Medicaid ID and you wish to continue billing with those NPIs, claims for those NPIs will be rejected. You may resubmit claims once you have received confirmation that the electronic provider enrollment application is complete. Revalidation FAQs PDF


On a hospital claim, if the pay-to provider has revalidated, but the line provider fails to revalidate, will the claim deny?

If MMIS validates the NPI of the rendering physician, then the claim will deny if the individual has not revalidated. Revalidation FAQs PDF


Will there be training available for the South Carolina Healthy Connections Medicaid provider revalidation process?

There will be webinars, e-learning opportunities, and classroom training sessions available. For information about dates, times and registration, please visit medicaidelearning.remote-learner.net. Revalidation FAQs PDF


Where can I find additional information about the South Carolina Healthy Connections Medicaid provider revalidation process?

For additional information about the South Carolina Healthy Connections Medicaid provider revalidation process, please visit www.scdhhs.gov/revalidation or medicaidelearning.remote-learner.net. Revalidation FAQs PDF


Do all providers need to pay the provider revalidation application fee?

If you are an institutional provider as determined by CMS, you will need to pay a provider revalidation fee of $553.00 if you revalidate in 2015. The 2016 fee will be determined by CMS and will be published after it is established by CMS. If you are a provider with multiple NPIs associated with your Medicaid ID, you will need to complete a new enrollment for each non-primary NPI. You are responsible for the new enrollment fee/s. Revalidation FAQs PDF



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