Frequently Asked Questions


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Frequently Asked Questions

 

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What is a Temporary Moratorium?

A temporary moratorium is the imposition of a hold or freeze on the enrollment of new or initial Medicaid providers and suppliers of a particular provider type or the establishment of new practice locations of a particular provider type in a specific geographic area for a period of six months.  CMS may extend a temporary moratorium in six month increments.  The announcement of a moratorium will be reported in the Federal Register.


What is an MHN referral number?

If your service requires a referral, the MHN gives you an authorization number.


What is provider revalidation?

All enrolled South Carolina Healthy Connections Medicaid providers who are not Durable Medical Equipment (DME) suppliers must revalidate their enrollment criteria every five years in accordance with the Affordable Care Act. DME suppliers must revalidate every three years. Revalidation FAQs PDF


What is the payment cycle?

The payment cycle is: Wed-Mon, payments are processed on Tuesday, and payment is received as early as Friday.


What is the physical address to over-night a TAD?

The PO boxes and physical address are included in the Provider manual as well as on the mailing envelope.

For regular mail:
Medicaid Claims Receipt – NF Claims Section
Nursing Homes
P.O. Box 100122
Columbia, SC 29202-3122
 
Medicaid Claims Receipt – NF Claims Section
OSS/IPC/Hospice:
P.O. Box 67
Columbia, SC 29202
 
For UPS, FedEx, etc.
Medicaid Claims Receipt – NF Claims Section or CRCF Claims Section
8901 Farrow Road
Columbia, SC 29203

NOTE: Late change forms should be sent overnight or faxed, with all attachments, to (803) 870-9020. Forms should not be faxed unless they are sent past the deadline. Faxed corrections should be received no later than the third working day of each month for Nursing Home providers and the 17th day of the month for OSS providers.


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.


What should I do if one line does not pay on your claim?

Correct and refile that one line.

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.


When are TADs available for providers to view on the Web Tool?

TADs are not yet available on the Web Tool. Medicaid will continue to send copies of the TADs to providers until the TADs are available on the Web Tool.


When are the DHHS Form 181, CRCF 01 and IPC forms due back to MCCS?

Nursing Home change forms are due to MCCS on the first working day of each month. OSS change forms are due no later than the 17th of each month. These dates are subject to change based on holidays, etc.



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