Frequently Asked Questions


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Frequently Asked Questions

 

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How can you get copies of enrollment letters?

To receive a copy of a beneficiary’s enrollment letter, they may contact Healthy Connections Choices or the beneficiary’s plan (that they were enrolled into).

How do I complete the provider revalidation process for all other NPIS associated with my Medicaid ID?

You will need to complete a new enrollment for every NPI associated with your Medicaid ID except for the primary NPI that is identified on the revalidation notification letter. All new enrollments need to be completed within 30 days from the date on the revalidation notification letter. To access the online provider enrollment application, copy and paste https://providerservices.scdhhs.gov/ProviderEnrollmentWeb/ into your browser. Revalidation FAQs PDF


How do I complete the provider revalidation process?

The provider revalidation application is available exclusively online. When it is time to revalidate your enrollment as a provider, you will receive a revalidation notification letter. You have 30 days from the date on the revalidation notification letter to complete and submit the provider revalidation application in its entirety with all current information. Revalidation FAQs PDF


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 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


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.


How do I know the charge?

You can find the charge for the service in your provider manual.


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 update the individual provider’s name?

SCDHHS requires the individual provider to send in a completed/signed W9 form with the individual’s name, SSN, address and signature. Providers are also required to complete the Disclosure of Ownership and Control Interest Statement Form.


How do patients learn updated information?

Patients learn of updates at their enrollment anniversary dates, or you may share information with them.



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