Learning Resources
Frequently Asked Questions
Special | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | ALL
I |
|---|
I enrolled after 12/03/2012. Am I required to go through the provider revalidation process?You are not required to go through this current provider revalidation process. You will be notified of the next provider revalidation process when it begins. Revalidation FAQs PDF | |
I’m concerned about entering my payment information on the website. Is the website secure?Yes, the website is secure. South Carolina Healthy Connections Medicaid uses the national standard in website security software to ensure that the information entered onto the site is secure. Revalidation FAQs PDF | |
I’m concerned about entering my social security number or other identifying information on the provider revalidation website. Is the website secure?Yes, the website is secure. South Carolina Healthy Connections Medicaid uses the national standard in website security software to ensure that the information entered onto the site is secure. Revalidation FAQs PDF | |
If a beneficiary doesn’t have their copay, can you refuse them?No, as a Medicaid provider you cannot refuse a beneficiary if they do not have their copay. | |
If a beneficiary isn’t eligible, will the Web Tool show ineligible?Yes, information is listed in red. | |
If a Health Insurance Information Referral Form (HIIRF) is completed with no documentation, will the beneficiary's TPL record be updated?No, MIVS will further investigate and draft a letterhead showing steps taken. | |
If a plan doesn’t cover family planning, do we bill to Medicaid and send the EOB? | |
If doing a void/replace adjustment, does the Form 130 go along with the CMS-1500 claim form?Yes, the replacement claim will be attached to the Form 130. | |
If I am currently enrolled in Medicare or with Medicaid in another state, will I have to go through the entire enrollment and screening process and pay another application fee to enroll in South Carolina Medicaid?For 2015, SCDHHS must collect a $553 application fee prior to executing a provider agreement whether upon an initial enrollment, reactivation, revalidation or an enrollment to add a new practice location. [Note: $542 for 2014.] The provider enrollment application fee is applicable to providers that the Centers for Medicare & Medicaid Services (CMS) has identified as institutional providers. South Carolina Healthy Connections Medicaid recognizes and enrolls the following institutional providers: Ambulatory Surgery Centers, Community Mental Health Centers; Comprehensive Outpatient Rehabilitation Facilities; Durable Medical Equipment, End Stage Renal Disease Facilities; Federally Qualified Health Centers; Home Health Agencies; Hospices; Hospitals, Acute Inpatient Facilities, Inpatient Psychiatric Facilities, Inpatient Rehabilitation Facilities, Independent Clinical Laboratories; Skilled Nursing Facilities and Rural Health Clinics. The fee is to be used to cover the cost of program integrity efforts including the cost of screening associated with provider enrollment processes. This fee can vary from year to year based on adjustments made pursuant to the Consumer Price Index for Urban Areas (CIP-U). A provider will be exempt from the fee if they have submitted and received approval for a Hardship Waiver request or they can demonstrate they are enrolled or have paid the application fee to Medicare and/or another state’s Medicaid or CHIP for the same enrollment location jurisdiction. A different enrollment jurisdiction means “a new enrollment with an address different from a currently enrolled location.” Individual physicians (sole proprietors enrolling with an EIN and Social Security Number (SSN) are considered individuals), non-physician practitioners and non-physician practitioner organizations are exempted from paying the enrollment application fee. | |