Learning Resources
Frequently Asked Questions
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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 | |
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Should claims returned on Form 017 or 017CI without processing be re-filed? | |
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The bulletin references March 2016 as being the due date/last day for provider revalidation.Is that the last day that I can submit my provider revalidation application? Is that the day I will receive provider revalidation confirmation from South Carolina Healthy Connections Medicaid? South Carolina Healthy Connections Medicaid mailed revalidation notification letters for phase 1 of provider revalidation on June 4th, 2015. South Carolina Healthy Connections Medicaid provider revalidation will occur in phases from June 2015 to March 2016. When it is time to revalidate your enrollment as a South Carolina Healthy Connections Medicaid provider, you will receive a revalidation notification letter in the mail. Revalidation FAQs PDF | |
To which address will the provider revalidation notification letter be mailed?The provider revalidation notification letter will be mailed to the primary practice location address. Revalidation FAQs PDF | |
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Under the Web Tool's status option, can I check the status of a claim I submit hard copy?Yes, it doesn’t matter the submission method. | |
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What are some of the new provider screening and enrollment guidelines?
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What do I need to do to prepare for a site visit?You will receive a site visit form with this information after your site visit has been scheduled. 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. | |
What do you do if a beneficiary is out of visit counts?When checking eligibility, you will see what visit counts they have left. You can request more from your representative or treat them as a self pay. | |
What do you do if monies are sent to the patient?Change them to self pay after or before service completion. | |