Frequently Asked Questions


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Frequently Asked Questions

 

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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.

How does Medicaid know what the provider is receiving from another carrier/third party payer?

There are spaces/sections on the claim form that identify what you receive from the other carrier.

How far back can you bill?

Within 12 months

How far back can you file a void?

15 - 18 months

How long do I have to complete the provider revalidation process?

You have 30 days from the date on the revalidation notification letter to complete and submit your provider revalidation application in its entirety with all current information. Revalidation FAQs PDF

How long do you have to request a hearing for an appeal?

You have 30 days to request a hearing.

How long does it take to process an adjustment?

It takes approximately 30-45 days to process an adjustment - the same as a normal claim in process.

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