Learning Resources
Frequently Asked Questions
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Where is the Provider Service Center located?It is housed at MCCS. | |
Who initiated these new screening and enrollment guidelines?The Centers for Medicare and Medicaid Services (CMS), under standards established by the Affordable Care Act (ACA), with a focus on strengthening requirements for Medicaid provider screening and other enrollment requirements. | |
Who is mandating the provider revalidation process?This implementation is in response to directives in the standards established by Section 6401(a) of the Affordable Care Act (ACA) in which CMS requires all state Medicaid agencies to implement the provider enrollment, screening, and revalidation provisions of the Affordable Care Act. These regulations were published in the Federal Register, Vol. 76, February 2, 2011, and were effective March 25, 2011. Revalidation FAQs PDF | |
Who updates the website for manuals? | |
Why are our claims denying for dates of service prior to the individual provider leaving the practice?Prior to requesting the removal of an Individual provider from your group practice ensure that the pending claims are adjudicated. However, if the provider has already been removed from the group prior to the claim(s) being adjudicated and needs to be added back to the group, submit the request on the business letterhead with the provider’s or an authorized signature via Fax: (803) 870-9022 or Mail: Medicaid Provider Enrollment, PO Box 8809, Columbia, SC 29202-8809. Updates will be processed within ten (10) days of receipt. | |
Why are Web Tool claims suspending?Contact the PSC, option “2” for claims issues. | |
Why can’t we update our enrollment profile over the phone?SCDHHS requires updates to a provider’s file to be submitted in writing on business letterhead with the provider’s or an authorized signature. Submit any updated changes via Fax: (803) 870-9022 or Mail: Medicaid Provider Enrollment, PO Box 8809, Columbia, SC 29202-8809. Updates will be processed within ten (10) days of receipt. | |
Why did my enrollment application get rejected after I made the corrections I was told to?A provider is notified about rejections via the Enrollment Rejection Letter. The rejection letter indicates the reason(s) for the rejection. For further assistance, contact the Provider Service Center at 1 (888) 289-0709, option 4. | |
Why is the group enrollment effective date before the date our individual provider joined the group?When an Individual provider is affiliated with a group, the original group enrollment date remains the same regardless of when the individual provider was affiliated. The individual provider does not receive a new enrollment date when affiliated with the group. | |