The SC Department of
Health and Human Services

How to Refund Medicaid

 Monies are refunded back to the agency for various reasons.  The most common type of refund that the South Carolina Department of Health and Human Services receives is a refund coming back in from a provider.  Whenever a provider receives monies that are not due to them, they need to prepare a refund to the agency using the 205 form.

"State Health and Human Services Form for Medicaid Refunds" (205 form) must accompany all checks.  The form must be completed correctly and in its entirety to insure proper credit.  The checks are then made payable and mailed to:              

                        SC Department of Health & Human Services

                        Division of Accountability and Collections

                        PO Box 8355

                        Columbia, South Carolina 29202

 Some helpful hints to remember when completing the 205 form  are:

 ·        The correct provider ID number must be put on the 205 form.  This is the six digit provider ID number in which the claim was originally paid to.  This provider ID number can be located in the top left corner of the Medicaid Remittance.

 ·        If the monies are being refunded because another insurance paid, we need to have the details of their other insurance (i.e. insurance company name, policy number, policy holder, group name and amount they paid) along with their EOB.

 ·        If the monies are being refunded because of Medicare, please state the reason and send the Medicare EOB.

 ·        A Medicaid remit is also required with all refunds to insure that the monies are posted back to the correct place.

 ·        If the funds are being requested back by DHHS, please attach a copy of that request.

 ·        Please also make sure the date of service and Medicaid Recipient ID number that is listed on the 205 form is correct.  This is the ten-digit number that is assigned to each Medicaid Recipient.

 ·        If there are multiple refunds sent in on one check, please make sure that the individual lines total the amount of the check, and that there is a 205 form completed for each refund.

 ·        Lastly, please make sure a contact person with their phone number is listed on the 205 form.

The 205 form is located in the Provider Medicaid Manual for your convenience. It is also located under Service Providers within this web site.  If there are any additional questions pertaining to refunding monies back to Medicaid, please call your provider representative.

Contact Info

S C Department of Health and Human Services

Division of Accountability and Collections

PO Box 8355

Columbia, South Carolina 29202