Claims
In addition to information about how to submit claims and view remits, SCDHHS offers tools to find specific information, such as claim status and member eligibility status. SCDHHS accepts claims in a variety of formats, including electronic and paper claims.
Note: These claim filing options apply only to providers that will file a direct claim to SCDHHS. Providers filing a dental or pharmacy claim or filing with a MCO, should refer to the claims filing options detailed in the respective provider manuals.
Providers filing directly to SCDHHS may choose one or more of the following options for filing claims:
- Paper Claim Submissions
Paper claims are mailed to Medicaid Claims Receipt at the following address:
- Medicaid Claims Receipt, P.O. Box 1412, Columbia, SC 29202-1412
- Electronic Claim Submissions
South Carolina Medicaid Web-based Claims Submission Tool
This tool is a free, online Web-based application for submitting HIPAA-compliant professional claims, institutional claims, and associated adjustments to South Carolina Medicaid.
- File Transfer Protocol
A biller using this option exchanges electronic transactions with South Carolina Medicaid over the Internet.