Deadline for Provider Revalidation is Sept. 24; Provider Termination is Sept. 25

PROVIDER ALERT

Federal regulations mandate that the South Carolina Department of Health and Human Services (SCDHHS) revalidate the enrollment of all providers serving Medicaid beneficiaries. In accordance with this federal mandate, South Carolina Healthy Connections Medicaid providers that have not completed and submitted the provider enrollment revalidation application will be terminated Sept. 25, 2016.

All providers that enrolled as a South Carolina Healthy Connections Medicaid provider before Dec. 2, 2012, received notice(s) from SCDHHS regarding the need for revalidation beginning April 20, 2015, with the final revalidation requirement notices delivered before Dec. 31, 2015. SCDHHS has reinforced this requirement during meetings of the Medical Care Advisory Committee and has also worked with key provider associations to make providers aware of the revalidation requirement.

Revalidation is not optional and is required in order to continue receiving payment for services provided to Healthy Connections Medicaid beneficiaries. Completed revalidation applications are required to be submitted by Sept. 24, 2016, for all enrolled organizations, provider groups, individual providers associated with a provider group(s) and individual sole practitioners. Providers who have not submitted a complete revalidation application by Sept. 24, 2016, will be terminated and will not receive Medicaid fee-for-service payments for services provided to Healthy Connections Medicaid beneficiaries after this date.

Providers who submitted a completed revalidation application by Sept. 24, 2016, but have not had their application processed by SCDHHS will be permitted to continue to serve Medicaid beneficiaries pending a final determination of their application. These providers will continue to receive status notifications during the processing of their application.

All providers that have not submitted a completed revalidation application prior to Sept. 25, 2016, will be terminated on that date. Terminated providers are required to submit a new provider enrollment application with South Carolina Healthy Connections Medicaid in order to receive payment for services on or after the termination date.

How to Revalidate:

  1. Go to the online revalidation application: https://providerservices.scdhhs.gov/ProviderEnrollmentWeb/initializePERe....
  2. To sign in, you will need your revalidation number, Medicaid legacy identification number and National Provider Identifier (NPI) number, if applicable.

 

The revalidation number, Medicaid legacy identification number and NPI number is on your original revalidation notification letter. If you don't have the letter, please call the SCDHHS Provider Service Center at (888) 289-0709, option 4.

Please visit https://msp.scdhhs.gov/revalidation for additional information regarding the provider enrollment revalidation process.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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