Individuals with Disabilities Education Act Part C Program (BabyNet) Updates and Important Dates

PROVIDER ALERT

Claims-level Adjudication Begins in November; Expanded Resources Available
On Nov. 1, the South Carolina Department of Health and Human Services (SCDHHS) will implement the claims-level adjudication process for payments to providers rendering services to children through the Individuals with Disabilities Education Act (IDEA) Part C program, commonly known as BabyNet. Beginning Nov. 13, providers will be able to access claims-level remittance advice in the SCDHHS web toolfor claims submitted and dates of service on or after Nov. 1. Instructions on accessing remittance advice are available on the BabyNet website.

The claims-level adjudication system has been one of the central projects critical to the success of the integration of the BabyNet and South Carolina Healthy Connections Medicaid programs. The new system institutes a change to how claims are processed and how payments are made to providers. Additional resources have been developed to ensure any provider concerns are addressed quickly while the new payment system is brought online. Some of these resources include:

SCDHHS is also publishing a list of points of contact for providers who encounter any issues with BabyNet operations following the implementation of claims-level adjudication. Please refer to the table below for the appropriate points of contact as determined by the potential issue.

Nature of Inquiry

Contact Information

System access issues in BRIDGES

BRIDGES Help Desk: Submit a ticket

 

Specific application errors in BRIDGES

BRIDGES Help Desk: Submit a ticket

 

Billing questions

Managed Care Organization (MCO): Contact the relevant MCO using the tableprovided on the BabyNet FAQ page

 

Fee-for-service: SCDHHS Provider Service Center

Click hereto complete the web form; or

Call: (888) 289-0709

SCDHHS web tool/remittance advice issues

Visit the Provider Service Center website here; or,

Call: (888) 289-0709

MCO-specific inquiries

MCO: Contact the relevant MCO using the tableprovided on the BabyNet FAQ page

 

Credentialing Reminder for Providers in Advance of Continuity of Care Period Ending Dec. 31

Providers who have not yet submitted their information for credentialing with a MCO are reminded that the process can take up to 60 days. The continuity of care period for the integration of BabyNet and South Carolina Healthy Connections Medicaid ends on Dec. 31, 2019.

Next Call in Series Announced: Question and Answer Session for BabyNet Providers and MCOs

SCDHHS will host a call with representatives from MCOs and BabyNet providers on Nov. 15. BabyNet providers are encouraged to submit questions and comments for MCOs to bnproviderenrollment@scdhhs.govby noon Thursday, Nov. 7. SCDHHSwill forward submitted questions to the MCOs to be addressed during the call. Due to time constraints, answers presented on each call will only be available for questions that were submitted by the noon deadline on Nov. 7.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid and BabyNet programs.

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