KEPRO Prior Authorizations

PROVIDER ALERT

The South Carolina Department of Health and Human Services (SCDHHS) encourages all autism spectrum disorder (ASD) providers to complete their prior authorization submissions through Keystone Peer Review Organization (KEPRO), the agency's quality improvement organization.

All authorizations approved before April 1, 2018, will expire June 30, 2018. If you have not done so, please submit your prior authorization requests through KEPRO. Authorization requests submitted after June 25, 2018, may not be approved before the expiration of current authorizations. Accordingly, providers submitting untimely requests may experience reimbursement gaps for services provided after July 1. 

Please be aware that claims with dates of service on and after July 1, 2018, will not be reimbursed unless a KEPRO prior authorization number is present on the claim. When entering a claim using the web-based claims submission tool, enter the prior authorization number in the box labeled "Prior Authorization Number" at the bottom of the window on the "Additional Information" tab. 

Please refer any questions regarding this bulletin to the SCDHHS Office of Behavioral Health at (803) 898-2136.

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

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