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.