What is DDSN Direct Billing?
The South Carolina Department of Health and Human Services (SCDHHS) is transitioning billing and payment of services rendered to South Carolina Department of Disabilities and Special Needs (DDSN)-operated waiver participants from the current pay band system to Medicaid direct fee-for-service (FFS) billing. The transition will streamline administrative and payment processes and allow providers to direct bill Medicaid as the payor of waiver services. SCDHHS has targeted a go-live date of April 1, 2022, to fully transition to provider direct FFS billing. During the transition period from Jan. 1, 2022, to April 1, 2022, DDSN will pay providers in the same manner in which DDSN is currently paying providers.
Prior to the go-live date, providers must be enrolled as a Healthy Connections Medicaid provider. A provider enrollment checklist and depiction of SCDHHS’ claims process is included in the Guidance on DDSN Provider Transition to Medicaid Direct Billing. SCDHHS will conduct provider payment testing and provider training during the transition period to ensure a smooth conversion to direct FFS billing.
Provider training and testing opportunities will be announced in future communications from SCDHHS. Providers with questions about Healthy Connections Medicaid enrollment or the transition to Medicaid direct billing should email MedicaidWaiver@scdhhs.gov.
The provider enrollment portal is available to accept enrollment applications from DDSN waiver service providers as of Jan. 8, 2022.
- Additional Resources
- Updated Guidance on DDSN Provider Transition to Medicaid Direct Billing - Jan. 7, 2022
- Application for 1915(c) HCBS Waiver_ Draft SC.014.06.00 - Jan. 1, 2022
- ID/RD Waiver Rates Used for Financial Impact Analysis Jan. 1, 2022
- Guidance on DDSN Provider Transition to Medicaid Direct Billing - Nov. 24, 2021
- Fax Cover Sheet
- DDSN Provider Transition Timeline
- Training
Click the button below to view all training resources.