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Updates to the SCDHHS Dental Services Program

FREQUENCY LIMITATION APPLICATION
With the transition to DentaQuest (DQ), the South Carolina Department of Health and
Human Services (SCDHHS) made changes to the frequencies allowed for certain dental
services. These changes were communicated in a Provider Bulletin dated October 15,
2010. Providers should review the latest version of the Dental Office Reference Manual
(ORM) to verify frequency limits and to check the web portal to determine if the
beneficiary has received the service within the frequency time period. Failure to follow

Spacers for Metered Dose Inhalers

 

 

I.              Spacers for Metered Dose Inhalers

Retirement of Toll Free Eligibility Verification Line

Effective December 31, 2011, the South Carolina Department of Health and Human Services’ (SCDHHS) toll free eligibility verification line (1-888-809-3040) will no longer be available. This system is currently used by a small number of providers to validate member eligibility and/or to check the status of the most recent payment from SCDHHS. Providers may access this same information via the free SCDHHS Web Tool.

New SCDHHS Website

The South Carolina Department of Health and Human Services (SCDHHS) is excited to announce the launch of its newly designed public website on Monday, Nov. 7, 2011.

Alcohol and Drug Testing Policy

 

Effective with dates of service on or after December 1, 2011, the South Carolina Department of Health and Human Services (SCDHHS) will implement limitations on Alcohol and Drug Screens.  For the complete policy and billing instructions, please see the Physician, Laboratories and Other Medical Professionals manual located at www.scdhhs.gov.

 

Revised Administrative Day Policy

Effective for claims with discharge dates on or after November 1, 2011, the South Carolina Department of Health and Human Services (SCDHHS) has revised the policy for patients eligible for Administrative Days. This revision removes all references to the 50-mile limit for Nursing Home placements. The revised policy will read:

Price Increase For Synagis Injectable

 

Effective for dates of service on or after October 15, 2011, the South Carolina Department of Health and Human Services (SCDHHS) will increase the rate for Synagis to the current Average Wholesale Price (AWP) minus 18%.  The new rates for 100mg vial will increase from $1,995.36 to $2,192.89.  The 50mg vial will increase from $1,056.71 to $1,161.31.

 

Hospital Discharge Planners

 

Effective immediately, Medicaid eligible hospital patients who no longer require acute care and are seeking long term care may exempt the waiting list for Community Choices. An assessment and level of care must be made by CLTC prior to the patient’s discharge. Referrals must be made to the appropriate CLTC office.

Medicaid Insurance Verification Services (MIVS) - Third Party Liability (TPL) Support Services

 

Effective November 1, 2011, the Medicaid Insurance Verification Services (MIVS) contract will no longer be administered by Affiliated Computer Services, Inc.  Blue Cross Blue Shield of South Carolina (BCBSSC) will be performing the following services on behalf of the South Carolina Department of Health and Human Services (SCDHHS):

 

SCDHHS Announces Use of National Correct Coding Initiative (NCCI) on a Prepayment Basis

 

NCCI Background and FAQs

Initially National Correct Coding Initiative (NCCI) was developed by CMS for Medicare Part B claims and is now being implemented for state Medicaid programs.

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