All Providers

Bulletins and Information for All Medicaid Providers

Claim Correction (Void and Replace) Functionality in BRIDGES

The South Carolina Department of Health and Human Services (SCDHHS) has enhanced its claim correction functionality in the integrated BabyNet Reporting & Intervention Data Gathering Electronic System (BRIDGES) and Medicaid Management Information System (MMIS). This functionality is an automatic internal void and/or replace process in the integrated BRIDGES and MMIS systems, and often requires little provider interaction with the claim. Exceptions to this occur when providers request to delete or update service logs in BRIDGES as described below.

Updated Guidance for Behavioral Health Policies

The South Carolina Department of Health and Human Services (SCDHHS) is announcing updated guidance to clarify several behavioral health policies. The clarifications are described below.

Licensed Independent Practitioners

Elimination of the KEPRO Prior Authorization Requirement for BabyNet Services

Effective immediately, the South Carolina Department of Health and Human Services (SCDHHS) will recognize the Individualized Family Service Plan (IFSP) as prior authorization (PA) for all services rendered under the Individuals with Disabilities Education Act (IDEA) Part C program, commonly known as BabyNet in South Carolina.

South Carolina Recovery Audit Contractor

The South Carolina Department of Health and Human Services (SCDHHS) has awarded a contract to Health Management Systems, Inc. (HMS) to act as the agency’s recovery audit contractor (RAC). Federal regulations (42 CFR 455.500 et. seq.) require states to establish a RAC program as a measure to promote the integrity of the Medicaid program. As a part of the RAC contract, HMS will also conduct Credit Balance audits according to 42 CFR § 455.506(a).

Upcoming Healthy Connections Medicaid Provider Trainings – Spring 2021

The South Carolina Department of Health and Human Services (SCDHHS) regularly offers free trainings to prospective and enrolled Healthy Connections providers. In response to the public health emergency related to coronavirus 2019 (COVID-19), many of these trainings are also now available virtually. Information about the upcoming trainings for Spring 2021 is listed below.

Medicaid Managed Care Enrollment Broker Training

Updated Rehabilitative Behavioral Health Services (RBHS) Accreditation Crosswalk

The South Carolina Department of Health and Human Services (SCDHHS) has published an updated RBHS accreditation crosswalk. The accreditation crosswalk includes updates to covered services and standards for each accrediting body (i.e., Commission on Accreditation of Rehabilitation Facilities, Council on Accreditation and The Joint Commission).

Eligibility and Claims Inquiries from Providers

CORRECTION: The original alert titled "Eligibility and Claims Inquiries from Providers" that was issued on March 22, 2021, erroneously stated that the Provider Service Center (PSC) is open on Fridays from 8 a.m.- 5 p.m. The alert should have stated that the PSC is open on Fridays from 8:30 a.m. – 5 p.m. We apologize for any confusion resulting from the original alert. 
 
Set out below is the corrected alert in its entirety.
 

Updated COVID-19 Testing Fee Schedule

The South Carolina Department of Health and Human Services (SCDHHS) has published an updated fee schedule for coronavirus disease 2019 (COVID-19) testing. The fee schedule is available below and here on SCDHHS’ COVID-19 website.

New SCDHHS Healthy Connections Training Materials Available for Behavioral Health Providers

The South Carolina Department of Health and Human Services (SCDHHS) has posted new training resources for Healthy Connections Medicaid behavioral health providers online. These new resources provide an overview of processes and policies applicable to the following behavioral health service areas: Applied Behavior Analysis (ABA), Medicaid Targeted Case Management (MTCM) and Rehabilitative Behavioral Health Services (RBHS).

Approval of South Carolina’s Appendix K Amendment Request for the Palmetto Coordinated System of Care (PCSC) Waiver

As part of the South Carolina Department of Health and Human Services’ (SCDHHS) ongoing response to the state and federal states of emergency related to coronavirus disease 2019 (COVID-19), SCDHHS submitted a request to the Centers for Medicare and Medicaid Services (CMS) to amend the Palmetto Coordinated System of Care (PCSC) waiver with the Emergency Preparedness and Response Appendix K. The request was approved on Jan. 15, 2021, and will grant providers additional flexibility in delivering services to waiver participants.

Pages

Subscribe to RSS - All Providers
Report Fraud