All Providers

Claims-level Adjudication and Updated Web Resources

The South Carolina Department of Health and Human Services (SCDHHS) will operate on an updated schedule for Healthy Connections Medicaid claims submission and payments for one week in November 2019 to accommodate the Thanksgiving holiday.

Due to this holiday schedule, claims must be submitted by 5 p.m. on Saturday, Nov. 23 to be included with the payment scheduled for Friday, Nov. 29. Payments will run on Monday, Nov. 25 and electronic remittance advices will be available on Tuesday, Nov. 26. Payments will be dated Friday, Nov. 29, as usual.

Conference Call Information for Question and Answer Session with BabyNet Providers and MCOs

The South Carolina Department of Health and Human Services (SCDHHS) is continuing 2019 provider revalidation.  

Claims-level Adjudication Begins in November; Expanded Resources Available

The Centers for Medicare and Medicaid Services (CMS) released a memo on Oct. 17, 2019, with key dates for contract year (CY) 2021 Medicare-Medicaid Plan (MMP) applications. The memo included several key deadlines for organizations that are interested in participating in the Healthy Connections Prime Dual Demonstration Waiver in South Carolina for CY 2021. These dates are listed in the table below for reference. The first date, the deadline to submit a notice of intent to apply (NOIA) as a New/Initial MMP, is Nov. 11, 2019.

New Claims-level Remittance Advice Features Coming in November

Individualized Family Service Plans will be Regenerated Oct. 17-23

Medicaid managed care organizations (MCOs) who contract with the South Carolina Department of Health and Human Services (SCDHHS) for the provision of Medicaid services request medical records from providers to comply with SCDHHS' requirements for reporting Healthcare Effectiveness Data and Information Set (HEDIS ^® ). Thank you for cooperating with the MCOs' medical record requests and ensuring that any medical record vendors do so as well.

Continuity of Care Period in Effect Oct. 1