All Providers

Bulletins and Information for All Medicaid Providers

SCDHHS Offers Free Provider Workshops

Below is a schedule of the free provider workshops offered by the
SCDHHS to include Medicaid Basics, Comprehensive Web Tool, Overview of
Third Party Liability and Overview of Claim-level Adjustments. 

SCDHHS Offers Free Provider Workshops

Below is a schedule of the free provider workshops offered by the SCDHHS to include Medicaid Basics, Comprehensive Web Tool, Overview of Third Party Liability and Overview of Claim-level Adjustments. To attend these training sessions, you may register through the South Carolina Medicaid Provider Outreach Web site at www.scmedicaidprovider.org or by calling the South Carolina Medicaid Provider Service Center at 1-888-289-0709. Select menu option 1 for the Electronic Data Interchange (EDI) Support Center. 

Managed Care Organizations (MCOs) and Behavioral Health

Effective April 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will be including the professional and outpatient facility charges associated with Medicaid covered behavioral health services as part of the Managed Care Organization (MCO) covered responsibilities.  Providers will be required to file claims for behavioral health services to the MCOs for MCO enrolled beneficiaries.  Providers must verify eligibility and contact the applicable MCO for prior authorization before rendering services.

 

South Carolina Non-Emergency Medicaid Transportation (NEMT)

American Medical Response, Incorporated, operating as Access2Care in South
Carolina, has terminated their contract with South Carolina Department of Health
and Human Services (SCDHHS) for the Non-Emergency Medical Transportation
Program (NEMT). Effective December 22, 2011, Access2Care began its 60-day
transition plan to exit the state by February 21, 2012.

Implementation of 5010 Transaction Standards

 

The South Carolina Department of Health and Human Services (SCDHHS) will begin processing 5010 transactions January 1, 2012, as mandated.

On November 17, 2011, the Centers for Medicare and Medicaid Services (CMS) announced a 90-day delay in enforcement of the new 5010 transactions standards. Although enforcement of compliance to ASC X12 5010 Version 5010 and NCPDP D.0 was delayed until March 31, 2012, the mandatory compliance date remains January 1, 2012.

Implementation Schedule and Important Dates:

 

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.

 

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):

 

October 2011 Bulletin Archive

Price Increase For Synagis® Injectable
Description: 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%.
Posted: 10/13/2011 4:12:48 PM

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