All Providers

Bulletins and Information for All Medicaid Providers

New Medicaid Quality Improvement Organization (QIO)

 

Effective March 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) began implementation of a contract with the Keystone Peer Review Organization, Inc. (KePRO), to serve as the new Quality Improvement Organization with an operational date of June 1, 2012.

 

SCDHHS Offers Free Provider Workshops - Apr -May -June 2012

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.

~~~TRAINING SESSIONS ARE NOW AVAILABLE ONLINE ~~~

To access the online training sessions through our e-learning Web site:

South Carolina Medicaid ICD-10 Web page

 

The South Carolina Department of Health and Human Services (SCDHHS) is pleased to announce its new web page dedicated to information related to the implementation of the International Classification of Diseases Version 10 (ICD-10), with a mandatory compliance date of October 1, 2013. 

The SCDHHS ICD-10 web page is available now and includes important information related to ICD-10 implementation including project status, pertinent ICD-10 links, as well as other relevant information to assist with this transition.

Training Workshop SBIRT

 

The South Carolina Department of Health and Human Services (SCDHHS) is offering training to Medicaid enrolled Federally Qualified Health Clinics, Rural Health Clinics, Family Practice, and OB/GYN providers on Screening, Brief Intervention, and Referral to Treatment (SBIRT).  SBIRT is an agency initiative, in partnership with other stakeholders, to help identify and offer treatment to pregnant beneficiaries who may have alcohol or other /substance dependence, depression, or domestic violence.

 

South Carolina Medicaid Preferred Drug List

The following revisions to the Preferred Drug List (PDL) are effective with dates of service on or after April 9, 2012

TETRACYCLINES

Preferred

Non-Preferred

DOXYCYCLINE HYCLATE Added as Preferred

 

DOXYCYCLINE MONOHYDRATE (50, 100MG)

Added as Preferred

Managed Care Organizations, Nursing Facilities, and Swing-Bed Hospitals

 

Effective with dates of service on or after April 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will expand coverage of nursing home admission or swing-bed placement from the initial thirty (30) days of continuous confinement to ninety (90) days of continuous confinement as part of the Managed Care Organization (MCO) covered responsibilities.  Providers will be required to file claims to the MCOs for MCO enrolled beneficiaries. 

 

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.

Pages

Subscribe to RSS - All Providers
Report Fraud