All Providers

Below is a schedule of the free provider workshops offered by the South Carolina Department of Health and Human Services to include Medicaid Basics, Comprehensive Web Tool, Web Tool Updates and Third Party Liability.

To attend these training sessions, you may register through the Healthy Connections Medicaid Provider Education website at Medicaidelearning.com or by calling the Provider Service Center at 1 (888) 289-0709. From the main menu, select option 1.

Medicaid Basics

Nov. 5, 10 a.m.-4 p.m., Columbia
Dec. 3, 10 a.m.-4 p.m., Columbia

The South Carolina Department of Health and Human Services (SCDHHS) announces the following changes to the Healthy Connections Medicaid claims submission and payment schedule for two weeks in November and one week in December in order to accommodate the 2015 holiday schedule.

Due to Veteran's Day, Saturday, Nov. 7, at 5 p.m. is the deadline to submit claims for payment date Friday, Nov. 13. Payments will run Monday, Nov. 9, and electronic remittance advices will be available Tuesday, Nov. 10. Payments will be dated Friday, Nov. 13, as usual.

In the bulletin dated April 20, 2015, providers were informed their enrollment information must be revalidated, per the Centers for Medicare and Medicaid Service (CMS). To avoid risk of termination in the South Carolina Department of Health Human Services (SCDHHS) Healthy Connections Medicaid program, you must complete and submit an enrollment application 30 days from the date of your official revalidation notification letter. DO NOT begin the revalidation process until you receive notification.

This is a reminder that, as a condition of participation in the Healthy Connections Medicaid program, providers are required to maintain and provide access to records. These records should fully disclose the medical necessity for treatment and the extent of services provided to Medicaid beneficiaries. Unless program policy otherwise allows, this documentation must be present in the beneficiaries' records before the provider files claims for reimbursement.

In the bulletin dated April 20, 2015, providers were informed their enrollment information must be revalidated, per the Centers for Medicare and Medicaid Service (CMS). To avoid risk of termination in the South Carolina Department of Health Human Services (SCDHHS) Healthy Connections Medicaid program, you must complete and submit an enrollment application 30 days from the date of your official revalidation notification letter. DO NOT begin the revalidation process until you receive notification.

On Oct. 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) transitions from International Classification of Diseases, 9th Edition (ICD-9) to International Classification of Diseases, 10th Edition (ICD-10) as the medical code set for medical diagnosis and inpatient hospital procedures. Providers not using valid ICD-10 codes beginning Oct. 1, 2015, will be unable to successfully bill for services.

In the bulletin dated April 20, 2015, providers were informed their enrollment information must be revalidated, per the Centers for Medicare and Medicaid Service (CMS). To avoid risk of termination in the South Carolina Department of Health Human Services (SCDHHS) Healthy Connections Medicaid program, you must complete and submit an enrollment application 30 days from the date of your official revalidation notification letter. DO NOT begin the revalidation process until you receive notification.

Effective Oct. 1, 2015, Field 21 of the CMS 1500 form will require an indicator of “9” or “0.” This indicator is for the purposes of the ICD-10 implementation. Entering a “9” will indicate the provider intends to submit ICD-09 codes. Entering a “0” will indicate the provider intends to submit ICD-10 codes. Below is a guide for provider claim staff.