All Providers

Bulletins and Information for All Medicaid Providers

Possible One-Day Delay in Claims Payment

Several providers may experience a delay in claims scheduled for payment Friday, June 19, 2015. These payments may be delayed until Saturday, June 20, 2015.

ICD-10 Clinical Modification/Procedure Coding System

On Jan. 16, 2009, the U.S. Department of Health and Human Services (HHS) published a final rule on the International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System (ICD-10 CM/PCS), requiring all Health Insurance Portability and Accountability Act (HIPAA)-covered entities to adopt the ICD-10-CM/PCS (diagnosis/inpatient procedure codes) by Oct. 1, 2015.

Obtaining Infant Medicaid ID Numbers on Provider Web Tool

The South Carolina Department of Health and Human Services (SCDHHS) has released a guide to demonstrate how to use the existing Provider Web Tool, https://portal.scmedicaid.com/, to obtain Healthy Connections Medicaid Identification (ID) Numbers for infants.

Provider Revalidation

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.

Update to Nondiscirmination Portion of the State Plan

The South Carolina Department of Health and Human Services (SCDHHS) has updated the Nondiscimination section of the State Plan. Effective on or after July 1, 2015, SCDHHS will amend the South Carolina Title XIX state plan to:

Provider Enrollment Revalidation

The South Carolina Department of Health and Human Services (SCDHHS) is required to revalidate providers' enrollment information in accordance with the Patient Protection and Affordable Care Act (PPACA) provider enrollment and screening regulations published by the Centers for Medicare and Medicaid Services (CMS).

HCBS C4 Individual Facilities/Settings Assessment Process

The South Carolina Department of Health and Human Services (SCDHHS) will begin assessing Home and Community-Based Services (HCBS) settings in May of 2015. This process is implemented as part of the agency’s Statewide Transition Plan. SCDHHS must ensure compliance with the recent updates to the Centers for Medicare and Medicaid Services’ (CMS) HCBS regulations.
 

ICD-10 Introductory Classes

The Centers for Medicare and Medicaid Services (CMS) is hosting ICD-10 classes designed for physicians, practice managers, billing managers and others who need help transitioning from ICD-9 to ICD-10. These in-person classes will be hosted in South Carolina March 23-27. Below is a list of classes and registration information:

Monday, March 23, 1-3 p.m.
Columbia, S.C.
Register: Class Full

Tuesday, March 24, 8-10 a.m.
Greenville, S.C.
Register: Class Full

Rehabilitative Behavioral Health Services Frequently Asked Questions

On Feb. 20, the South Carolina Department of Health and Human Services (SCDHHS) released a bulletin on changes to the Rehabilitative Behavioral Health Services (RBHS) policy, effective March 1, 2015. These changes, which only apply to fee for service, include medical necessity and prior authorizations, staff credentials, staff to client ratio, frequency limits and reimbursement rates and modifier changes.

For a list of answers to commonly asked questions on these RBHS service changes, please visit scdhhs.gov/rbhsfaq.

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