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Provider Information

Important Alert for Providers

On February 21, 2014, SCDHHS notified providers that 1099s for the week of October 29, 2013 were overstated. SCDHHS has resolved the issue, and the agency mailed corrected 1099s on March 3, 2014 to the approximately 5,000 providers whose original 1099 was not correct.
 
Only those providers who received a payment from SCDHHS for the week of October 29, 2013 will receive a corrected 1099.  The corrected 1099 will display a checked box at the top center of the form to identify it as the corrected form.

 

Provider Manuals

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Fee Schedules

Physicians

Family Practice, General Practice, Osteopath, Internal Medicine, Pediatrics, Geriatrics
Effective For Dates Of Service 01/01/14

Effective For Dates Of Service 01/01/2013

Resources

New Tool! SC HealthViz

Access maps, reports and data on Medicaid health services in South Carolina SC HealthViz is designed to provide greater transparency of the data that...

Provider Enrollment and Screening Requirements

  Be licensed by the appropriate licensing body, certified by the standard-setting agency, and/or other pre-contractual approval processes...

SC Medicaid Companion Guides

South Carolina Medicaid Companion Guides supplement the HIPAA-required ANSI X-12 Implementation Guide to explain billing instructions specific to...

Fee Schedules

Physicians Family Practice, General Practice, Osteopath, Internal Medicine, Pediatrics, Geriatrics Effective For Dates Of Service 01/01/14...

Electronic Data Interchange (EDI)

  Electronic claims are processed faster and more accurately than those received by mail. SCDHHS will provide an electronic response indicating that...

Carrier Codes

  Megallan Carrier Code List Alpha12/13/2013 (MS Excel Spread sheet) Megallan Carrier Code List Numeric12/13/2013 (MS Excel Spread sheet) Carrier...

Proviso 33.34

The 2014 budget currently includes Proviso 33.34 which-for the first time-provides funds that may only be accessed if hospitals and clinics serving...

Affordable Care Act Initiatives

South Carolina Department of Health and Human Services (SCDHHS) received final State Plan Amendment approval for the payment methodology for enhanced...

ICD-10

  Read More about the ICD-10 Implementation   On January 16, 2009, the Department of Health and Human Services released the HIPAA Administrative...

OSS Advisories

OSCAP advisory August 2013   July 1, 2013 OSCAP Advisory07/09/2013 February 2013 OSS AdvisoryDescription: OSS Advisory NewsletterPosted:01/29/2012...

Claim Submission Tool (Web Tool)

Web tool

Medicaid Web-based Claims Submission Tool Send CMS-1500 and UB-04 claims and their associated adjustments to SC Medicaid via the Internet. Support...

APR-DRG

The South Carolina Department of Health and Human Services (SCDHHS) intends to move to a new method of paying for hospital inpatient services. The...

MHN/MCO Eligibility Verification Feature Now Available

  Effective Tuesday, June 12, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will add a new feature to the SC Web-based...

Organizations

Screening, Brief Intervention and Referral to Treatment (SBIRT)

What is SBIRT?  SBIRT is evidence based, integrated and comprehensive approach to the identification, intervention treatment/referral of substance (...

Adult Protection Coordinating Council

The Adult Protection Coordinating Council was created by the South Carolina General Assembly to foster coordination and cooperation among multiple...

South Carolina Birth Outcomes Initiative

  SCBOI Core Objectives South Carolina Birth Outcomes Initiative (BOI) is an effort by the South Carolina Department of Health and Human Services (...

Division of Community and Facility Services

The Division of Community and Facility Services is responsible for oversight for the following Medicaid programs: home health, hospice,nurse aide...

Nurse Aide Registry, Testing and Training

The South Carolina Healthy Connections Medicaid is committed to ensuring that anyone who is interested in becoming a Certified Nursing Assistant (CNA...

Nursing Facility Services (Nursing Homes)

Nursing Facility Services Links Nurse Aides (CNA) Residents Family Members Nursing Facility Providers Reference Nursing Home Level of Care...

Home Health

Conditions and Criteria for Home Health Services: Home Health Services are intermittent skilled nursing services, physical therapy, speech therapy,...

Healthy Connections Prime

As part of the State Demonstrations to Integrate Care for Dual Eligible Individuals, South Carolina is one of fifteen states selected to design new...

Long Term Care & Behavioral Health Service

The bureau consists of three divisions: Division of Community Long Term Care Division of Community and Facility Services (Nursing Home, Home Health...

Medicaid Coordinated Care Improvement Group

The purpose of this Group is to examine the current Medicaid coordinated care system to determine what is working and not working and develop...

Payment Error Rate Measurement (PERM)

PERM 2013 Provider Education Webinar/Conference Calls The Centers for Medicare & Medicaid Services (CMS) is hosting four Payment Error Rate...

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