Claims
In addition to information about how to submit claims and view remits, SCDHHS offers tools to find specific information, such as claim status and member eligibility status. SCDHHS accepts claims in a variety of formats, including electronic and paper claims.
Note: These claim filing options apply only to providers that will file a direct claim to SCDHHS. Providers filing a dental or pharmacy claim or filing with a MCO, should refer to the claims filing options detailed in the respective provider manuals.
Providers filing directly to SCDHHS may choose one or more of the following options for filing claims:
- Paper Claim Submissions
Please mail paper claims to Medicaid Claims Receipt at the following address:
- CMS-1500: P.O. Box 1412 Columbia, S.C. 29202
- UB-04: P.O. Box 1458 Columbia, S.C. 29202
Nursing Facilities/Intermediate Care Facilities for Individuals with Intellectual Disabilities/Swing-Bed Hospitals:
- P.O. Box 100122 Columbia, S.C. 29202
Community Residential Care Facilities:
- P.O. Box 67 Columbia, SC 29202-0067
Claim Reconsideration:
- P.O. Box 8809 Columbia, S.C. 29202
- Electronic Claim Submissions
South Carolina Medicaid Web-based Claims Submission Tool
This tool is a free, online Web-based application for submitting HIPAA-compliant professional claims, institutional claims, and associated adjustments to South Carolina Medicaid.
The Medicaid Web Tool Online Training includes six interactive videos that cover the following topics: getting started, customize your web tool, check eligibility, enter a claim, submit a claim and revisit, re-use and remit.
- File Transfer Protocol
A biller using this option exchanges electronic transactions with South Carolina Medicaid over the Internet.