South Carolina Medicaid

Please follow the Enrollment Instructions below to become an electronic submitter for South Carolina Medicaid.

 

Required Documents for those applying for new Submitter IDs

The following documents are required enrollment documents that must be completed, signed, and returned to the Medicaid office prior to initiation of electronic claims submission or inquiry.

1. Trading Partner Agreement Enrollment Instructions for Providers

http://www1.scdhhs.gov/openpublic/hipaa/webfiles/TPE%2010-2011%20Provide...

If you have any questions regarding any of the documents in this package, please phone the Medicaid EDI Technology Support Center at 1-888-289-0709 option 2.

 

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.

 

Trading Partner Agreement Enrollment Form

Section 1

  • Enter today's date

Section 2

  • Enter your Business/Organization or Provider name (you are the Trading Partner)

Section 3

  • Please select No Access Needed for the South Carolina Medicaid Web Based Claims Submission Tool section

Section 4

  • For Protocol please select Secure FTP

Section 5

  • Print your Name and Sign

Section 6 & 7

  • Enter the name of the primary contact person for your office and his/her contact information

  • For the name of Software Vendor please enter the information for the software or vendor that creates your 837 files you need ClaimShuttle to transfer for you. If you have paid for our billing software please call our support line for our software information.

    • If you are a provider that has a Billing Service submitting your claims, please enter your Billing Service's name.

Section 8

  • For Transaction Volume Estimate please only check off the following choices:

    • ASC X12N 837I (for UB04 billings)

    • ASC X12N 837P (for CMS billings)

    • ASC X12N 835 (for electronic remittance advice)

Section 9

  • If you are applying as a billing service please complete this section with all your provider's information

  • If you are a provider billing for yourself only, please skip this section

 

Submitting your Forms

It is recommended that you keep a copy of all the forms you will be submitting for your records. Fax or Mail the enrollment form reflecting original signatures to:

Fax to 803-870-9021

SC Medicaid TPA
P.O. Box 17
Columbia, SC 29202
 

Waiting for a Response

Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately two weeks from the date of receipt. (Remember that mailing time can take as much as five days.)

After processing, a confirmation will be sent to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the Medicaid EDI Technology Support Center at 1-888-289-0709.

 

Testing

Once you have received your Submitter ID and Password from Medicaid, please call the ClaimShuttle Support Team and set an appointment for a Mailbox setup and Test Transmission to Medicaid.

Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.