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
If you have any trouble accessing the link above, you can download the application directly from their site by going here: www.scdhhs.gov/resource/electronic-data-interchange-edi
(the forms are listed at the bottom of that page)
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
Reason for Submission
- Please select "New Enrollment"
Trading Partner Information
- Please enter your provider/business name
- Enter your demographic information, tax ID, NPI, and provider ID
- Please leave the "Trading Partner ID" field blank
- For Type of Business, please select Medcaid Provider if you are with the providers office
- If you are a Billing Service billing on behalf of Medicaid Providers, please check the box for "Billing Service"
Provider Contact Information
- Please enter your contact information
- For preference of aggregation, please select either tax ID or NPI and enter the number accordingly
Claims Submission/Retrieval Information
- Check the box for "No" stating you will not be using a clearinghouse or billing agent
- Please check the box for "Secure FTP"
- Skip the section for their web-based tool
- Please check "Yes" for the following transactions, based on your claim type:
- 837I Institutional claims if you bill on a UB 04
- 837P Professional claims if you bill on a CMS 1500
- 835 if you wish to receive your remittance advice (EOB's) electronically
- Please check "No" on the rest of the options listed
TPA Authorization Agreement
- Please have the authorized official check the box, print their name, and sign the application
- Please enter today's date as the "Submission Date" and "Requested Effective Date"
- Please complete the last page with any additional Providers you want to link to your Submitter ID
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.
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.