Wednesday, September 7, 2016

SEPTEMBER 24 DEADLINE: Medicaid Revalidation for Providers

The South Carolina Department of Health and Human Services (SCDHHS) is required by federal regulations to revalidate the enrollment of all providers serving Medicaid beneficiaries.
SCDHHS informed the SCMA that approximately 2,500 physicians have not responded to previous communications regarding the revalidation requirement. These physicians are in jeopardy of termination from the South Carolina Medicaid program if they do not revalidate. The SCMA has requested that SCDHHS send a list of SCMA member physicians that have not revalidated as of September 7, 2016 so that we can send those physicians a letter with instructions on how to complete this process.

In the meantime and in the essence of time, we encourage all physicians to check the status of their revalidation.



What is Medicaid revalidation?
Medicaid requires you to revalidate your enrollment information every five years. If you miss this important deadline, Medicaid billing privileges will be terminated until you successfully complete a new provider enrollment application.

How do I revalidate?
Each provider must electronically complete and submit a revalidation application before midnight September 24, 2016, to avoid termination as a Medicaid provider.

Who can revalidate my information?
This can be done personally by you the provider or by your credentialing officer. Whomever is completing the revalidation needs to ensure that they are revalidating for both the individual physician identification number and the group identification number. 

Which numbers do I need to revalidate?
In some instances SCDHHS is finding that only the group number was revalidated. In other instances they are finding individuals have revalidated without revalidating the group identification number. It is crucial that revalidation is completed on both the individual and the group enrollments.
Who do I need to contact if I have questions?
If you have any questions or need for clarification, please contact SCDHHS provider enrollment at 1-888-289-0709 option 4, then option 4, then option 3.
What happens if physicians miss the deadline?
Providers that do not revalidate before the deadline of midnight September 24, 2016, will be terminated in the Medicaid system. Providers will not receive payment for Medicaid services delivered after termination.
Providers who are not revalidated must successfully complete a new Medicaid provider enrollment application to begin receiving payment for Medicaid services.