How to Become a Medicaid Provider

Providers delivering autism spectrum disorder (ASD) services must be enrolled with SCDHHS as a Medicaid provider to deliver and bill for Medicaid state plan benefit ASD services. 

To enroll with SCDHHS as a Medicaid provider:

  1. Prep for Enrollment: Providers will need a national provider identification (NPI) and taxonomy number.
    Apply for individual National Provider Identifier (NPI) number.
    • Use the correct taxonomy code as listed in the provider manual.
  2. Complete and submit the Medicaid provider enrollment application.
  3. SCDHHS will notify providers of successful enrollment.

*Note, BCBA and BCaBA providers must enroll individually. If there is a group practice, a group enrollment must also be completed.

To enroll with one of the managed care organizations (MCOs), a provider must be an approved Medicaid provider. Providers need to contact the MCO directly to complete the network enrollment process. Providers are not required to enroll with a MCO, but they may not be reimbursed by the MCO for services provided to beneficiaries enrolled in managed care.

To enroll with a MCO:

  • Contact each MCO to begin the process of contracting, credentialing and enrolling.
  • MCO contact information:

    • Absolute Total Care
      (866) 433-6041
      absolutetotalcare.com

    • Healthy Blue (formerly BlueChoice Healthplan Medicaid)
      (866) 757-8286
      healthybluesc.com

    • First Choice by Select Health
      (800) 741-6605
      selecthealthofsc.com

    • Molina Health Care of South Carolina
      (855) 237-6178
      molinahealthcare.com

    • WellCare of South Carolina
      (888) 588-9842
      wellcare.com

 

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