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  • South Carolina Claim Adjustment Form 130

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South Carolina Department of Health and Human Services - Claim Adjustment Form 130 Provider Name: (Please use black or blue ink when completing form) Provider Address : Total paid amount on the original.

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(800) 763-9087 You can appeal several types of rulings related to Healthy Connections Medicaid.

You can also contact your Medicaid eligibility worker or call the South Carolina Healthy Connections Resource Center toll-free at 1-888-549-0820.

Call First Choice Member Services at 1-888-276-2020 or the Healthy Connections Member Contact Center at 1-888-549-0820 for questions about: Medicaid eligibility.

SCDHHS recommends that you file a claim with the primary insurer within 30 days of the date of service.

If you have not received a card or if it has been lost, please call Member Services toll free at 1-888-276-2020. We will mail you a new card.

Claim Submission Tool (Web Tool) Toll Free-Dial 1-888-289-0709. Fax to (803) 870-9021. Email us at EDIG.OPS-MCAID@palmettogba.com.

Q. How long does it take Healthy Connections to determine my Medicaid eligibility? A. Generally, it takes up to 45 days for Healthy Connections to determine eligibility, though determination times can increase for certain applicant categories.

Verifying Eligibility for Enrolled Members Providers can access information online to help determine if an individual is enrolled in Medicaid through the South Carolina Medicaid Web Portal, commonly known as the “web tool.” To access the web tool, please visit https://portal.scmedicaid.com/login .

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232