Get Fm 181 - Medicaidelearning.com

The FM 181 form is essential for the authorization of Medicaid services for eligible patients in South Carolina. This guide provides clear and simple instructions for filling out the FM 181 form online, ensuring that users can navigate through each section with confidence.

Follow the steps to complete the FM 181 form effectively.

1. Use the ‘Get Form’ button to obtain the FM 181 and open it for editing.
2. In Section I, complete the identification of the provider and patient. Ensure you fill out each field, including the beneficiary’s name, birth date, Medicaid number, facility name, and provider Medicaid ID. Pay special attention to the HIB suffix associated with the Social Security number.
3. Section II covers type of coverage and statistical data. Indicate the patient’s level of care, admission dates, and any applicable changes in status. This section may be initiated by the service provider or the SCDHHS Medicaid Eligibility Worker.
4. In Section III, the designated SCDHHS Medicaid Eligibility Worker will complete the authorization and change of status. Ensure that this section is signed and dated by the appropriate authority, especially for new admissions or changes affecting income liability.
5. Finally, review the completed form for accuracy. Then, save your changes, and print or download the form as needed. Submit the completed FM 181 form to the SCDHHS Central Mail address specified in the instructions.

Begin filling out your FM 181 form online now for a streamlined application process!