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Get Sc Dhhs Provider Enrollment Manual 2018-2025
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How to fill out the SC DHHS Provider Enrollment Manual online
Filling out the SC DHHS Provider Enrollment Manual is an important process for healthcare providers seeking participation in Medicaid programs. This guide will walk you through the steps to successfully complete the manual online.
Follow the steps to fill out the form correctly
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Review the manual to familiarize yourself with the different sections and forms needed, including the W-9 and Authorization Agreement for Electronic Funds Transfer.
- Begin by providing your basic information in the designated fields, ensuring accuracy to avoid future delays.
- Complete the Disclosure of Ownership and Control Interest Statement if applicable, providing detailed ownership information.
- Fill out the Participation and Payment Agreement by outlining your agreement to the terms and conditions specified.
- If you need a Hardship Waiver, fill out the corresponding request form with the necessary documentation.
- Double-check all completed sections for correctness and completeness before submitting.
- After completing the form, you can save your changes, download, print it, or share it as needed.
Begin completing your documents online today for a seamless enrollment experience.
If you have any questions regarding provider enrollment and screening, please contact the Provider Service Center at (888) 289-0709, Option 4. Visit https://.scdhhs.gov/provider for additional information. Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.
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