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  • Sc Uniform Managed Care Provider Credentialing Application 2005

Get Sc Uniform Managed Care Provider Credentialing Application 2005-2025

Urance of an adequate and acceptable amount reflective of your specialty as a prerequisite for participating in a managed care organization. Please attach a copy of your most recent malpractice insurance binder. List current and previous malpractice insurance carrier(s) for past five years: CARRIER NAME/ADDRESS VI. POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE AMOUNT OF COVERAGE Five Year Work History (CV can not be used in lieu of completing this section) NAME OF PREVIOUS/CURRENT EMPLOYER(.

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A provider must immediately report any change in enrollment or contractual information (e.g., mailing or payment address, physical location, telephone number, specialty information, change in group affiliation, ownership, etc.) to SCDHHS Provider Service Center (PSC) within thirty (30) days of the change.

If you need help applying for Healthy Connections (Medicaid), need assistance with your existing health plan or have other questions, please contact Healthy Connections at (888) 549-0820.

Contact the Provider Service Center (PSC) (888) 289-0709, option 4 for Provider Enrollment. Please have your Reference ID number available.

To Change Your Plan Enrollment Once You Are a Member To make a change, visit the South Carolina Healthy Connections Choices website or call 1-877-552-4642, Monday through Friday, from 8 a.m. to 6 p.m. TTY users should call 1-877-552-4670.

Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month (capitation) payment for these services.

To Change Your Plan Enrollment Once You Are a Member To make a change, visit the South Carolina Healthy Connections Choices website or call 1-877-552-4642, Monday through Friday, from 8 a.m. to 6 p.m. TTY users should call 1-877-552-4670.

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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
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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