Medicaid

How to Get Credentialed with SC Healthy Connections in South Carolina

Network: Open
30-60 Days

Quick Overview

Timeline

30 - 60 days

CAQH

Not Required

Re-credentialing

Every 5 year(s)

Delegated

No

South Carolina-Specific Requirements

South Carolina Medicaid (Healthy Connections) enrollment steps: (1) Obtain NPI via NPPES. (2) Register through the SC DHHS (Department of Health and Human Services) Medicaid Web-Based Claims Submission provider enrollment portal. (3) Submit application with SC state license, proof of malpractice insurance, and required documentation. (4) Background check including SLED and federal criminal history is required for all providers. South Carolina operates managed care through Healthy Connections with 5 MCOs. Behavioral health providers accepted include LPC, LISW-CP (Licensed Independent Social Worker - Clinical Practice), and LMFT with active South Carolina licensure. Revalidation is required every 5 years.

Medicaid Information: South Carolina

Agency: SC DHHS

Program: Healthy Connections

Portal: https://www.scdhhs.gov

Phone: 1-888-289-0709

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for South Carolina.

2

Prepare Your Application

Complete SC Healthy Connections's provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to SC Healthy Connections.

4

Track & Follow Up

Credentialing typically takes 30-60 days. Monitor your application status and respond promptly to requests for additional information.

Free Consultation

Need help enrolling with SC Healthy Connections?

Our specialists handle the entire SC Healthy Connections enrollment process: applications, follow-ups, and approvals in South Carolina.

Required Documents Checklist

Background Check

Federal/state background check required for Medicaid enrollment

CV/Resume

Work history required

Malpractice Insurance

Conditional

Required in most states; some state programs waive for government employees

Medical License

NPI Certificate

Enrollment Forms

South Carolina Medicaid Provider Enrollment

Required
Online Open →

Key Credentialing Terms

Capitation
A payment model where a payer pays a provider a fixed amount per member per month regardless of whether the member recei...
CAQH
The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
Credentialing
The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
Effective Date
The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
Managed Care
A healthcare delivery system organized to manage cost, utilization, and quality through techniques such as provider netw...
Network Adequacy
The requirement that a health plan's provider network has enough providers in each specialty and geographic area to give...
NPI
The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
Primary Source Verification
The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...

Credentialing Checklist

Make sure you have everything ready before applying to SC Healthy Connections.

View Physician Credentialing Checklist →

Contact Information

Provider Credentialing

National

1-888-289-0709

Mon-Fri 8am-5pm

Provider Services

National

1-888-289-0709

Claims & Billing

National

1-888-289-0709

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Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.

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