South Dakota is continuing to process the revalidation submissions requested of all Medicaid providers in the summer of 2016 in order to meet federal requirements. Given the large volume of applications to review and process, the revalidation process can take months to complete and approve.
Upon approval of a revalidation record, Department of Social Services (DSS) Provider Enrollment staff send an approval email to the listed enrollment contact. Providers who submitted the revalidation application and have claims that were not paid timely should include the approval email with each claim that the provider was unable to have processed that meets the conditions shown in the sample below. Please note that providers are not required to submit claims repeatedly in order to preserve timely filing.
The department is offering additional guidance:
- If you are unsure if your record has been revalidated, please login to SD MEDX to check the status of your enrollment record.
- If you or your entity have not received approval for revalidation actions requested in 2016 and you have had a change in payment details or EDI partners that require immediate updates, please contact Ellen Blauert or Patrick Cushing at (605) 773-3495. Other updates, e.g., changes to staffing, need to be made following the revalidation approval.
- If your record is approved, but your enrollment contact isn’t in receipt of a revalidation approval message and need it for claims processing, please send the entity NPI to SDMEDXGeneral@state.sd.us and request that the revalidation approval be resent. Please note, this approval will be shared with the listed enrollment contact.
The approval notice, as show in the example below, includes the instructions for handling provider claims.