South Carolina Pharmacy Services

Due to system maintenance, the following web applications will be unavailable for approximately 30 minutes between Sunday, November 22, 11pm ET and Monday, November 23, 6am ET: UAC, Web PA, Web RA, Pharmacy Web Claims Submission, Virginia ARS Web Inquiry, Nevada EVS Web Inquiry and FirstHCM/OPAS. We apologize for any inconvenience this may cause.

Welcome to First Health Services' South Carolina Pharmacy Services Web site for beneficiaries and providers.

The Provider Perspective

Interested in the latest news pertaining to the SC Medicaid Provider Community? View the current provider newsletter.

Web Claims Submission

South Carolina Medicaid now offers Web Claims Submission, a tool created by First Health Services Corporation (FHSC) which allows DME providers to submit certain preferred diabetic supply products (meters and strips) electronically. This will now allow real-time adjudication for specific DME claims. Keep in mind, for those pharmacy providers who also have a DME line of business, you will be allowed to submit the preferred diabetic supply products through the point-of-sale (POS) system. Please ensure you transmit your DME NPI on SC Medicaid c laims for diabetic meters and strips.

Note: Prior to obtaining access to the Web Claims Submission tool, DME providers or the designated delegated administrator must access the User Administration Console (UAC) to request a personal identification number (PIN), register with the PIN, and create a user id/ password. Now is the perfect opportunity to access the User Administration Console by clicking on the UAC link in the upper right hand corner of this screen. There are instructions, educational documents, and online presentations available in the Reference collection link in the upper right hand corner of this screen. First Health Services also provides a Web Support Call Center (800-241-8726) for assistance with any questions you may have during this process.

Web PA

South Carolina Medicaid offers Pharmacy Web Prior Authorization (Web PA), a web-based application developed by First Health Services Corporation (FHSC) which allows prescribers to request PAs online and receive real-time approvals. Go to Physician/ Prescriber > Announcements for details.

Note: Prior to obtaining access to the Pharmacy Web Prior Authorization tool, prescribers or the designated delegated administrator must access the User Administration Console (UAC) to request a personal identification number (PIN), register with the PIN, and create a user id/ password. Now is the perfect opportunity to access the User Administration Console by clicking on the UAC link in the upper right hand corner of this screen. There are instructions, educational documents, and online presentations available in the Reference collection link in the upper right hand corner of this screen. First Health Services also provides a Web Support Call Center (800-241-8726) for assistance with any questions you may have during this process.

Prescription Limits

Adult SC Medicaid beneficiaries are allowed 4 standard prescriptions per month and potentially up to six additional prescriptions if certain criteria listed in the SC Medicaid policy manual are met. The total number of prescriptions allowed will be 10 per month in the fee for service program for adult beneficiaries with no exceptions.

Note: Children from birth to the date of their 21st birthday are eligible for an unlimited number of Medicaid-covered prescriptions per month.

Hepatitis C Program

To improve patient compliance and clinical outcomes, South Carolina Medicaid has implemented a specialty care management program for beneficiaries receiving certain specialty medications. The major focus of this program is to provide outreach to a population of South Carolina Medicaid beneficiaries who will receive high intensity intervention services to improve their care and outcomes. This program, administered by First Health Services, assists beneficiaries in an attempt to avoid duplication of existing services and serves as a “safety net” to identify any problems that may have occurred during the first level of services.

Medicaid Bulletin Subscriptions

All Medicaid Bulletins will be sent by email and can be viewed at your convenience online at www.scdhhs.gov. To make certain that you receive bulletins in the near future, please visit http://bulletin.scdhhs.gov/.

Note: If you are currently receiving bulletins from the "Medicaid Bulletins" email address, you must re-subscribe. For full details see the Medicaid Bulletin dated August 26, 2008.