Healthy Connections MCOs vs. FFS: SC Medicaid Credentialing
By George Ruan • October 9, 2026
Last updated: October 9, 2026.
As of October 9, 2026, SCDHHS’s official Healthy Connections managed care list names five MCOs. Use that live list when deciding which South Carolina Medicaid networks to contact. A state Medicaid provider ID and an MCO network agreement are separate requirements to track.
Sections
The current Healthy Connections MCO list
The state’s directory lists these organizations and links to each plan:
Absolute Total Care.
BlueChoice, branded Healthy Blue.
Humana Healthy Horizons.
Molina.
Select Health, branded First Choice.
Check the directory again when starting an application. Older plan material can describe other products or programs. For example, the state’s Healthy Connections Prime program page says Prime ended January 1, 2026; a legacy Prime plan list should not be used as the current Healthy Connections MCO list.
First complete the state enrollment work
The Provider Administrative and Billing Manual explains South Carolina’s FFS and managed care programs and requires state enrollment for providers contracting with Healthy Connections MCOs. State enrollment establishes the Medicaid provider record; it does not substitute for a plan’s network agreement.
For an LPC, LISW-CP, LMFT or psychologist, start with our SC Medicaid LIP enrollment guide. Track the clinician, group and service-location information used in the application so the same records can be checked during plan onboarding.
Then request each intended MCO network
Contact the Medicaid network for the plans you intend to join. For example, Absolute Total Care’s current contracting page distinguishes its Healthy Connections Medicaid product from its Medicare and Marketplace products and provides a contract-request route. Selecting the right insurer name is only the beginning; identify the Medicaid product explicitly.
Ask the plan to confirm the application route for your provider type, the requested credential documents, the group and rendering-provider relationships, and whether the relevant network is accepting applications. Keep the plan’s response with the application rather than assuming one MCO’s process applies to all five.
Maintain a simple status record for each plan: application submitted, missing items resolved, credential review outcome, contract completed and confirmed effective date. Treat these as checkpoints to verify with that plan, rather than promises of an approval timeline. Before scheduling on an in-network basis, obtain confirmation for the clinician, group, location and product you will bill.
FFS and MCO claims follow the member’s coverage
The administrative manual directs providers to follow the applicable managed care program’s benefit requirements. Being enrolled with SCDHHS does not make the state Web Tool the receiving route for every Medicaid claim. Verify the member, service and date before choosing FFS or the MCO.
For behavioral health, the state’s telehealth policy bulletin specifically assigns MCOs responsibility for authorization, coverage and reimbursement for their enrolled members. A statewide covered service still needs the responsible plan’s billing and authorization instructions.
Absolute Total Care’s behavioral health resources, for example, direct providers to its own portal for claims and authorizations. Use each actual plan’s current resources; do not copy that plan’s authorization limits onto another MCO or an FFS case.
Build the billing handoff
Before the first claim, record the coverage result, receiving payer and the practice’s participation confirmation. Then use SC Medicaid eligibility verification and claims and telehealth guidance for the next steps. If the obstacle is user access, resolve Web Tool account and biller setup separately from contracting.
Frequently Asked Questions
Which Healthy Connections MCOs are listed now?
As of October 9, 2026: Absolute Total Care, BlueChoice (Healthy Blue), Humana Healthy Horizons, Molina and Select Health (First Choice). Recheck SCDHHS’s official list before applying.
Does SCDHHS enrollment put me in every MCO network?
No. Track state enrollment and each intended plan’s credentialing, contract and effective-date confirmation separately.
Should every SC Medicaid behavioral health claim go through the Web Tool?
No. Verify the member, service and date to identify FFS or the responsible MCO, then follow that payer’s claim and authorization instructions.
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