Provider Information

As a provider, you are essential to the South Dakota Medical Assistance Program (SDMA).  

Here you will find information and tools to enroll as a South Dakota Medical Assistance provider, operate effectively according to SDMA policies and administrative rule, and find important information like billing updates, fee schedules and covered services.  

Once SD MEDX is fully implemented, you will be able to check recipient eligibility, view your own claim history, retrieve remittance advices, submit online claims, upload prior authorization forms as well as many other features once you have obtained valid log in credentials to SD MEDX. 

For specific eligibility, managed care, or claims information, you may call the provider telephone service unit:

• In-state: 1-800-452-7691
• Out-of-state: (605) 945-5006

For more information on SD MEDX schedule, please sign up for one of the list servs below.

NEW: South Dakota Medical Assistance Program In-Patient Hospitalization Form

• Effective October 17, 2011, hospitals are required to submit this form to the South Dakota Medicaid Program when a recipient has been hospitalized for an acute care
  admission for six consecutive days.
  
  
  • The notice must be completed online or faxed to 605-773-5246 on day six of the acute care admission. Fill out the form.
  • Upon discharge, please submit the form with the pertinent discharge information.
  • For more information regarding the In-patient Hospitalization Process, please review this Frequently Asked Questions document.

SD MEDX Readiness Listservs

Medicaid Incentive Payment Program

The Division of Medical Services Medicaid Incentive Payment Program for eligible providers is currently in development. For more information, click here.

Provider Contact Registration

To help us identify staff in your organization that interact with South Dakota Medicaid and need information on provider outreach activities and training opportunities, we are asking you to provide contact information for specific individuals within your organization.

• Click here to enroll individuals as the Security Contact, Provider Enrollment Supervisor, Claims Supervisor and Prior Authorization.

Provider Bulletins

• Upcoming 5010 Implementation
• PERM Provider Education Webinar/Listening Session
• SD MEDX Training
• Hydroxxyprogesterone Caproate (Makena)
• Update: Cost Sharing for IHS and IHS-Contract Providers
• Provider Address Change Information
• Provider Correspondence
• Archive Bulletins