RA Messages for March 10, 2008

PHARMACY PROVIDERS, PLEASE NOTE!!!


IF YOU ARE UNSURE ABOUT THE COVERAGE OF A DRUG PRODUCT, PLEASE CONTACT THE PBM HELP DESK AT 1-800-648-0790.
PLEASE NOTE THE FOLLOWING CHANGES TO APPENDIX A:
DRUG                                                                 DOSAGE                     STRGTH                 MAC                     EFF.
TERBUTALINE SULFATE                                   VIAL                        1MG/ML             OFF MAC             02/25/08

 PLEASE FILE ADJUSTMENTS FOR CLAIMS THAT MAY HAVE BEEN INCORRECTLY PAID. ONLY THOSE PRODUCTS OF THE MANUFACTURERS WHICH PARTICIPATE IN THE FEDERAL REBATE PROGRAM WILL BE COVERED BY THE MEDICAID PROGRAM. PARTICIPATION MAY BE VERIFIED IN APPENDIX C, AVAILABLE AT WWW.LAMEDICAID.COM

 

ATTENTION PROVIDERS

EFFECTIVE WITH PROCESSING DATE MARCH 1, 2008, LA MEDICAID IMPLEMENTED CHANGES TO THE PROCESSING AND PAYMENT OF THIRD PARTY LIABILITY (TPL) CLAIMS. THIS CHANGE IS IN CONJUNCTION WITH THE EXPANSION OF THE LA HEALTH INSURANCE PREMIUM PAYMENT PROGRAM (LAHIPP). THESE CHANGES MAY AFFECT THE PAYMENT OF YOUR TPL CLAIMS. WITHIN THE NEXT WEEK, TRAINING MATERIALS AND OTHER DOCUMENTS RELATED TO THIS CHANGE WILL BE POSTED ON THE LA MEDICAID WEB SITE, WWW.LAMEDICAID.COM, LINK "TRAINING" - 2008 PROVIDER TRAINING MATERIALS. PLEASE REVIEW THIS INFORMATION CAREFULLY IN ORDER TO UNDERSTAND THE CHANGES MADE. IF YOU DO NOT HAVE WEB ACCESS, PLEASE CONTACT UNISYS PROVIDER RELATIONS (800-473-2783 OR 225-924-5040) TO OBTAIN A COPY OF THIS INFORMATION.
 


ATTENTION PROFESSIONAL AND DME PROVIDERS

EFFECTIVE WITH PROCESSING DATE APRIL 1, 2008 (CYCLE OF APRIL 7, 2008), LOUISIANA MEDICAID WILL ACCEPT AND PROCESS TPL CLAIMS SUBMITTED ELECTRONICALLY BY PROFESSIONAL AND DME PROVIDERS. IT WILL NO LONGER BE NECESSARY FOR THESE PROVIDERS TO SUBMIT TPL CLAIMS HARD COPY WITH EOBS ATTACHED. PROVIDERS MUST ENTER THE APPROPRIATE AND ACCURATE INFORMATION FROM THE PRIMARY PAYOR EOB FOR TRANSMISSION ELECTRONICALLY TO LOUISIANA MEDICAID FOR PROCESSING AND PAYMENT. DETAILED INFORMATION IS AVAILABLE IN THE 837P (PROFESSIONAL) COMPANION GUIDE LOCATED ON THE LOUSIANA MEDICAID WEB SITE, WWW.LAMEDICAID.COM, LINK "HIPAA BILLING INSTRUCTIONS AND COMPANION GUIDES." CONTACT SOFTWARE VENDORS AND/ OR UNISYS EDI FOR ASSISTANCE. PLEASE SEE THE WEB SITE FOR A MORE DETAILED NOTICE ON THIS TRANSITION. OTHER PROVIDER TYPES SHOULD MONITOR RA MESSAGES AND THE WEB SITE FOR INFORMATION CONCERNING EDI PROCESSING OF TPL CLAIMS.