RA Messages for March 25, 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 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.
ATTENTION PROFESSIONAL SERVICES
PROVIDERS
2007 REIMBURSEMENT RATE CHANGES
BASED ON FUNDING APPROPRIATED IN THE
2007 LEGISLATIVE SESSION AND APPROVAL BY CMS, DHH IS PLEASED TO ANNOUNCE
REIMBURSEMENT RATE CHANGES FOR SELECTED PHYSICIAN SERVICES. EFFECTIVE
FOR DATES OF SERVICE ON OR AFTER OCTOBER 15, 2007. REFER TO THE HOME
PAGE OF THE LOUISIANA MEDICAID WEB SITE,
WWW.LAMEDICAID.COM, LINK �2007
PROFESSIONAL SERVCIES RATE CHANGES� FOR MORE DETAILS OR CONTACT UNISYS
PROVIDER RELATIONS (800-473-2783 OR 225-924-5040).
CLAIMS PAID AT THE PREVIOUS RATES WILL BE SYSTEMATICALLY RECYCLED.
PROVIDERS WILL BE NOTIFIED WHEN AND HOW THE RECYCLE WILL OCCUR.
PLEASE MONITOR FUTURE RA MESSAGES AND THE LOUISIANA MEDICAID WEBSITE
WHICH WILL INFORM PROVIDERS OF ANY ADDITIONAL UPDATES.