RA Messages for December 13, 2004

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ATTENTION DENTAL PROVIDERS - NEW DENTAL CLAIM FORM REQUIREMENTS

EFFECTIVE JANUARY 1, 2005, THE 2002 AMERICAN DENTAL ASSOCIATION CLAIM FORM AND THE 2002, 2004 AMERICAN DENTAL ASSOCIATION CLAIM FORM WILL BECOME THE ONLY HARDCOPY DENTAL CLAIM FORMS ACCEPTED FOR MEDICAID PRIOR AUTHORIZATION AND REIMBURSEMENT OF SERVICES PROVIDED IN THE EPSDT, EDSPW AND ADULT DENTURE PROGRAMS. FURTHER INFORMATION REGARDING THIS REQUIREMENT WILL BE PROVIDED IN THE SEPTEMBER/OCTOBER 2004 ISSUE OF THE MEDICAID PROVIDER UPDATE AND IS CURRENTLY AVAILABLE ON THE FOLLOWING WEBSITE: HTTP://WWW.LAMEDICAID.COM . SHOULD YOU HAVE ANY QUESTIONS REGARDING THIS MATTER, YOU MAY CONTACT UNISYS PROVIDER RELATIONS AT (225)924-5040 OR (800)473-2783 OR THE MEDICAID DENTAL PRIOR AUTHORIZATION UNIT AT (504)619-8589. 

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ATTENTION ALL MEDICAID PROVIDERS

DUE TO NUMEROUS PROBLEMS ENCOUNTERED IN THE PAST, EFFECTIVE JANUARY 1, 2005, U.S. MAIL IS NO LONGER AN ACCEPTABLE METHOD OF REQUESTING/ISSUING COMMUNITYCARE REFERRALS/AUTHORIZATIONS. HOSPITAL TO PCP POST- AUTHORIZATIONS SHALL BE REQUESTED AND ISSUED(OR DENIED WHEN APPROPRIATE) VIA FAX OR ELECTRONIC REFERRAL AUTHORIZATION SYSTEM (ERA). WHEN REFERRING A COMMUNITYCARE RECIPIENT FOR SPECIALTY CARE, THE PCP MAY ELECT TO SEND THE REFERRAL/AUTHORIZATION WITH THE RECIPIENT, OR FAX IT TO THE OTHER PHYSICIAN. ANY QUESTIONS REGARDING THIS POLICY SHOULD BE DIRECTED TO THE COMMUNITYCARE PROGRAM OFFICE AT (225)342-4810. 

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ATTENTION DENTAL PROVIDERS

POLICY CLARIFICATION REGARDING PROCEDURE CODE D5650 PROCEDURE CODE D5650 (ADD TOOTH TO EXISTING PARTIAL DENTURE) REMAINS AS A REIMBURSABLE SERVICE IN THE EPSDT DENTAL AND ADULT DENTURE PROGRAMS. THIS PROCEDURE CODE WAS INADVERTANTLY REMOVED FROM THE EPSDT DENTAL PROGRAM FEE SCHEDULE EFFECTIVE 9/1/04. SHOULD YOU HAVE ANY QUESTIONS, YOU MAY CONTACT THE MEDICAID DENTAL UNIT BY CALLING 504-619-8589.