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.
Should you have any questions
regarding any of the following messages, please contact Molina Medicaid
Solutions at (800) 473-2783 or (225) 924-5040.
ATTENTION PROVIDERS:
Providers who submitted claims for claim type 14 and 15
for the period of 3/1/2012 forward, for those individuals who are in populations that are excluded
from the LBHP program and that originally denied for edit 555 (submit claim to LBHP SMO), those claims
are being recycled for either payment or denial for the correct edit by Molina on the RA of 12/18/12.
We apologize for any inconvenience that this may have caused providers.
ATTENTION PROVIDERS:
Providers who submitted claims for claim types
01, 04, 14 and 15 for the period of 3/1/12 forward for those individuals who are in populations
that are excluded from the LBHP program, with a diagnosis of specialized behavioral health, and
that originally denied for edit 555 (submit claim to LBHP SMO), are recycled for payment by
Molina on the RA of 12/10/12. We apologize for any inconvenience that this may have caused
providers.
ATTENTION ALL PROVIDERS
HOLIDAY CHECKWRITE DATES ADJUSTED
Due to the State, Federal and Bank Holiday schedules, the checkwrite
dates for the last week in December and the first week in January will be adjusted to Wednesday, December 26, 2012,
and Wednesday, January 2, 2013. EFTs will be released on December 27th and January 3rd.
Reminder: The EDI cutoffs for these weeks are Thursday, 12/20/12,
at noon for the December 26th checkwrite and Thursday, 12/27/12, at noon for the January 2nd checkwrite.
ATTENTION HOSPITAL
PROVIDERS: EFFECTIVE 12/14/12 MOTHER'S MEDICAID NUMBER REQUIRED FOR
INITIAL PRECERT
OF LEGACY NEWBORNS
DHH is requesting that in order for
Providers to begin the Precert
process, initial newborn requests submitted to Legacy Medicaid will
require the mother's Medicaid number to be included on the
PCF01 form. The 13 digit Medicaid number area on the PCF01should remain as all zeros until the baby's Medicaid number is assigned.
If submitting electronically through ePrecert, the mother's number
should be typed in the text box area.
These requests will be rejected if the Provider fails to provide this
information or if the mother is verified as having Bayou Health Plan
coverage on the day of admit. Please visit www.lamedicaid.com
for the notice. If you have any questions please contact Molina
Provider Relations (800) 473-2783 or (225) 924-5040.