RA Messages for December 7, 2004
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 WHICH MAY HAVE BEEN INCORRECTLY PAID
ATTENTION ALL PROVIDERS: THE LA MEDICAID RECIPIENT
ELIGIBILITY VERIFICATION SYSTEMS (REVS, MEVS, E-MEVS, AND PROVIDER RELATIONS)
ARE CHANGING EFFECTIVE 11/27/04. NOTIFICATION OF THESE CHANGES WAS PREVIOUSLY
DISTRIBUTED TO PROVIDERS THROUGH NEWSLETTERS, RA STUFFERS, TRAINING MATERIALS,
ETC. PLEASE BE AWARE OF THESE CHANGES WHEN ACCESSING THESE SERVICES AFTER
11/27/04.
NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES
THE 2004 CPT CODES HAVE BEEN LOADED TO OUR FILES AND MAY BE BILLED WITH
THE EFFECTIVE DATE OF SERVICE 01-01-2004. PROVIDERS MAY NOW SUBMIT CLAIMS FOR MEDICAID COVERED 2004 CODES.
THE 2004 PROFESSIONAL FEE SCHEDULE CAN BE FOUND ON OUR WEBSITE @
LAMEDICAID.COM.
ATTENTION PROVIDERS SUBMITTING ELECTRONIC CLAIMS
IT IS IMPERATIVE THAT ALL EMC PROPRIETARY ELECTRONIC CLAIMS SUBMISSIONS
CONVERT TO HIPAA COMPLIANT FORMS AS QUICKLY AS POSSIBLE. PLEASE CONTACT YOUR VENDOR, BILLING AGENT, OR CLEARINGHOUSE TO ENSURE THAT THEY ARE
COMPLETING ALL NECESSARY TESTING TO ALLOW UNINTERRUPTED SUBMISSION OF ELECTRONIC CLAIMS. SPECIFIC DEADLINES FOR EDI TRANSACTIONS ARE AS
FOLLOWS: INPATIENT/OUTPATIENT (UB92)-OCTOBER 31, 2004; DME/AMBULANCE TRANSPORTATION - DECEMBER 31, 2004; PROFESSIONAL - MARCH 31, 2005;
OTHER PROGRAMS - TBD. PROPRIETARY CLAIMS SUBMITTED AFTER APPLICABLE DEADLINES WILL NOT BE PROCESSED.
ATTENTION SCHOOL-BASED HEALTH CENTER PROVIDERS
MEDICAID HAS MADE PROGRAMMING CHANGES TO ADDRESS THE KIDMED CLAIM 068
DENIALS. CLAIMS PREVIOUSLY DENIED IN ERROR WILL BE RECYCLED IN THE NEAR FUTURE.