RA Messages for January 15, 2002

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 PHARMACY PROVIDERS,PLEASE NOTE!!!

 PLEASE MAKE THE FOLLOWING CHANGES TO THE 1/1/02 VERSION OF APPENDIX C

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  PLEASE MAKE THE FOLLOWING CHANGES TO THE 1/1/02 VERSION OF APPENDIX A

 IF YOU ARE UNSURE ABOUT THE COVERAGE OF A DRUG PRODUCT, PLEASE CONTACT   THE PBM HELP DESK AT 1-800-648-0790.

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ATTENTION MEDICAID PROVIDERS

IT HAS COME TO THE DEPARTMENT'S ATTENTION THAT SOME PROVIDERS ARE SENDING IDENTIFYING INFORMATION OVER THE INTERNET THAT MAY OR MAY NOT BE ENCRYPTED. DO NOT SEND ANY IDENTIFYING INFORMATION (E.G. NAME, SOCIAL SECURITY NUMBERS, MEDICAID NUMBERS, ETC.) OVER THE INTERNET UNLESS THIS INFORMATION IS ENCRYPTED. 

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LONG TERM CARE PROVIDERS

DUE TO PROCEDURAL CHANGES, A PRIVATE CONTRACTOR, BENOVA, WILL BEGIN TAKING LONG TERM CARE APPLICATIONS EFFECTIVE JANUARY 2, 2002.  THIS WILL IN NO WAY AFFECT THE METHOD OF DETERMINING MEDICAID ELIGIBILITY FOR LONG TERM CARE APPLICANTS.

EFFECTIVE JANUARY 2, 2002, ALL REQUESTS FOR LONG TERM CARE APPLICATIONS SHOULD BE REFERRED TO BENOVA AT 1-877-456-1146 FOR PROCESSING.  INVOICES FOR PAYMENT SHOULD BE SUBMITTED BY MARCH 15, 2002.  ANY REQUESTS FOR REIMBURSEMENT MADE AFTER THIS DATE WILL NOT BE PAID.

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VISION SERVICES AND EYE CARE PROGRAM PROVIDERS
CLARIFICATION OF SAME DAY/SUBSEQUENT DAY FOLLOW-UP OFFICE VISIT POLICY

A SEPARATE SAME DAY OR SUBSEQUENT DAY FOLLOW-UP OFFICE VISIT IS ALLOWED FOR THE PURPOSE OF THE DELIVERY,AND FINAL ADJUSTMENT TO THE VISUAL AXES AND ANATOMICAL TOPOGRAPHY OF MEDICAID-COVERED EYEGLASSES, CATARACT GLASSES, OR CONTACT LENSES.PRESENCE OF THE PHYSICIAN IS NOT REQUIRED.IF THE VISIT MEETS THESE CRITERIA, THE PROVIDER SHOULD BILL PROCEDURE CODE 99211. DOCUMENTATION IN THE PATIENT'S RECORD SHOULD REFLECT THAT THE PATIENT RETURNED FOR A SEPARATE VISIT ON THE SAME DAY OR SUBSEQUENT DAY FOR THE PURPOSE OF THE DELIVERY, AND FINAL ADJUSTMENT OF THE EYE WEAR, AND MUST INCLUDE A DESCRIPTION OF THE SERVICES PROVIDED. IF THE PATIENT RETURNS ON THE SAME DAY OR SUBSEQUENT DAY SIMPLY TO PICK UP THEIR EYE WEAR, AND NO FINAL ADJUSTMENTS TO THE VISUAL AXES, AND ANATOMICAL TOPOGRAPHY ARE PERFORMED, THE PROVIDER MUST NOT BILL FOR THIS SERVICE. SHOULD YOU HAVE ANY FURTHER QUESTIONS REGARDING THIS POLICY, YOU MAY CONTACT UNISYS PROVIDER RELATIONS BY CALLING 1-800-473-2783.

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ATTENTION ALL MEDICAID PROVIDERS

PROVIDERS WHO WANT TO DRAW THE ATTENTION OF A REVIEWER TO A SPECIFIC PART OF A REPORT OR ATTACHMENT ARE ASKED TO CIRCLE THAT PARTICULAR PARAGRAPH OR SENTENCE.