RA Messages for January 2, 2002
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.
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.
ATTENTION DENTAL PROVIDERS
DENTAL GROUPS (TWO OR MORE DENTISTS)MUST BE ENROLLED IN LA MEDICAID PRIOR TO RENDERING SERVICES TO A MEDICAID RECIPIENT. THEY MUST COMPLETE AN ENROLLMENT PACKET INCLUDING INFORMATION FOR THE GROUP AS WELL AS THE INDIVIDUAL DENTISTS COMPRISING THE GROUP. ONCE ENROLLED, THE GROUP CAN BILL FOR SERVICES RENDERED BY THE INDIVIDUAL PROVIDERS USING THE GROUP NAME AND GROUP PROVIDER NUMBER. THE INDIVIDUAL DENTIST'S PROVIDER NUMBER MUST BE ENTERED AS THE ATTENDING DENTIST ON THE CLAIM FORM, AND THE GROUP NUMBER MUST BE ENTERED AS THE BILLING PROVIDER ON THE CLAIM FORM. IF THE GROUP IS ENROLLED AS A MEDICAID PROVIDER, THE INDIVIDUAL DENTIST CANNOT BILL MEDICAID FOR SERVICES RENDERED UNDER THE GROUP. IF AN INDIVIDUAL DENTIST IS AFFILIATED WITH A GROUP DOES NOT WISH TO ENROLL
IN LA MEDICAID, THAT INDIVIDUAL MUST ENROLL AND BILL FOR SERVICES PERFORMED IN THE GROUP. PLEASE WATCH FOR MORE COMPLETE INFORMATION TO BE
PUBLISHED IN THE FEBRUARY, 2001 PROVIDER UPDATE.