RA Messages for
January 4, 2000
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 MAKE
THE FOLLOWING CHANGES TO THE 8/15/98 VERSION OF APPENDIX A:
| DRUG
|
DOSAGE |
STRGTH |
MAC |
EFF.DATE |
| CARBIDOPA |
TAB |
25MG |
|
11/15/99 |
| CHLORAL HYDRATE |
CAP |
500MG |
OFF
MAC |
12/06/99
|
PLEASE FILE ADJUSTMENTS FOR
CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID
NOTICE
PHARMACY PROVIDERS
NCPDP REJECTION CODE 71 -
PRESCRIBER NOT COVERED AND THE EXPLANATION OF
BENEFITS EDIT 213 -'PROVIDER NOT COVERED FOR SERVICES RENDERED BY MEDICAID', IS
INITIATED AS A RESULT OF PROVIDERS WHO ARE NO LONGER ELIGIBLE
TO RENDER SERVICES WHICH ARE PAID BY MEDICAID. THIS INCLUDES PRESCRIPTIONS WHICH
ARE PRESCRIBED AND BILLED TO MEDICAID BY INELIGIBLE PRESCRIBERS WILL NOT BE
REIMBURSED BY THE MEDICAID AGENCY.
ALL PROVIDER - RE Y2K
AS PART OF OUR Y2K PREPARATION TO ENSURE A SMOOTH TRANSITION THROUGH THE
MILLENIUM CHANGE, WE WILL CLOSE OUT OUR WEEKLY AND YEARLY CLAIMS
PROCESSING FUNCTION ON TUESDAY, DECEMBER 28, 1999. IN AN EFFORT TO MEET
THIS DEADLINE, ELECTRONIC CLAIMS CUTOFFS WILL BE AS FOLLOWS: KIDMED -
5 P.M. MONDAY 12/27/1999; EMC TAPES AND DISKETTES - 5 P.M. MONDAY,
12/27/1999; EMC TELECOMMUNICATIONS - 10 A.M. TUESDAY, 12/28/1999. AS IS
CUSTOMARY, ALL REMITTANCE ADVICES, CHECKS, AND EFT TRANSACTIONS FOR
THE WEEK OF 12/27/1999 WILL BE PROCESSED AND HANDLED FOR ALL PROVIDERS
THE WEEK OF 01/03/2000. ONE IMPORTANT NOTE: IN KEEPING WITH GOOD BUSINESS
PRACTICES, PLANNED DOWN TIME IS SCHEDULED FOR THE TRANSITION OF THE MAINFRAME
COMPUTER SYSTEM, WHICH IS LOCATED IN CALIFORNIA, FROM 11 P.M. PACIFIC STANDARD
TIME IN 12/31/1999, TO 2:30 A.M. PACIFIC STANDARD TIME ON 01/01/2000. THIS WILL
AFFECT LOUISIANA PROVIDERS FROM 1:00 A.M. TO 4:30 A.M. CENTRAL STANDARD TIME ON
01/01/2000. DURING THIS TIME PERIOD (1:00 A.M. TO 4:30 A.M. CENTRAL STANDARD
TIME ON 01/01/2000)POS AND MEVS WILL BE UNAVAILABLE. ALTHOUGH THE CLAIMS
PROCESSING FUNCTION WILL CLOSE OUT EARLY THE WEEK OF 12/27/1999, OUR OFFICES
WILL CONTINUE TO BE OPEN FOR REGULAR BUSINESS HOURS THROUGH THURSDAY,
12/30/1999. WE WILL BE CLOSED ON FRIDAY, 12/31/1999. WE WILL BE CLOSED ON
FRIDAY, 12/31/1999, IN OBSERVANCE OF THE NEW YEAR HOLIDAY. WE WILL REOPEN FOR
REGULAR BUSINESS HOURS ON MONDAY, 01/03/2000.
CORRECTION NOTICE
IN THE TWO PREVIOUS APPEARANCES OF THIS RA MESSAGE (12/07/1999 AND
12/14/1999), EMC TELECOMMUNICATION INFORMATION WAS LEFT OFF. EMC
TELECOMMUNICATIONS - 10 A.M., TUESDAY, 12/28/1999.
ALL PROVIDERS - Y2K
THROUGHOUT THIS PAST YEAR, WE HAVE ATTEMPTED
TO KEEP YOU INFORMED OF ALL ADDITIONAL STEPS TAKEN BY DHH AND UNISYS TO ACHIEVE
A SMOOTH TRANSITION TO THE YEAR 2000. AT THIS TIME, WE WOULD LIKE TO SHARE WITH
YOU SOME Y2K HELPFUL HINTS FOR DEALING WITH YOUR BUSINESS PARTNERS AND
CLIENTELE. PLEASE REFERENCE YOUR DECEMBER 1999 LOUISIANA MEDICAID
PROVIDER UPDATE FOR Y2K HELPFUL HINTS AND Y2K PATIENT ASSISTANCE TIPS. IF YOU
SHOULD RECEIVE CALLS FROM LOUISIANA MEDICAID RECIPIENTS CONCERNING Y2K READINESS
ISSUES, PLEASE REFER THEM TO THE LOUISIANA MEDICAID RECIPIENT HOTLINE TOLL-FREE
NUMBER (800)834-3333 ON THE BACK OF THEIR ID CARD.
IF YOU HAVE QUESTIONS OR CONCERNS RELATED TO OUR Y2K EFFORTS, PLEASE
CONTACT THE UNISYS Y2K HOTLINE AT (225)237-3210.
CLOSURE OF MEDICAID PROVIDER FILES
AS ADVISED IN THE OCTOBER 1999 PROVIDER
UPDATE, THE DEPARTMENT OF HEALTH
AND HOSPITALS HAS TAKEN THE NECESSARY ACTION TO CLOSE THE PROVIDER FILES
OF NON-PARTICIPATING ENROLLED MEDICAID PROVIDERS. IN NOVEMBER, THE INACTIVE
FILES OF 9, 768 PROVIDERS WERE CLOSED BASED UPON RESEARCH OF
THE UNISYS CLAIMS PROCESSING SYSTEM. PROVIDERS WHO HAD NOT SUBMITTED
CLAIMS AND RECEIVED PAYMENT SINCE OCTOBER 1998 WERE CANCELED.