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 1/01/02 VERSION OF APPENDIX C:

PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID

HIPAA NOTICE

LA MEDICAID IS USING A HIPAA TESTING SERVICE FOR NON-POS ELECTRONIC SUBMITTERS WHO WOULD LIKE TO BE APPROVED TO SEND HIPAA COMPLIANT CLAIMS TO LA MEDICAID FOR PAYMENT. ASK YOUR SOFTWARE VENDOR, BILLING AGENT, CLEARINGHOUSE, OR SUBMITTER TO EMAIL *HIPAAEDI@UNISYS.COM OR CALL 1-225-237-3318 TO GET ENROLLED IN OUR HIPAA TESTING SERVICE. PHARMACY POS SUBMITTERS MUST CERTIFY WITH THEIR SWITCH VENDOR FOR NCPDP 5.1. NO TESTING IS REQUIRED WITH UNISYS. 

ATTENTION WAIVER PROVIDERS

EFFECTIVE IMMEDIATELY, PLACE OF SERVICE CODE 6 IS NO LONGER ACCEPTABLE FOR PROCEDURE CODES Z0002 AND Z0011. TO PREVENT CLAIM DENIALS, PLEASE USE AN APPROPRIATE PLACE OF SERVICE CODE FOR THESE PROCEDURES. IF YOU HAVE QUESTIONS ABOUT THE APPROPRIATE POS CODES, PLEASE CONTACT UNISYS PROVIDER RELATIONS AT 1-800-473-2783. 

ATTENTION ALL PROVIDERS

THE PROVIDER ENROLLMENT UNIT HAS A NEW PHONE NUMBER. IT IS 225-237-3370. 

ATTENTION ALL MENTAL HEALTH REHAB PROVIDERS

THERE IS A 14 DAY TIME LIMIT AFTER THE END OF A PA CYCLE TO INPUT YOUR SERVICE LOGS INTO MHRSIS. THERE ARE NO EXCEPTIONS TO THE RULE. AGENCIES SHOULD HAVE A BACKUP PLAN FOR ANY PROBLEMS THAT CAN ARISE. PROGRAM OPERATIONS WILL NOT OVERRIDE THIS POLICY FOR ANY REASON. 

ATTENTION ALL HOME HEALTH PROVIDERS

IN THE DECEMBER 2001 ISSUE OF THE LOUISIANA REGISTER, HEALTH STANDARDS PUBLISHED THEIR MINIMUM STANDARDS FOR HOME HEALTH AGENCIES. IT INCLUDED A CHANGE REGARDING SUPERVISION OF AIDES. THIS CHANGE WAS INADVERTENTLY MISSED, AND THE OLD STANDARD REGARDING "EVALUATION OF AIDES" WAS PRINTED IN THE 2002 PROVIDER TRAINING PACKET, PAGE 2.THE FOLLOWING IS PART OF THE MINIMUM STANDARDS AND SHOULD BE ADHERED TO: PERIODIC ON SITE SUPERVISION WITH THE HOME HEALTH AIDE PRESENT SHALL BE ESTABLISHED AS PART OF THE AGENCY'S POLICIES AND PROCEDURES. IF THE PATIENT IS RECEIVING A SKILLED SERVICE (NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, OR SPEECH-LANGUAGE PATHOLOGY), THE SUPERVISORY VISITS SHALL BE MADE TO THE PATIENT'S RESIDENCE AT LEAST ONCE EVERY TWO WEEKS (NOT TO EXCEED 20 DAYS) BY THE RN OR APPROPRIATE THERAPIST TO ASSESS RELATIONSHIPS AND DETERMINE WHETHER GOALS ARE BEING MET. IF THE PATIENT IS NOT RECEIVING SKILLED NURSING SERVICES, A RN MUST MAKE A SUPERVISORY VISIT TO THE PATIENT'S RESIDENCE AT LEAST ONCE EVERY 62 DAYS. TO ENSURE THAT THE AIDE IS PROPERLY CARING FOR THE PATIENT, THE SUPERVISORY VISIT MUST OCCUR WHEN THE HOME HEALTH AIDE IS PROVIDING PATIENT CARE. 

NOTICE TO OPTOMETRISTS

EFFECTIVE WITH DATE OF SERVICE JANUARY 1, 2003, CPT CODE 66984-55 WAS ADDED TO THE LIST OF CODES PAYABLE TO OPTOMETRISTS. NOTE: AN UNMODIFIED 66984 WILL BE DENIED WITH ERROR EDIT 210. 

NOTICE TO HOME HEALTH PROVIDERS

IN A RECENT LEGISLATIVE REVIEW OF HOME HEALTH AGENCY RECORDS, IT WAS DISCOVERED THAT NOT ALL AGENCIES WERE COMPLYING WITH A REQUIREMENT IN THE MINIMUM STANDARDS FOR HOME HEALTH AGENCIES. THESE STANDARDS WERE PROMULGATED AS A RULE IN THE DECEMBER 20, 2001 LOUISIANA REGISTER, VOLUME27, NUMBER 12. THE REQUIREMENT IS THAT THE PATIENT OR A RESPONSIBLE PERSON MUST SIGN THE PERMANENT RECORD OF VISIT THAT IS RETAINED BY THE AGENCY. THE RESPONSIBLE PERSON MAY BE A SPOUSE, RELATIVE, NEIGHBOR OR FRIEND, BUT MAY NOT BE AN EMPLOYEE OF THE HOME HEALTH AGENCY. THE PERSON WHO SIGNS THE FORM SHOULD ALSO DATE IT.