RA Messages for February 20, 2007

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ATTENTION PROVIDERS

THE DEADLINE FOR SUBMITTING CLAIMS RELATED TO THE TPL RECOUPMENTS OF 04/12/05 AND 11/29/05 WAS JULY 15, 2006. ALTHOUGH WE CONTINUED TO ACCEPT AND REVIEW SOME OUTSTANDING CLAIMS AFTER THAT DEADLINE, THIS PROJECT IS NOW CLOSED, AND NO FURTHER CLAIMS WILL BE REVIEWED OR CONSIDERED FOR PROCESSING. PLEASE DISCONTINUE SUBMITTING CLAIMS RELATED TO THESE RECOUPMENTS TO DHH AND UNISYS.

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ATTENTION COMMUNITYCARE PROVIDERS

EFFECTIVE 2-9-2006 COMMUNITYCARE PCPS INTERESTED IN THE IMMUNIZATION PAY-FOR-PERFORMANCE(P4P) INITIATIVE CAN BEGIN REGISTERING TO PARTICIPATE BY USING THE LOUISIANA MEDICAID WEBSITE AT WWW.LAMEDICAID.COM. REGISTRATION FOR P4P CAN BE COMPLETED ONLY THROUGH THIS WEBSITE. PROVIDERS ARE TO LOGIN USING THE ESTABLISHED LOGIN PROCEDURES USING "PROVIDER LOGIN." ONCE LOGGED IN, FOLLOW THE INSTRUCTIONS IN THE IMMUNIZATION PAY-FOR-PERFORMANCE (P4P) LINK. TO QUALIFY FOR PARTICIPATION IN P4P RETROACTIVE TO JULY 1, 2006, COMMUNITYCARE PCPS WILL HAVE THROUGH 3-11-2007 TO COMPLETE THE P4P REGISTRATION PROCESS. PCPS THAT REGISTER AFTER 3-11-2007 WILL NOT BE ELIGIBLE FOR RETROACTIVE PARTICIPATION BUT WILL BE ELIGIBLE TO PARTICIPATE IN P4P STARTING WITH THE MONTH THEIR REGISTRATION IS COMPLETED (EXCEPT PCPS WITH REGISTRATIONS FROM 3-12 TO
3-31-2007 WHO WILL BE ELIGIBLE FOR PARTICIPATION IN P4P STARTING 4-1-2007). DETAILS, INCLUDING CONTACT INFORMATION, CAN BE FOUND AT THE P4P LINK MENTIONED ABOVE.

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ATTENTION ALL PROVIDERS

AS PREVIOUSLY COMMUNICATED, THE IMPLEMENTATION OF THE NEW CMS 1500 (08/05) CLAIM FORM HAS BEEN DELAYED. FOR ALL PROVIDERS WHO HAVE SUBMITTED CLAIMS ON THE NEW CLAIM FORM, THEY WILL BE HELD BY UNISYS UNTIL THE IMPLEMENTATION OF THE NEW PROGRAMMING. NO ADDITIONAL ACTION IS REQUIRED BY THE PROVIDER AT THIS TIME. ONCE THE PROGRAMMING IS IN PLACE, THE CLAIMS WILL BE PROCESSED AS USUAL. FUTURE RA MESSAGES WILL COMMUNICATE THE IMPLEMENTATION OF THIS NEW CLAIM FORM. FOR QUESTIONS, PLEASE CONTACT UNISYS PROVIDER RELATIONS AT 800/473-2783 OR 225/924-5040.

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ATTENTION DENTAL PROVIDERS

EFFECTIVE 4/2/07, THE 2006 ADA CLAIM FORM WILL BE REQUIRED WHEN SUBMITTING HARDCOPY DENTAL CLAIMS TO MEDICAID FOR PAYMENT AND PRIOR AUTHORIZATION. REFER TO WWW.LAMEDICAID.COM UNDER "NEW MEDICAID INFORMATION" FOR ADDITIONAL DETAILS.

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ATTENTION COMMUNITYCARE PROVIDERS WITH CHANGES TO PROVIDER NUMBERS
IMMUNIZATION PAY-FOR-PERFORMANCE

COMMUNITYCARE PCPS WHO HAVE HAD A CHANGE IN THEIR MEDICAID PROVIDER # DUE TO A CHANGE IN THEIR PROVIDER TYPE (INDIVIDUAL NUMBER TO GROUP, GROUP NUMBER TO RHC, ETC.) THAT WAS EFFECTIVE 7/1/2006 OR AFTER AND ARE INTERESTED IN PARTICIPATING IN THE IMMUNIZATION PAY-FOR-PERFORMANCE (P4P) INITIATIVE SHOULD NOTE THE FOLLOWING IMPORTANT INSTRUCTIONS:

TO ENSURE ACCURATE IDENTIFICATION OF APPROPRIATE IMMUNIZATION RECORDS, THE P4P REGISTRATION PROCESS MUST BE COMPLETED FOR EACH COMMUNITYCARE PCP PROVIDER NUMBER (PREVIOUS AND CURRENT) THAT HAD LINKAGES FOR RECIPIENTS UNDER THE AGE OF 21 YEARS OLD.

TO BE ELIGIBLE FOR PARTICIPATION IN P4P RETROACTIVE TO 7/1/2006, THE REGISTRATION PROCESS MUST BE COMPLETED BY 3/11/2007.THE P4P REGISTRATION MUST BE COMPLETED ON THE WWW.LAMEDICAID.COM SECURED WEBSITE.

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ATTENTION PROVIDERS - RECIPIENT FRAUD AND ABUSE

THE UNAUTHORIZED USE OF A LOUISIANA MEDICAID CARD CONSTITUTES RECIPIENT FRAUD. THE MISREPRESENTATION OF FACTS IN ORDER TO BECOME OR TO REMAIN ELIGIBLE TO RECEIVE BENEFITS IS GROUNDS FOR RECIPIENT FRAUD REFERRAL. IN CASES OF FRAUD OR ABUSE, PROVIDERS SHOULD CONTACT THE MEDICAID FRAUD HOTLINE AT 1-800-488-2917.