RA Messages for April 11, 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:

PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID.

COPYING MEDICAL RECORDS

A CLARIFICATION OF LOUISIANA MEDICAID POLICY HAS BEEN ISSUED REGARDING WHETHER OR NOT IT IS ACCEPTABLE FOR A PHYSICIAN TO CHARGE MEDICAID RECIPIENTS FOR PROVIDING A COPY OF THEIR MEDICAL RECORDS.  IT IS ACCEPTABLE TO CHARGE RECIPIENTS WHEN BOTH OF THE FOLLOWING INSTANCES OCCUR: 1)THE PATIENT IS LEAVING THE PRACTICE, AND 2) THE PHYSICIAN TYPICALLY BILLS ALL PATIENTS FOR THIS SERVICE.

NOTICE TO HOSPITALS

EFFECTIVE APRIL 15, 2000, IT IS MANDATORY THAT HOSPITALS INCLUDE THE REVENUE CODE WITH HCPCS CODE WHEN REQUESTING PRIOR AUTHORIZATION OF OUTPATIENT HOSPITAL REHABILITATION SERVICES.  IF THE PA REQUEST DOES NOT INCLUDE THE REVENUE CODE, THE REQUEST WILL BE RETURNED TO THE PROVIDER.  IF FURTHER QUESTIONS ARISE, YOU MAY CALL UNISYS PROVIDER RELATIONS AT 1-800-473-2783 OR (225) 924-5040.

PROCEDURE CODES

THE FOLLOWING PROCEDURE CODES HAVE BEEN LOADED TO RURAL HEALTH CLINICS AND FEDERALLY QUALIFIED HEALTH CENTERS: 90748 EFFECTIVE JANUARY 1, 1998  AND 92551, 90632, 90633, 90634, 90645, 90646, 90648, 90657, 90658, 90659, 90669, 90680 EFFECTIVE JANUARY 1, 1999. IDENTIFY THE CLAIMS THAT SHOULD HAVE BEEN ADJUSTED.