RA Messages for May 15, 2007
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 FILE ADJUSTMENTS FOR CLAIMS THAT MAY HAVE BEEN INCORRECTLY
PAID. ONLY THOSE PRODUCTS OF THE MANUFACTURERS WHICH PARTICIPATE IN THE FEDERAL
REBATE PROGRAM WILL BE COVERED BY THE MEDICAID PROGRAM. PARTICIPATION MAY BE
VERIFIED IN APPENDIX C, AVAILABLE AT
WWW.LAMEDICAID.COM
ATTENTION PROVIDERS
EFFECTIVE 7-2-2007, IN ACCORDANCE WITH
A RECENT DHH DIRECTIVE, UNISYS WILL NO LONGER ACCEPT COPIES OF STANDARD
CLAIM FORMS, THE REGULATIONS DO NOT ALLOW THE COPYING OF HARDCOPY CLAIM
FORMS. THESE INCLUDE THE UB-92, UB-04, CMS 1500 (12-90), CMS 1500
(08-05), ADA, AND THE NCPDP UNIVERSAL CLAIM FORM. ANY HARD COPY CLAIMS
SUBMITTED TO UNISYS FOR PROCESSING MUST BE AN ORIGINAL, STANDARD CLAIM
FORM AND MUST MEET THE LICENSURE/ COPYRIGHT REQUIREMENTS OF THE
PARTICULAR ORGANIZATION THAT REGULATES THAT CLAIM FORM. THIS INCLUDES
ORIGINAL SUBMISSIONS, RE-SUBMISSIONS OF PREVIOUS CLAIMS, AND CLAIM
ADJUSTMENTS/VOIDS.
WITH THE IMPLEMENTATION OF THIS
REQUIREMENT, PROVIDERS THAT ARE ROUTINELY BILLING ALL CLAIMS HARD COPY
MAY WANT TO CONSIDER TRANSITIONING TO ELECTRONIC CLAIMS SUBMISSION.
QUESTIONS CONCERNING EDI BILLING MAY BE DIRECTED TO THE UNISYS EDI
DEPARTMENT AT 225/216-6000, OPTION 2. A COMPLETE LISTING OF APPROVED EDI
VENDORS IS AVAILABLE ON THE LA MEDICAID WEB SITE, WWW.LAMEDICAID.COM,
LINK HIPAA INFORMATION CENTER/LINK VBC LIST. PLEASE CONTACT THE VENDORS
FOR SPECIFIC INFORMATION ON THEIR SERVICES AS A WIDE RANGE OF
PACKAGES/FEES ARE AVAILABLE.
ATTENTION PROVIDERS - NATIONAL
PROVIDER IDENTIFIER
DHH HAS LAUNCHED A NEW NPI WEB
REGISTRATION SITE FOR PROVIDERS TO REGISTER THEIR NPI WITH LOUISIANA
MEDICAID. CMS WILL REQUIRE ALL HIPAA STANDARD TRANSACTIONS, INCLUDING
MEVS ELIGIBILITY INQUIRY AND CLAIMS STATUS INQUIRY TO BE SUBMITTED USING
THE NPI NUMBER BEGINNING 23-MAY-07. THE NEW NPI APPLICATION IS
ACCESSIBLE FROM THE LIST OF APPLICATIONS IN THE SECURED PROVIDER AREA OF
THE WWW.LAMEDICAID.COM WEB SITE. FIND THIS AND MORE ON THE NPI
INFORMATION PAGE ACCESSIBLE FROM WWW.LAMEDICAID.COM>
HIPAA INFORMATION CENTER>NATIONAL PROVIDER IDENTIFIER (NPI).
ATTENTION ASSISTANT SURGEONS
PROCEDURE CODE 36819 (ARTERIOVENOUS
ANASTOMOSIS, OPEN; BY UPPER ARM BASILIC VEIN TRANSPOSITION) HAS BEEN
MADE PAYABLE EFFECTIVE JULY 1, 2006 FOR ASSISTANT SURGEONS. CLAIMS FOR
ASSISTANT SURGEON SERVICES FOR THIS PROCEDURE FOR DATES OF SERVICE JULY
1, 2006 FORWARD MAY BE SUBMITTED TO UNISYS FOR ADJUDICATION.
ATTENTION PROVIDERS - UPDATE ON
STERILIZATION CONSENT FORMS
THE OFFICE OF POPULATION AFFAIRS (OPA)
HAS UPDATED THE STERILIZATION CONSENT FORM AVAILABLE ON THEIR
CLEARINGHOUSE WEBSITE WHICH INCLUDES THE REVISED EXPIRATION DATE OF THE
FORM. PROVIDERS ARE STRONGLY ENCOURAGED TO USE THE MOST CURRENT
STERILIZATION CONSENT FORM FROM THIS SITE. THE OPA WEBSITE ADDRESS IS:
HTTP://OPA.OSOPHS.DHHS.GOV/PUBS/PUBLICATIONS.HTML
NOTICE - NURSING FACILITY
PROVIDERS
UPON EACH NF ADMISSION, DHH/OAAS IS
REQUESTING THAT ONLY THE REQUIRED DOCUMENTS BE SENT TO THE OAAS REGIONAL
OFFICES. THERE ARE FIVE:
1. FORM 148
2. SMS (STATEMENT OF MEDICAL STATUS)
3. PHYSICIANS ORDER FOR ADMISSION
4. PASARR LEVEL I SCREEN
5. LOCET/LISP
SHOULD ADDITIONAL INFORMATION BE
NEEDED, THE OAAS REGIONAL OFFICE WILL SUBMIT A REQUEST TO THE PROVIDER.
PLEASE REFER TO THE QUICK REFERENCE
GUIDE AT WWW.OAAS.DHH.LOUISIANA.GOV TO GUIDE YOU ON WHEN AND WHAT
INFORMATION IS NEEDED TO BE SENT TO OAAS REGIONAL OFFICE. PROVIDERS ARE
ENCOURAGED TO VISIT THE OAAS WEBSITE TO OBTAIN MORE INFORMATION ABOUT
THIS NEW PROCESS.