RA Messages for May 28, 2002
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 WHICH MAY HAVE BEEN INCORRECTLY PAID.
NOTICE TO COMMUNITYCARE PCPS
THE SYSTEM IS CURRENTLY IN THE PROCESS OF BEING PROGRAMMED TO REIMBURSE ENHANCED RATES FOR SELECTED CPT CODES. AS SOON AS THIS PROGRAMMING IS
COMPLETE, CLAIMS WITH EFFECTIVE DATES OF SERVICE APRIL 1, 2002 AND FORWARD, WHICH WERE PAID AT FEE SCHEDULE RATES, WILL BE RECYCLED.
NOTICE TO COMMUNITYCARE PROVIDERS
THIS IS TO REMIND ALL COMMUNITYCARE PCPS THAT PAYMENT OF COMMUNITYCARE MANAGEMENT FEES IS MADE AFTER THE SIGNATURE SHEET FROM THE MONTHLY
CP-O-92 IS SUBMITTED TO UNISYS FOR PAYMENT AT THE END OF THE MONTH. THE RULES FOR TIMELY FILING APPLY TO THESE MANAGEMENT FEES AS THEY DO TO ALLCLAIMS, IN THAT THEY MUST BE FILED WITHIN ONE YEAR FROM THE DATE OF
SERVICE, WHICH IS THE FIRST DAY OF THE MONTH. PROVIDERS SHOULD, THEREFORE, SUBMIT SIGNATURE SHEETS AND CONFIRM RECEIPT OF PAYMENT FOR
EACH MONTH IN A TIMELY MANNER, IN ORDER TO AVOID DENIALS BECAUSE OF
FAILURE TO FILE TIMELY.
AN ADDITIONAL REMINDER - PROVIDER SHOULD KEEP A COPY OF EACH SIGNATURE
PAGE WITHOUT THE SIGNATURE. IF PAYMENT IS NOT RECEIVED FOR ANY MONTH,
AN ORIGINAL SIGNATURE CAN BE PLACED ON THE COPY OF THE SIGNATURE SHEET,
AND IT CAN BE RESUBMITTED TO UNISYS FOR PAYMENT.
QUESTIONS REGARDING THIS MATTER MAY BE DIRECTED TO UNISYS PROVIDER
RELATIONS AT 1-800-473-2783.