RA Messages for June 4, 2002

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 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 1/1/02 VERSION 0F APPENDIX B: 

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

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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. 

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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.