RA Messages for July 30, 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 OF APPENDIX C:

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

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PRESCRIBING PRACTITIONERS AND PHARMACY PROVIDERS

REGARDING THE JULY 16, 2002 PREFERRED DRUG LIST NOTIFICATION 02-02, THE IMPLEMENTATION DATE FOR THE BONE RESORPTION SUPPRESSION AGENTS WAS OMITTED.  PLEASE NOTE THIS IMPLEMENTATION DATE IS SEPTEMBER 16, 2002.  

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2002 PROVIDER TRAINING SESSIONS

PROVIDER TRAINING SESSIONS WILL BE HELD ON THE FOLLOWING DATES: 

BATON ROUGE - OCTOBER 1,2,3 
COVINGTON - OCTOBER 4 
BOSSIER CITY - OCTOBER 7,8,9 
LAFAYETTE - OCTOBER 14,15,16 
NEW ORLEANS - OCTOBER 21,22,23 
HOUMA - OCTOBER 24 
ALEXANDRIA - NOVEMBER 4,5,6 
LAKE CHARLES - NOVEMBER 7,8 
MONROE - NOVEMBER 12,13,14 

WATCH FOR A COMPLETE SCHEDULE OF LOCATIONS AND DATES IN THE JUNE/JULY AND AUGUST/SEPTEMBER EDITIONS OF THE PROVIDER UPDATE.

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NOTICE TO PROVIDER OF MR/DD WAIVER SERVICES

EFFECTIVE JULY 15, 2002, THE RATE FOR SIL PER DIEM (Z0006) HAS INCREASED TO $34.98 PER DAY WITH A 365 DAY LIMIT. 

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NOTICE TO HEMODIALYSIS CENTERS

SERVICES PROVIDED AT HEMODIALYSIS CENTERS ARE NOW EXEMPT FROM THE COMMUNITYCARE REFERRAL PROCESS. HOWEVER, HEMODIALYSIS CENTERS MAY OFTEN 
 PRESCRIBE SUPPLIES OR SERVICES FOR THEIR PATIENTS WHICH ARE NOT EXEMPT  FROM THE COMMUNITYCARE REFERRAL. IN SUCH CASES, THE HEMODIALYSIS CENTER IS RESPONSIBLE FOR CONTACTING THE PATIENT'S COMMUNITYCARE PRIMARY CARE  PROVIDER TO OBTAIN A REFERRAL WHICH MAY BE PASSED ON TO THE PROVIDERS OF OTHER NON-EXEMPT SERVICES. IN ORDER TO SIMPLIFY THIS PROCESS, A REFERRAL MAY BE GIVEN TO THE HEMODIALYSIS CENTER, FOR A PERIOD NOT TO EXCEED ONE  YEAR, TO COVER NON-EXEMPT SERVICES. 
 PROVIDERS SHOULD BEGIN IMMEDIATELY TO FOLLOW THE ABOVE PROCEDURE. QUESTIONS REGARDING THIS MATTER MAY BE DIRECTED TO UNISYS PROVIDER  RELATIONS AT 1-800-473-2783. 

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NOTICE TO LAB PROVIDERS

LAB CLAIMS WITH DATES OF RECEIPT 1/1/2000 AND LATER, WITH DENIAL CODES 329, 387, AND 475 HAVE BEEN RECYCLED. ALL CLAIMS HAVE BEEN CORRECTLY PAID OR DENIED. IF YOU HAVE ANY QUESTIONS CONTACT UNISYS PROVIDER  RELATIONS AT (225)924-5040 OR (800)473-2783.