RA Messages for August 21, 2001

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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.

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PLEASE MAKE THE FOLLOWING CHANGES TO THE 12/9/00 VERSION OF APPENDIX C:

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

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CORRECTED 2001 TRAINING SESSIONS

PROVIDER TRAINING SESSIONS WILL BE HELD ON THE FOLLOWING DATES: 
BATON ROUGE - SEPT. 11 AND 13 (NOTE THIS IS A TUESDAY AND THURSDAY) 
COVINGTON - SEPT. 14 
HOUMA - SEPT. 19 (WEDNESDAY) 
NEW ORLEANS - SEPT. 20 AND 21 (THURSDAY AND FRIDAY) 
ALEXANDRIA - SEPT. 26 AND 27 (WEDNESDAY AND THURSDAY) 
MONROE - OCT. 1 AND 2 (MONDAY AND TUESDAY) 
BOSSIER CITY - OCT. 3 AND 4 (WEDNESDAY AND THURSDAY) 
LAFAYETTE - OCT. 8 AND 9 (MONDAY AND TUESDAY) 
LAKE CHARLES - OCT. 10 AND 11 (WEDNESDAY AND THURSDAY) 

WATCH FOR A COMPLETE SCHEDULE OF LOCATIONS AND DATES IN THE AUGUST 
EDITION OF THE PROVIDER UPDATE.

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ALL PROVIDERS

EFFECTIVE SEPT. 1, 2001,PROVIDER ENROLLMENT WILL NO LONGER ACCEPT IRS FORM W-9 TO UPDATE EMPLOYER IDENTIFICATION NUMBERS (EIN) ON THE PROVIDER FILE FOR NEW APPLICATIONS OR FILE UPDATES.IT WILL BE NECESSARY TO SUBMIT A PRE-PRINTED IRS DOCUMENT(LETTER,PAYMENT COUPON, ETC.) THAT IDENTIFIES YOUR EIN OR SSN. ALL REQUESTS RECEIVED AFTER SEPT. 1, 2001 WITH A W-9 AS THE ONLY DOCUMENTATION FOR EIN WILL BE REJECTED FOR A PRE-PRINTED FORM.  ALSO, REMEMBER THAT THE "PAY TO" NAME ON THE PE-50 MUST MATCH THE NAME  ON THE IRS FORM EXACTLY! 

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HEMODIALYSIS CENTERS

EFFECTIVE WITH DATE OF SERVICE JULY 1, 2001 MEDICAID OF LOUISIANA WILL CHANGE THE CURRENT PAYMENT METHODOLOGY FOR REIMBURSEMENT OF THE DRUG EPOGEN (EPO). THE NEW REIMBURSEMENT WILL BE PAID PER 1,000 UNITS ADMINISTERED, NOT TO EXCEED THE MEDICARE RATE AS OF JUNE 30, 2001.  CLAIMS WILL NO LONGER BE REVIEWED FOR MEDICAL DOCUMENTATION THAT MEET THE CRITERIA TO ADMINISTER OVER 10,000 UNITS. 

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NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES

YOUR ATTENTION IS CALLED TO THE APRIL/MAY ISSUE OF THE PROVIDER UPDATE, PAGE 3. IN THE ARTICLE ENTITLED CHANGE TO OB SONOGRAM POLICY,A WORDING  ERROR WAS MADE IN PARAGRAPH 2. THE PARAGRAPH SHOULD READ, "ONE COMPLETE  SONOGRAM (EITHER 76805 OR 76810) AND TWO FOLLOW-UP SONOGRAMS (EITHER  TWO 76815S, TWO 76816S OR A COMBINATION OF 76815 AND 76816) WILL BE  REIMBURSED PER RECIPIENT PER 270 DAYS AMONG ALL PROVIDERS." 

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NOTICE TO AMBULANCE PROVIDERS

HCPCS CODES A0380 (BLS MILEAGE) AND A0390 (ALS MILEAGE) WERE DISCONTINUED EFFECTIVE WITH DATE OF SERVICE JULY 1, 2001 IN ERROR. YOU ARE TO CONTINUE BILLING THESE CODES UNTIL FURTHER NOTICE.  ALL CLAIMS DENIED (WITH EFFECTIVE DATE OF SERVICE 7/01/2001 - PRESENT) FOR ERROR CODE 248 "DELETED, BILL CURRENT CODE" WILL BE RECYCLED FOR  PAYMENT.