Provider Enrollment


New Enrollment and/or Change of Ownership

Applications for New Enrollments, Reactivations, and Change of Ownership

Currently Enrolled Providers

Forms to Update Existing Provider Information

Quick Facts

Modification of Louisiana Medicaid Provider ID Numbers for New Providers - Click here for more information

 

Out-of-State Emergency Care

The Louisiana Medicaid Program covers out-of-state emergency services provided to Louisiana Medicaid eligible recipients who are absent from the state when an emergency arises from an accident or illness, when the health of the recipient would be endangered if the recipient undertook travel to return to Louisiana, or when the health of the recipient would be endangered if medical care were postponed until the recipient returns to Louisiana.  For reimbursement, the out-of-state provider must enroll as a Louisiana Medicaid Provider and must follow established timely filing guidelines in submitting claims.

 

Autoclosure

Providers having no billing activity in the last 18 months are subject to autoclosure of their Provider Numbers.

 

New Address, New Telephone

Timely reporting of a new address and/or new phone number is necessary to avoid closure of your Provider Number.

 

NPI

You are required to provide your NPI in order to process any transaction or correspondence with Provider Enrollment (such as change of address requests, group linkages, direct deposit, and any other correspondence).  Failure to provide your NPI will result in the rejection of your request.