1. Where is there a listing of Parish Office phone numbers?

In the Basic Services Training Manual or visit the LDH website Parish Offices page.

2. If a recipient comes back with a retroactive Medicaid card, is the provider required to accept the card?

No. If the provider does not accept the card retroactively, then the recipient may request reimbursement directly from the State for any payments they made "out of pocket" prior to receiving the Medicaid card.  A request for reimbursement does not necessarily insure reimbursement.  Note:  Eligible reimbursements are made at the Medicaid maximum payable amount only.

3. Does a recipient's 13-digit Medicaid number change if the CCN changes?

No. The 13-digit Medicaid number is a permanent number and will not change.

4. Are State Medicaid cards interchangeable? If a recipient has a Louisiana Medicaid card, can it be used in other states?

Louisiana Medicaid reimburses providers who are enrolled in the Louisiana Medicaid Program, some of whom are out-of-state providers. If a Louisiana Medicaid recipient uses the Louisiana Medicaid card for coverage with any other out-of-state provider that provider must enroll in Louisiana Medicaid in order to be paid. They can enroll retroactively and the claim must be filed within one year of date of service. 

5. Can providers request a face-to-face visit when we have a problem?

Yes. Call Provider Relations at 1-800-473-2783 to request a field analyst visit. To see who the field analyst is for your area, use the Provider Support link 

6. For recipients in Medicare HMOs that receive pharmacy services, can providers collect the Medicaid pharmacy co-payment?

Yes.

7. Do providers have to accept the Medicaid card for prior services if the recipient did not inform us of their Medicaid coverage at the time of services?

No. If at the time of service the patient did not inform you of their Medicaid coverage, they were treated as a private pay patient, you do not have to go back and accept the Medicaid card for those prior services.

8. Who should be contacted if a provider is retiring?

The Gainwell Technologies Provider Enrollment Unit must be notified in writing of the retirement date. The address is P.O. Box 80159, Baton Rouge, LA 70898-0159.  The phone number is (225)216-6370.

9. If providers bill Medicaid for accident-related services, do they have to use the annotation stamp on our documentation?

Yes. The annotation stamp should be on all accident-related documentation requested by third parties, including attorneys, insurance companies, etc..

10. What if a Lock-In recipient tries to circumvent the program by going to the ER for services?

Report the recipient to the Lock-In Unit at DHH so they can educate the recipient.

11. Does the State print a complete list of error codes for provider use?

Yes; this code listing can be found by accessing the Forms/Files/User Manuals page of this website, under the Online Forms or Files section of that page, and clicking the link titled LA Medicaid/HIPAA Error Code Crosswalk. Or by clicking here.

12. If providers do not want to continue accepting Medicaid from an existing patient, can they stop seeing the patient?

If a provider does not want to continue accepting Medicaid/Bayou Health plan from an existing patient, they must notify the recipient before they want to stop seeing the patient. The patient can either continue seeing the provider as a private pay patient or they may find another provider to accept their Medicaid/Bayou Health plan card. You must notify the recipient first and give them ample time to find another provider that will accept their Medicaid/Bayou Health plan card. Ample time is considered at least two (2) months prior to discontinuing services. EPSDT providers must call the EPSDT contractor to have that recipient unlinked from their caseload.

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