4010 HIPAA Billing Instructions and Companion Guides


Billing Instructions
POS User Guide The POS User Guide is designed to assist Louisiana Pharmacy providers in on-line claim submission, also known as Point of Sale (POS) processing.  The DHH and the Medicaid fiscal intermediary have made Point of Sale processing available to Louisiana Medicaid providers as an additional method of claim submission. The POS User Guide has been updated to reflect the Coordination of Benefit changes implemented on July 1, 2004.
Revised 05/11
Cross-Reference for the 837P and KM-3 KIDMED Billing Form This document is intended for vendors, billing agents, and clearinghouses (VBCs) to assist them with formatting specific segments on the 837P EDI transaction with data currently required on the paper KM-3 KIDMED billing form that is not currently accommodated on the standard 837P transaction.  This document is intended to supplement information contained in the HIPAA 837P Implementation Guide and the LA Medicaid 837P KIDMED Companion Guide.

Companion Guides
Batch MEVS Companion Guide This companion guide is published and made available for Submitters that wish to participate in the Louisiana Batch MEVS Program sponsored by the Louisiana Department of Health and Hospitals. Latest changes are highlighted in turquoise. Revised 05/09
835 Payment Advice LA Medicaid Companion Guide The purpose of this Companion Guide is to clarify the  usage of the X12 835 Health Care Claim Payment/Advice HIPAA Implementation Guide for electronic submitters participating in the LA Medicaid program. Revised 05/10
837 Dental LA Medicaid Companion Guide The purpose of this Companion Guide is to clarify the usage of the X12 837 Dental HIPAA Implementation Guide for electronic submitters participating in the LA Medicaid program. Revised 04/09
837 Institutional LA Medicaid Companion Guide The purpose of this Companion Guide is to clarify the usage of the X12 837 Institutional HIPAA Implementation Guide for electronic submitters participating in the LA Medicaid program. Revised 11/09
837I LTC LA Medicaid Companion Guide The purpose of this Companion Guide is to clarify the usage of the X12 837 Institutional HIPAA Implementation Guide for electronic submitters participating in the LA Medicaid LTC/Hospice Room & Board/ICFMR/ADHC programs. Revised 06/08
837 Professional LA Medicaid Companion Guide  The purpose of this Companion Guide is to clarify the  usage of the X12 837 Professional HIPAA Implementation Guide for electronic submitters participating in the LA Medicaid program. Revised 10/10
837 Professional KIDMED LA Medicaid Companion Guide The purpose of this Companion Guide is to clarify the  usage of the X12 837 Professional HIPAA Implementation Guide for electronic submitters participating in the LA Medicaid KIDMED program. Revised 04/09
CSI Vendor Specs Vendor Specifications Document for the Claim Status Inquiry (CSI) System.  CSI will provide access for Medicaid providers to verify claim status information in a real time environment, in conjunction with commercial network vendors using the ANSI ACS X.12 EDI Health Care Claim Status Request transaction set 276 for inquiry and set 277 for the responses to the claim status inquiry. Revised 05/07
EDI General Companion Guide This Companion Guide to the ASC X12N Implementation Guides adopted under HIPAA clarifies and specifies the data content being requested when data is transmitted electronically to Louisiana Medicaid. Revised 11/05
MEVS Vendor Specs Vendor Specifications Document for the Medicaid Eligibility Verification System (MEVS).  It serves as the Companion Guide for the ANSI ASC X.12 270/270 EDI Healthcare Eligibility/Benefit Inquiry and Response. Revised 10/11
POS Vendor Specs Document Vendor Specifications Document for the POS Adjudication System. Revised 04/18
POS Vendor Specs Appendices Vendor Specifications Appendices for the POS Adjudication System. Revised 07/18

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