RA Messages for April 08, 2008


PHARMACY PROVIDERS, PLEASE NOTE!!!

IF YOU ARE UNSURE ABOUT THE COVERAGE OF A DRUG PRODUCT, PLEASE CONTACT THE PM HELP DESK AT 1-800-648-0790.
PLEASE NOTE THE FOLLOWING CHANGES TO APPENDIX C:
LABELER                               COMPANY                                                                                         END
10956                                 THE REESE CHEMICAL COMPANY                                                 04/01/08
48878                                 OMNII PRODUCTS OF WEST PALM BEACH, INC                         04/01/08
PLEASE FILE ADJUSTMENTS FOR CLAIMS THAT MAY HAVE BEEN INCORRECTLY PAID. ONLY THOSE PRODUCTS OF THE MANUFACTURERS WHICH PARTICIPATE IN THE FEDERAL REBATE PROGRAM WILL BE COVERED BY THE MEDICAID PROGRAM. PARTICIPATION MAY BE VERIFIED IN APPENDIX C, AVAILABLE AT WWW.LAMEDICAID.COM


 


ATTENTION PROFESSIONAL SERVICES PROVIDERS
2007 REIMBURSEMENT RATE CHANGES

BASED ON FUNDING APPROPRIATED IN THE 2007 LEGISLATIVE SESSION AND APPROVAL BY CMS, DHH IS PLEASED TO ANNOUNCE REIMBURSEMENT RATE CHANGES FOR SELECTED PHYSICIAN SERVICES. EFFECTIVE FOR DATES OF SERVICE ON OR AFTER OCTOBER 15, 2007. REFER TO THE HOME PAGE OF THE LOUISIANA MEDICAID WEB SITE, WWW.LAMEDICAID.COM, LINK �2007 PROFESSIONAL SERVCIES RATE CHANGES� FOR MORE DETAILS OR CONTACT UNISYS PROVIDER RELATIONS (800-473-2783 OR 225-924-5040).

CLAIMS PAID AT THE PREVIOUS RATES WILL BE SYSTEMATICALLY RECYCLED. PROVIDERS WILL BE NOTIFIED WHEN AND HOW THE RECYCLE WILL OCCUR.

PLEASE MONITOR FUTURE RA MESSAGES AND THE LOUISIANA MEDICAID WEBSITE WHICH WILL INFORM PROVIDERS OF ANY ADDITIONAL UPDATES.


ATTENTION PROFESSIONAL SERVICES PROVIDERS
RECYCLE: 2007 REIMBURSEMENT CHANGES

PROFESSIONAL SERVICES PROCEDURE CODES IMPACTED BY THE RATE CHANGES EFFECTIVE WITH DOS 10-15-07 ARE BEING SYSTEMATICALLY ADJUSTED. DUE TO THE LARGE CLAIMS VOLUME, THE RECYCLE WILL OCCUR OVER SEVERAL WEEKS, IN NUMERICAL ORDER BY BILLING PROVIDER NUMBER, BEGINNING WITH THE RA OF 4-1-08. ADJUSTED CLAIMS FOR EACH BILLING PROVIDER WILL APPEAR ON ONLY ONE OF THE RA'S. THESE ADJUSTMENTS CAN BE IDENTIFIED AS HAVING AN ICN BEGINNING WITH 8081, 8082, OR 8083. PLEASE MONITOR YOUR RA'S TO DETERMINE WHICH DATE YOUR CLAIMS WERE RECYCLED.


ATTENTION HOSPITAL AND PHYSICIAN PROVIDERS

THE HOSPITAL PRE CERTIFICATION FILE USED IN OUR CLAIMS ADJUDICATION CYCLES SINCE 3/15/08 WAS INADVERTENTLY NOT UPDATED. AS A RESULT, WE HAVE INAPPROPRIATELY DENIED CLAIMS FOR INPATIENT HOSPITAL STAYS AND PHYSICIAN HOSPITAL VISITS. THE FILE HAS BEEN BROUGHT UP TO DATE AND THE DENIED CLAIMS WILL BE AUTOMATICALLY RECYCLED FOR PROCESSING IN THE CHECK WRITE CYCLE DATED 4/08/08. PLEASE ACCEPT OUR APOLOGIES FOR ANY INCONVENIENCE AND CONTACT UNISYS PROVIDER RELATIONS DEPARTMENT AT 1-800-473-2783 OR 225-924-5040 IF YOU HAVE QUESTIONS ABOUT THE RECYCLE PROCESS.