RA Messages for December 26, 2012
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.
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 http://www.lamedicaid.com/.
Should you have any questions
regarding any of the following messages, please contact Molina Medicaid
Solutions at (800) 473-2783 or (225) 924-5040.
ATTENTION PRIMARY CARE PROVIDERS
The Affordable Care Act requires Medicaid to reimburse
designated physicians for specified primary care services rendered during calendar years 2013
and 2014 at an enhanced rate. For more information on this enhanced reimbursement and what
physicians must do to receive it, visit http://www.lamedicaid.com/.
ATTENTION
PROVIDERS:
Providers who submitted claims for
claim type 14 and 15 for the period of 3/1/2012 forward, for those individuals
who are in populations that are excluded from the LBHP program and that
originally denied for edit 555 (submit claim to LBHP SMO), those claims are
being recycled for either payment or denial for the correct edit by Molina on
the RA of 12/18/12. We apologize for any inconvenience that this may have caused
providers.
ATTENTION
PROVIDERS:
Providers who submitted claims for
claim types 01, 04, 14 and 15 for the period of 3/1/12 forward for those
individuals who are in populations that are excluded from the LBHP program, with
a diagnosis of specialized behavioral health, and that originally denied for
edit 555 (submit claim to LBHP SMO), are recycled for payment by Molina on the
RA of 12/10/12. We apologize for any inconvenience that this may have caused
providers.
ATTENTION ALL
PROVIDERS
HOLIDAY CHECKWRITE DATES ADJUSTED
Due to the State, Federal and Bank
Holiday schedules, the checkwrite dates for the last week in December and the
first week in January will be adjusted to Wednesday, December 26, 2012, and
Wednesday, January 2, 2013. EFTs will be released on December 27th and January
3rd.
Reminder: The EDI cutoffs for these
weeks are Thursday, 12/20/12, at noon for the December 26th checkwrite and
Thursday, 12/27/12, at noon for the January 2nd checkwrite.
ATTENTION HOSPITAL
PROVIDERS: EFFECTIVE 12/14/12 MOTHER'S MEDICAID NUMBER REQUIRED FOR INITIAL
PRECERT
OF LEGACY NEWBORNS
DHH is requesting that in order for
Providers to begin the Precert process, initial newborn requests submitted to
Legacy Medicaid will require the mother's Medicaid number to be included on the
PCF01 form. The 13 digit Medicaid number area on the PCF01should remain as all
zeros until the baby's Medicaid number is assigned. If submitting electronically
through ePrecert, the mother's number should be typed in the text box
area.
These requests will be rejected if the Provider fails to provide
this information or if the mother is verified as having Bayou Health Plan
coverage on the day of admit. Please visit www.lamedicaid.com
for the
notice. If you have any questions please contact Molina Provider Relations (800)
473-2783 or (225) 924-5040.