RA Messages for December 2, 2008


If you are unsure about the coverage of a drug product, please contact the PBM help desk at 1-800-648-0790.  


DRUG                                             DOSE                 STRGTH             LMAC                 EFF
CLOTRIMAZOLE                         CREAM                     1%             $1.08733             11/17/08
DESOXIMETASONE                    CREAM                   0.25%          $2.15900             10/30/08
HYDROCODONE BIT/ACET       TABLET             7.5/650MG        $0.69500            11/28/08

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


Effective with date of processing Monday, December 1, 2008, the KIDMED Claims Processing Subsystem will be merged into the Medicaid Claims Processing System which processes all other Medicaid claims. This merge will be beneficial for KIDMED providers and should remove many of the current problem areas related to processing KIDMED claims through a separate subsystem prior to the claims data entering the regular Medicaid subsytem for processing. Current KIDMED claims reports will also be revised or eliminated. Detailed provider notices concerning this transition are being posted on the Home page and the New Medicaid Information link of the LA Medicaid web site, www.lamedicaid.com. Please visit the web site to obtain the details of this important transition that will affect you. After reviewing these notices, any questions may be directed appropriately to Unisys Provider Relations at (800) 473-2783, the Unisys EDI Helpdesk at (225) 216-6303, or the Unisys Web Technical Support Team at (877) 598-8753.


As reported earlier, we had a system problem that occurred on outpatient claims processed in the checkwrites dated 09/02/08 and 09/09/08. This problem caused the Units and Billed Charge fields on these claims to be expanded by one digit, and the claims were priced and paid accordingly. We have identified additional claims needing correction and will process systematic adjustments for the erroneously processed claims. No action is required on your part. Some of these claims were overpaid which necessitates a recoupment from the provider. Also, some of the claims will be adjusted to correct the incorrect Units or Billed Charges only, and there will be no adjustment/difference in the Medicaid paid amount for these claims. The systematic adjustments will be displayed in the Adjustment Claims/Previously Paid Claims sections of your remittance advice dated 11/25/08. We apologize for any inconvenience this error may have caused. Contact Unisys Provider Relations at (800) 473-2783 or (225) 924-5040 if you have questions.

The 2008 Holiday EDI Processing Schedule will be as follows

Tuesday 11/25/08 4:30PM - KIDMED deadline
Wednesday 11/26/08 10:00AM deadline - all claims (with exception of KIDMED and LTC)

Wednesday 12/24/08 10:00AM deadline - all claims (with exception of LTC)
Wednesday 12/31/08 10:00AM deadline - all claims (with exception of LTC)