Communications

Important updated provider information

Network Notifications

BH SE Modifier Rescind Notification 09182019

NDBH 60th Annual Conference Press Release 2019

Updated Pediatric Day Health Care Prior Authorization Checklist

ABHLA Urgent Care Flyer

BH SE Modifier Denials Notification 08022019 - Updated

CLIA Rejection Notification 08082019

Updated Hospital Provider Rates effective 07.01.2019

Network Notification Duplicate Remits 07.29.19

Multi Specialty Same Day Notification 07162019

Peer Support Specialist (PSS) Training Letter

Peer Support Specialists (PSS) Application

Member Assignment and Attribution Policy

Member Attribution Notification 07162019

MCNA LA Pain Medications Flyer

MCNA LA Vaccines Flyer

MCNA LA Measles Flyer

Hep C provider notice

Provider Bulletin - June Edition

BH Billing Notification 06042019

BH SE Modifier Denials Notification 05312019

Provider Bulletin

SCA Network Notification

DME MP Rebase Letter Updated

TAP Training for Physicians

SBIRT Provider Flyer

MAT Training for Physicians

Member Assignment & Attribution Policy 2019

DME Date Span Billing Clarification

Credentialing Documentation Request EBP Claims

ImCal Request for Letter of Interest 2019

Admission Criteria by ASAM Level

New Requirements for ASAM Level Triage Assessment

Electric Breast Pump Request Form

DME MP Rebase Letter

HCPCS Fee Schedule

Tracking Evidence-Based Practices

Flu Vaccinations Coverage 2018-2019

Update and Clarification – 2019 ABA CPT Codes

Act 582 BHS PM Update Blast 1-11-19

Newly Posted Sterilization Form Blast 1-11-19

ACT 582 18-14 11-15-18

Revised Provider Notification for Draft Policies 09.27.2018

Act 582 Legislation Summary 9-12-18

EM Up Coding and Down Coding 9-5-18

Member Choice Fax Blast

Pay For Quality - Aetna Better Health of Louisiana April 2018

Implementation of Member Choice Form. 4/24/18

Healthy Louisiana Mental Health Rehabilitation Member Choice Form. 4/24/18

Please submit all delivery claims. 4/16/18

LDH BH Provider Manual and SBHS Requirements 4/16/18

Policy Statements 2/9/18

Provider Policy Updates 1/1/18

Q1 2016 Fax blast

Q2 2016 Fax blast

Q3 2016 Fax blast

Q1 2017 Fax blast

11/20/17 Cotiviti Overpayment Letter

01/10/17 Clinical Documentation 
01/10/17 ABHLA Claims Reconsideration Form
01/10/17 LOCUS Training Q1 2017
12/19/16 Clinical Documentation
11/28/16 Provider Appeals Complaints
11/28/16 PA Retro Eligible
11/28/16 Retro Utilization Review
11/28/16  Credentialing Changes
11/28/16  HPA 16-32
11/28/16  CLAS Standard
11/28/16  Newborn Billing Guidelines 
09/22/16  ABHLA Emergency Acute Flaccid Notice
09/07/16  ABHLA Provider Newsletter Q2 2016
08/22/16  Provider notice TPL effective 20160901
08/19/16  Louisiana state of emergency fax blast
08/18/16  LDH flood DME fax blast
08/17/16  LDH flood call fax blast
07/01/16  PDHC Fax Blast
07/15/16  MCG BH Fax Blast
07/15/16  Notification of Pregnancy Fax Blast
07/15/16  Provider Referrals to CM Fax Blast
05/26/16  CareWebQI prior authorization issues
05/25/16  Instructions for processing voided NEAT claims
05/25/16  Provider quick guide New
05/24/16  HEDIS PCP tips, HEDIS pediatrician tips
05/24/16  Room and board
05/17/16  BiliTool
03/31/16  DHH rescinded bulletin 16-2: claims processing edits for provider taxonomy
03/31/16  ABHLA provider newsletter Q1 2016
03/11/16  Hospice code changes
02/20/16  Changes to ADHD drug prior authorization
02/17/16  Taxonomy needed for claims
01/08/16  New inpatient notification FAX number
12/11/15  New provider relations liason
12/11/15  Behavioral health provider training
11/02/15  Limitations on drug screening claim
11/24/15  LA website formulary tool not working
10/29/15  Genetic testing requires prior authorization
08/05/15  Hepatitis C pharmacy prior authorization
08/06/15  Authorization for standard deliveries

 

Monthly

Adverse incident reporting form
Adverse incident reporting form instructions

 

Newsletters

• We publish a provider newsletter several times a year. Just click on the links below to see current and previous issues.

  • Spring 2019
  • Winter 2019
  • Fall 2018
  • Spring 2018
  • Winter 2018
  • Fall 2017
  • Summer 2017
  • Winter 2017
  • Fall 2016
  • Summer 2016
  • Spring 2016
  • Spring 2015

LDH Bulletins

• IB 19-12: Extended Home Health Modifiers
• IB 19-11: Telemedicine/Telehealth Billing Changes
• IB 19-9 Urine Drug Testing
• IB 19-8 CLIA Number Information
• IB 19-4 2019 HCPCS and Physician-Administered Drug Reimbursement Updates
• IB 19-3 Medicaid Managed Care Provider Issue Resolution
• IB 18-18 Reimbursement for Continuous Glucose Monitoring Devices (CGM)
• IB 18-21 Immunization Coverage Update – Hepatitis B Adult 2 Dose Vaccine
• IB 19-2 EPSDT Personal Care Services – Administration of Medicine
• IB 18-20 New Applied Behavior Analysis (ABA) Codes
• IB 15-4 Medicaid Recipient Insurance Updates
• IB 13-02 revised 8.2.18 Managed Care Provider Claims Disputes and Resolution
• IB 16-7 Professional Services Fluoride Varnish Program Policy (Revised June 27, 2017)
• IB 16-11 Billing and Ordering Guidance for Long Acting Reversible Contraceptives (LARCs)
• IB 16-11 Billing and Ordering Guidance for Long Acting Reversible Contraceptives- Intrauterine Devices and Implantsrevised
• IB 16-12 Prevention of Zika Virus in Louisiana (Revised August 11, 2016)
• IB 17-2 Opioid Epidemic
• IB 18-1 2018 HCPCS and Fee Schedule Updates
• IB 18-2 Standardized Assessments for Members Receiving CPST and PSR
• IB 18-4 2018 Medicaid EPSDT Periodicity Schedule 05-03-18
• IB 18-5 Rehabilitation Therapy Services
• IB 18-6 Portable Oxygen Coverage and Reimbursement 05-11-18
• IB 18-7 Common Observation Policy 07-01-18
• IB 18-8 Hospice Fee Schedule 06-04-18
• IB 18-9 Home Health Program Federal and State Changes 08-23-18
• IB 18-10 Increased Security Measures for LA Medicaid Portal 09-14-18
• IB 18-11 Physician Administered Drugs Reimbursement Changes Revised 10-08-18
• IB 18-12 Non-Emergency Ambulance Program to Non-ER Provider Sites 10-26-18
• IB 18-13 Hospice Fee Schedule Federal Fiscal Year 2019 11-01-18
• IB 18-14 Act 582-Providers of Community Psychiatric Support and Treatment or Psychosocial Rehabilitation Services 11-13-18
• IB 18-15 Preventative Medicine Visits for Women 11-15-18
• ACT 582 18-14 11-15-18

Health Plan Advisories

HPA 19-13 EPSDT PCS Rate Change

HPA 19-12 Changes to DME, Home Health, Rehabilitation and Personal Care Services and Pharmacy Due to Tropical Storm Barry (Revised July 13, 2019)

HPA 19-10 Revised 7.19.19

HPA 19-9 CLIA Number Information (Revised July 1, 2019)

HPA 19-7 ABHLA Methodology

HPA 19-7 Behavioral Health Alternate Payment Methodology in FQHCs and RHCs

HPA 19-5 Member Reassignment Policy Core Elements

HPA 19-4 Breast Pump Coverage - Attestation and Equipment Requirements

The Aetna Better Health of Louisiana system was updated to reflect the updated HCPC changes 03/15/2019.  Any new claims received will be paid against the updated fee schedule rate.  All impacted claims began to be reprocessed on 3/18/19.  Claims are expected to be recycled no later than 15 days preceding the update.  If you have any questions regarding your claims or the system update please contact your provider relations representative.

• HPA 19-3 2019 HCPCS and Physician-Administered Drug Reimbursement Updates
• HPA 19-1 HCPCS Update
• HPA 18-21 Preventative Medicine Visits for Women 11-01-18
• HPA 18-20 Hospice Fee Schedule FF19 11-01-2018
• HPA 18-19 Reimbursement for Lynch Syndrome and Familial Adenomatous Polyposis Genetic Testing 11-01-18
• HPA 18-18 Reimbursement for Screening and Diagnostic Mammographies for FQHC and RHC Providers 11-01-18
• HPA 18-17 Seperate Reimbursement fo rLong-Acting Reversible Contraceptives in FQHC and RHC's 11-01-18
• HPA 18-16 Coverage of Electric Breast Pumps 11-01-18
• HPA 18-15 Coverage of Continuous Glucose Monitoring Devices 01-11-18
• HPA 18-14 Physician Administered Drugs Reimbursement changes 10-08-18
• HPA 18-13 Family Planning Clinic Fee Schedule 08-17-18
• HPA 18-12 Emergency Contraceptives 08-17-18
• HPA 18-11 Managed Care Linkage for Long Term Care (LTC) Members Revised 08-03-2018
• HPA 18-11 Managed Care Linkage for Long Term Care (LTC) Members 06-01-2018
• HPA 18-10 Physician Administered Drugs 05-29-2018
• HPA 18-9 Common Observation Policy
• HPA 18-8 Portable Oxygen Coverage and Reimbursement
• HPA 18-7 Rehabilitation Therapy Services 05-07-2018
• HPA 18-6 2018 Louisiana Medicaid EPSDT Periodicity Schedule
• HPA 18-5 Prior Authorization of Non-Emergency Ambulance Services Revised 04-26-2018
• HPA 18-5 Prior Authorization of Non-Emergency Ambulance Services
• HPA 18-4 Ambulance Non-Covered Services Modifiers – 03/09/2018
• HPA 18-1 Healthcare Common Procedure Codign System (HCPCS) Update #2
• HPA 17-22 Neonatal/Pediatric Critical Care Billing
• HPA 14-9 Coverage of Long Acting Reversible Contraceptives (LARCs) in Hospital Settings Effective 07-01-2018
• HPA 14-9 Coverage of Long Acting Reversible Contraceptives (LARCs) in Hospital Settings Revised_5.22.18
• HPA 18-7 Revised 2.6.19

Notices

• Pharmacy Notice Tropical Storm Barry
• ABHLA Quick Guide 02-12-19
• Member Access to Physical Health Care Notice
• FFS_Clin_PA_n_Diagnosis_Code_Requirement_Spinraza_and_Exondys_6-26-18
• FFS_Clin_PA_Removal_Entresto_6-26-18
• FFS_Clin_PA_VMAT2_Inhibitors_6-26-18
• FFS_OTC_Claims_Billing_for_LTC_Recipients_sig_6-28-18
• Pharmacy Prior Authorization Form
• Provider Update Asthma Management Tools _07_18
• Public Notice PBV Waitlist 6.22.2018
• Peer Support Specialist Training Reminder
• ABHLA Healthy Louisiana Billing for Hospital Services
• Behavioral Health- New Policies - Effective 08-07-2018
• ABHLA Quick Guide 06-26-2018
• ABHLA Quick Reference Guide 06-08-2018
• Lab Bundling Notification 05-25-2018
• Diagnosis Code BPH and PAH 6.1.18
• ZOLL Life Vest Patient Safety Communication - Service Code 102
• ZOLL Life Vest Physician Letter (Jan 2018)
• Independent Review Provider Reconsideration Form
• Louisiana Medicaid Provider Update Volume 34, Issue 4, 04-18
• Modifier Discount Table Notification
• Louisiana Medicaid FFS Pharmacy and MCOs POS Diagnosis Code Requirements for ADHD Agents, Stimulants, and SUD agents signed 4.1.18
• Manually Priced Codes to pay at 20% of Billed
• Louisiana Medicaid Drug Utilization Review Program for FFS Medicaid and MCOs 03-13-2018
• 2018 HEDIS Billing Guide and Tips
• Provider HEDIS Training Webinar Series
• HEDIS Training Webinar Series
• ABHLA Emergency Acute Flaccid Notice
• Provider notice TPL effective 20160901
• DHH warns Medicaid recipients of text message scam New
• Instructions for processing voided emergency ambulance transportation claims 
• DHH offering back to school vaccinations across Region Five
• DHH encourages individuals to get tested on National HIV Testing Day
• Medical record review criteria
• ICD-10 Frequently Asked Questions
• 17-P Alpha-Hydroxyprogesterone Caproate and Makena ordering & reimbursement guidelines
• Down's Syndrome Information
• Circumcision hospital procedure and reimbursement guidelines
• Makena® and Compounded 17-P in Louisiana Medicaid