Communications
Important updated provider information
We want to help keep you informed about the health plan and other news that's useful to you. Please check back periodically for important notices and updates to the Aetna Better Health of Louisiana plan.
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WEBINAR: Telehealth & COVID-19
Addressing billing and claims questions associated with meeting the demand for enhanced telemedicine needs during the Covid-19 emergency
RECORDED: April 20, 2020
PRESENTED BY: Louisiana Healthcare Connections Director of Claims and Contract Support Services Jennifer Pinkins on behalf of the Louisiana Managed Medicaid Association
KEY HIGHLIGHTS:
- Telehealth Resources
- Telehealth Billing & Procedure Codes
- Telehealth Guidance & Requirements
Click here to view.
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Network Notifications
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Behavioral Health - Rendering Provider NPI
Medicaid Dental Program Changes
Hospital Inpatient Per Diem Rate Updates
CPT E/M Office Revisions Level of Medical Decision Making (MDM)
Revision to COVID-19 Testing Payments - Lab Services Memo
HHS Provider Relief Fund Distribution Phase 3
ABHLA System Information Notifications
Pharmacy Prior Authorization Peer to Peer Requests
Update: Reporting of COVID-19/SARS-CoV-2 Results
Assistant Surgeon Payment Reduction
Multiple Procedure Payment Reduction
Discontinuation of Eviti for Oncology Support - 11/23/2020
Evaluation and Management (E/M) Changes
Continued Alignment with LDH Medicaid Services Manuals
Value-Based Payment Covid-19 Response
Holiday Check Run Schedule - December 2020 and January 2021
Holiday Check Run Schedule - November 2020
HHS Expands Relief Fund Eligibility and Updates Reporting Requirements
Claims Submission - Frequency Codes
Outpatient Services Before and After Inpatient Services
DaVita National Ancillary Agreement
Footbaths and Soaks Notification
Third General Distribution of Provider Relief Fund - October 2, 2020
Online Prior Authorization Search Tool (ProPAT)
Eviti Provider Training Notice 09/14/2020
MEMO - Providers Should Confirm Medicaid Eligibility Using MEVS
EVV for EPSDT Personal Care Services (PCS)
Claims Submission - Portable X-Ray
Federally Qualified Health Centers - Billing Guidelines
Behavioral Health - Inpatient Services - September16, 2020
Louisiana Census Day - September 9th
Louisiana Department of Health - Peer Support Services - Request for Information
NEW - Pain Management Program Changes
Labor Day Holiday Check Run (Revised August 28, 2020)
LDH Notification - Storm Ready 2020
ATLAS Shatterproof Addiction Treatment Notification
NEW - Free CE Opportunity on Treatment Planning
Medicaid Provider Relief Fund Update 08032020
Medicaid Provider Distribution of the Provider Relief Fund FAQs
NEW - Alignment with LDH Medicaid Services Manual
UPDATED DEADLINE: Medicaid Provider Relief Funding Application Due 8/3/2020
Altered Check Run Schedule 07.13.2020
CARES Act Provider Relief Fund Information
NEW - LA Children's Coordinated System of Care (CSoC)
NEW - Medical Transportation - Pickup Origin
NEW - Medical Transportation - Out of State Fee Schedule
NEW - Medical Transportation - Same Day Pickups
NEW - Medical Transportation - Hospital-Based Ambulances
NEW - Provider Taxonomy Code Claims Requirement
NEW - Home Health - Billing REV and CPT Codes
NEW - Home Health - Billing DME Supplies
Medicaid Provider Portal Webinars Memo
Holiday Check Run Notice - July 3, 2020
New LA Medicaid Website LDH Bulletin
ABHLA Webinar Series Schedule May 2020
Memorial Day Check Run Notice 05062020
COVID-19 Prohibited PPE Billing Memo
FQHC/RHC Encounter Code Notice 043020
Memo to Psych Hospitals and Residential Facilities Regarding COVID-19
Provider Telemedicine Visit Instructions
Medical Monitoring Station at New Orleans Convention Center
Personal Housing Units at the New Orleans Convention Center
LDH Informational Bulletin Registration
2020 HCPCS and Physician-Administered Drug Reimbursement Update
ABHLA Secure Web Portal Claim Status Education Notice
All MCO Provider Education Notification
NCQA Credentialing/Accreditation Requirements during COVID-19
MHR Provider Update - COVID19 Response
MSA 20-09 Bulletin Error Notification
COVID-19 Provider Update 03172020
COVID-19 Provider Update Revised 03122020
COVID-19 NEMT Provider Update 03142020
COVID-19 Provider Update 03142020
COVID-19 Medicaid Provider Update
Implementation of Prior Authorization for Multi-Systemic Therapy
Implementation of Authorization for Crisis Intervention
Changes to Out of State Hospital Reimbursement
LA Policy Out of State Outpatient CCR
Shatterproof Provider Update 01-2020
Recoupment Notification 01092020
ABHLA Focused IPAT Survey 12202019
Peer Support Specialist Training
Holiday Check Run Notification 11182019
Member Coverage Ending Notification 10/17/2019
Shatterproof Provider Update 10-2019
BH SE Modifier Rescind Notification 09182019
NDBH 60th Annual Conference Press Release 2019
Updated Pediatric Day Health Care Prior Authorization Checklist
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
Provider Bulletin - June Edition
BH Billing Notification 06042019
BH SE Modifier Denials Notification 05312019
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
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
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
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
Provider Policy Updates 1/1/18
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 deliveriesMonthly
Adverse incident reporting form
Adverse incident reporting form instructions -
Newsletters
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We publish a provider newsletter several times a year. Just click on the links below to see current and previous issues.
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System Information Notifications
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Date Published Status System Issue 1/04/2021 Active 1/04/2021 Active BH Providers with Multiple Education Levels 12/01/20 Active PSR Denials for Individual Providers Rendering Service 12/01/20 Active CLIA System Information Notification 12/02/20 Active ABA Services 12/04/20 Active TPN Services 12/09/20 Active Speech Therapy 12/10/20 Active ASC Provider Type and Specialty 12/11/20 Active COVID POS 11 -
LDH Bulletins
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- IB 20-23 EPSDT Periodicity Schedule
- IB 20-22 ESRD Facilities and Independent Laboratory – Non-Routine Laboratory Services (Revised November 20, 2020)
- IB 21-2 NEMT Provider Issue Resolution (Revised January 6, 2021)
- IB 21-1 Donor Human Milk
- IB 20-21 Inpatient Concurrent Care
- IB 20-20 Obstetric Ultrasounds by Maternal Fetal Medicine Specialists
- IB 20-19 Open Enrollment for Medicaid Dental Plans
- IB 20-18 Open Enrollment for Medicaid Managed Care Plans
- IB 20-17 Hurricane Laura Provider Assistance FAQs (Revised September 22, 2020)
- IB 20-16 Long-term Electroencephalography (EEG) Setup and Monitoring
- IB 20-15 Dental Members and Plan Choice vs. Provider Steering
- IB 20-13 Infection Control Guidance for Home Health Agencies
- IB 20-12 COVID-19 Update for PDHC Facilities
- IB 20-11 Teledentistry during the COVID-19 Declared Emergency
- IB 20-10 Revised 96-A Hysterectomy Acknowledgment Form
- IB 20-9 EPSDT Personal Care Services (Revised April 30, 2020)
- IB 20-8 CARES Act Provider Relief Funding (Revised April 29, 2020)
- IB 20-7 COVID-19 – SUD Telemedicine/Telehealth (Revised April 9, 2020)
- IB 20-6 COVID-19 – LMHP Telemedicine/Telehealth (Revised April 9, 2020)
- IB 20-5 COVID-19 Provider Update (Revised December 23, 2020)
- IB 20-4 COVID-19 – MHR Telemedicine/Telehealth (Revised April 8, 2020)
- IB 20-3 Changes to LaMedicaid.com Website (Revised April 23, 2020)
- IB 20-2 2020 HCPCS and Physician-Administered Drug Reimbursement Updates
- IB 20-1 Telemedicine and Telehealth Billing Changes for RHCs and FQHCs
- IB 19-16: LPC and LMFT Reimbursement at FQHCs and RHCs
- IB 19-15: Hospice Fee Schedule Federal Fiscal Year 2020
- IB 19-14: Act 370 - Limitation on Hours of Community Psychiatric Support and Treatment and Psychosocial Rehabilitation Services
- IB 19-13: Electronic Visit Verification for EPSDT Personal Care Services
- IB 19-12: Extended Home Health Modifiers
- IB 19-11: Telemedicine/Telehealth Billing Changes
- IB 19-10: Oxygen Probe Coverage
- 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
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Health Plan Advisories
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HPA 20-25: EPSDT Periodicity Schedule
HPA 20-24 MCO Preparation - 2021 Healthcare Common Procedure Coding System Update
HPA 20-22 Inpatient Concurrent Care
HPA 20-21 Obstetric Ultrasounds by Maternal Fetal Medicine Specialists
HPA 20-20 Dental Benefit Program Manager Update
HPA 20-16 Class Action Lawsuit AJ v. LDH
HPA 20-15 Long-Term Electroencephalography (EEG) Setup and Monitoring
HPA 20-13 COVID-19 Update for PDHC Facilities
HPA 20-12 Telehealth Marketing and Member Education
HPA 20-11 Revised 96-A Hysterectomy Acknowledgement Form
HPA 20-10 EPSDT Personal Care Services
HPA 20-9 COVID-19 - SUD Telemedicine/Telehealth (Revised July 28, 2020)
HPA 20-8 COVID-19 LMHP Telemedicine/Telehealth (Revised July 28, 2020)
HPA 20-7 COVID-19 - MHR Telemedicine/Telehealth (Revised July 28, 2020)
HPA 20-6 Response to COVID-19 Revised 092320
HPA 20-5 PASRR Level II Evaluations: COVID-19
HPA 20-4 HCPCS and Physician-Administered Drug Reimbursement Updates
HPA 20-3 Reimbursement for Opioid Use Disorder Treatment in Opioid Treatment Programs
HPA 20-2 Telemedicine and Telehealth Billing Changes for RHCs and FQHCs
HPA 20-1 LSU Enhanced Professional Service Fees to be Paid Effective 1/1/2020
HPA 19-18 2020 Healthcare Common Procedure Coding System (HCPCS) Update
HPA 19-17 LPC and LMFT Reimbursement in FQHCs and RHCs
HPA 19-16: Hospice Fee Schedule Federal Fiscal Year 2020
HPA 19-15 Electronic Visit Verification for EPSDT Personal Care Services
HPA 19-14 Severe Combined Immunodeficiency (SCID) Testing
HPA 19-13 EPSDT PCS Rate Change
HPA 19-9 CLIA Number Information (Revised July 1, 2019)
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 18-25 (Revised October 6, 2020) “Non-Invasive Prenatal Testing (NIPT)"
- 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 Revised 2.6.19
- 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
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Notices
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- Hurricane Laura - Delta
- Memo: CARES Act Provider Relief Funding Data Request
- 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
- 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