Learn Choose Enroll Healthy Louisiana health and dental plans for you and your family Find the coverage you need: To learn about Healthy Louisiana, go to Learn a secure portal and is available to Louisiana Medicaid providers only. Sign In Provider Network Active Network Providers Join the Network Provider Discounts FAQs Providing Care Initiating Care Clinical Guidelines Substance Use Treatment Autism Services Getting Paid Preparing Claims DSM-5 and ICD-10 HIPAA Coding Electronic Transactions Paper Claim Forms EAP Reimbursement FAQs Forms EAP Forms Admin Forms Clinical Forms All Urgent updates, where a member may be in danger of not receiving services (such as prescription refills), should still be sent to the selected Healthy Louisiana Plan. The listed vendors are available for Provider Enrollment - Applications for New Enrollments, Reactivations, and Change is Ownership. For help enrolling, you can call Healthy Louisiana at 1-855-229-6848 (TTY 711). We route telephonic/verbal grievances through our technology that identifies call type and routes to other databases according to category. Weunderstandhow important it isto getcare closeto home. The Specialize Behavioral Healthy Fee Schedule was revised on January 14, 2022 and is posted go the Louisiana Medicaid site in both Excel and PDF format. Residency finished. eligibility for multiple recipients at one time. Manage claimssubmit and manage claims entirely online. Visit our COVID-19 Resource Center for more information. Important Information from UnitedHealthcare onCOVID-19. Check out Care Conductor in the UnitedHealthcare Provider Portal under Clinical & Pharmacy. Wereproud to be members of yourcommunities, living and working here inLouisiana. You are required to provide your NPI in order Healthy Blue has discovered an error in processing childrens vision benefits (ages birth to 20 years) in January 2023. Race and/or ethnicity. To simplify the process, UnitedHealthcare Community Plan of Louisiana has partnered with Louisiana Medicaid for a provider enrollment drive that will devote time to each provider type over the next few months. CMS Issues Guidance Related to Patient Liability Income and Reductions, HHS Is Releasing $9 Billion in Provider Relief Fund Phase 4 Payments, Attention Providers/Submitters of Electronic Claims December 2021 Holiday Cutoff Dates for Receiving Electronic Claim Files, Vaccination Requirements for Healthcare Settings, LDH: Pfizer booster shots are now available to adults at increased risk, following new CDC guidance, HHS announces the availability of $25.5 billion in COVID-19 Provider Funding, Vaccination Requirements to Expand for Healthcare Settings, LDH Invites All Providers to Participate in the Final Louisiana eScan Survey, August 2021 Hurricane Ida Information for Medicaid Pharmacy, Emergency Medical Services Eligibility & Claims during the COVID-19 Public Health Emergency, Update: Medicaid Provider Enrollment Portal Launched July 26, 2021, LTC Monthly Processing Schedule for Calendar Year 2022, Medicaid Check Write Schedule for Calendar Year 2022, Medicaid Check Write Schedule for Calendar Year 2021, HRSA opens PRF reporting portal for providers, Healthy Louisiana Open Enrollment begins October 15, All providers on Medicare crossover claims receiving 444 Invalid Service Provider denials, Update: Medicaid Provider Enrollment Portal Anticipated to Launch in July 2021, Medicaid Renewals and Eligibility Checks Resuming, All providers on Medicare crossover claims must be enrolled in fee-for-service Louisiana Medicaid, UPDATE: Medicaid Eligibility Group Provides COVID-19 Related Coverage for Uninsured Patients, Update: Medicaid Provider Enrollment Portal Launching in June 2021, LDH Resumes Use of Johnson & Johnson Vaccine, Ambulance Treatment-in-Place/Telehealth Billing Guidelines, COVID-19 Vaccine Access for Uninsured Individuals Provider Fact Sheet, COVID-19 Vaccine Access for Uninsured Individuals Provider Fact Sheet - Spanish, Medicaid Provider Update on Vaccine Administration, 2021 Assistant Surgery and Assistant at Surgery Services, Increase to COVID-19 Vaccine Rates Effective March 15, 2021, 2021 HCPCS and Physician-Administered Drug Reimbursement Update, New Medicaid Provider Enrollment Portal to Launch in April 2021, Reminder of Upcoming Change in Process and Required Document for NEAT, Updated Guidance for COVID-19 Vaccine and Treatment Coverage, Updated Guidance Regarding the Process and Required Document Change for NEAT, HHS begins distributing over $24 billion in Phase 3 COVID-19 Provider Relief Funding, Attention Providers/Submitters of Electronic Claims Revised December 2020 Holiday Cutoff Dates for Receiving Electronic Claim Files, Change of Process and Required Document for NEAT effective January 1, 2021, Attention ESRD Facilities and Independent Laboratory Providers - Non-Routine Laboratory Services, LTC Monthly Processing Schedule for Calendar Year 2021, Tobacco Cessation Counseling for Pregnant Women, Attention Dental Providers: Upcoming e-MEVS Training, Attention Providers/Submitters of Electronic Claims - November and December 2020 Holiday Cutoff Dates for Receiving Electronic Claim Files, HHS Expands Relief Fund Eligibility and Reporting Requirements Updates, CHANGES TO DME, HOME HEALTH, PEDIATRIC DAY HEALTH CARE, REHABILITATION AND PERSONAL CARE SERVICES DUE TO HURRICANE DELTA - OCTOBER 2020, Provider Relief Fund: Third Phase of General Distribution Funding, Provider Relief Fund Post-Payment Reporting Requirements, New Medicaid Eligibility Group Covers COVID-19 Testing for Uninsured Patients, Provider Memo: Assisted Living Facilities can now apply for Provider Relief Funding, Changes to DME, Home Health, Pediatric Day Health Care, Rehabilitation and Personal Care Services due to Hurricane Laura August 2020, FFS Pharmacy Prior Authorization Emergency Override Procedure, Medicaid Provider Relief Funding Deadline Extended and Update on Eligibility, Medicaid Provider Relief Fund Extended Deadline Provider Memo, Long-term Electroencephalography (EEG) Setup and Monitoring, Medicaid Provider Relief Funding Update and Webinar, EMS COVID-19 Services Eligibility and Claims, Attention Physicians and Independent Laboratories: 2020 Clinical Laboratory Services - Reimbursement Changes, Memorandum to Providers: Data Requested by HHS for CARES Act Provider Relief Funding, Revised Hysterectomy Acknowledgment Form (BHSF Form 96-A), Some Medicaid Fee-For-Service Provider Payments Missed Week of April 13, 2020, Coronavirus (COVID-19) Medicaid Information, Attention Providers: Lamedicaid.com Website is Transitioning to a New Look and Feel, 2020 Assistant Surgeon and Assistant at Surgery Services, 2020 HCPCS and Physician-Administered Drug Reimbursement Updates. Were here for you 24 hours a day 7 days a week. Youre going to theproviderwebsite. Creating an account is free and easy. Member vision plan and benefit information can be found atUHCCommunityPlan.com/LAandmyuhc.com. MEVS allows a provider to retrieve a printable verification of: MEVS can be accessed by any of these methods: Providers may access recipient eligibility by using the following In a secured environment, you can review your claims or authorizations, validate member eligibility or submit requests. Temporary emergency enrollments will not be granted for an effective date prior to 3/1/20 and will be inactivated no later than six (6) months after the Ithas infofor health care providers. Together, we can improve health care access and quality. Mailing: Louisiana Department of Health | P.O. VisittheAetna Better Health website to learn more. Availability of these sites is not the responsibility of DHH. To get started, follow the steps to join our network. emergency declaration has lifted. Sign in to make the most of your day with the new provider portal from DentaQuest. To find the latest news about COVID-19 vaccines in Louisiana, visit the Louisiana Department of Health COVID-19 Vaccination Information page. View plansget vision and dental plan information prior to the member's visit. UnitedHealthcare Community Plan Or choose Go on tomove forward to the main AetnaMedicaidwebsite. as change of address requests, group linkages, direct deposit, and any other Learn more about how to submit and check the status of claims. If you dont want to leave the member site, choose the X in the upper right corner to close this message. The latest version/s of the United Healthcare Community Plan 2015 Contract and Amendments of the Healthy Louisiana contract is available on the Louisiana Department of Health website. If your application is received and you are required to pay a fee, You can reach us Monday through Fridayfrom 7 a.m. to 7 p.m. As always, we are happy to be your partner in care. Use our Community Resource Link for local help finding food, housing and other things you might need. Per our Member Grievance Policy, and on initial contact, we log and track criteria including member. As an agent of the Louisiana Medicaid provider, I acknowledge that I shall not use or If you fail to do so, and if you consequently provide services to a recipient who is ineligible on the date of service, you will not be paid for Providers who enroll by June 1, 2023 can resubmit their claims for payment. For Medicaid Providers | La Dept. Member plan and benefit information can also be found at UHCCommunityPlan.com/LAandmyuhc.com. notification to the participating submitter. The fee must be received before your application can be approved. This helps members find you. An eligibility request can be entered UnitedHealthcare adheres to the Louisiana Revised Statute 22:1874 (which incorporates Act 897) for practitioners joining an existing, contracted medical group to be temporarily approved to receive claims payment upon submitting their completed UnitedHealthcare application, and then will be fully credentialed upon application approval. Wehaveover 30 years of experience serving Medicaid populations,including children, adults and people with disabilities or other serious health conditions. As a network provider, youget lots of benefits, from ongoing support and training to timely claims processingand competitive compensation. For reimbursement, the out-of-state provider musts enroll as a Louisiana Medicaid Provider and must pursue established timely archiving guidelines in submitting claims. those services. In joining our network, youll become part of a group of physicians, health care professionals and facilities who share our commitment to helping people live healthier lives and making the health care system better for everyone. Welcome. By creating a Louisiana Healthcare Connections account, you can: Change your Primary Care Doctor Request a new Member ID Card Update your personal information Send us a message Provider Portal 6701 Center Drive West, Suite 790 After your report is made, we will work to detect, correct and prevent fraud, waste, and abuse in the health care system. We want to help make sure your patients are prepared for hurricane season and the resulting hazards such as storm surge, high winds, tornadoes, and flooding. Providers that do not have a provider number yet will receive one based on a unique provider type and NPI combination. Learn more about filing a grievance or an appeal. Keep your Medicaid information up to date to maintain coverage. Need access to the UnitedHealthcare Provider Portal? You can make changes to your address and your financial and employment information online at https://mymedicaid.la.gov/. Feel free to contact us at 844-521-6941 (TTY 711) Monday through Friday from 7 a.m. to 7 p.m. Again, welcome to Healthy Blue. Provider Enrollment Portal Webinars 08/06/21, Help Protect Members and Their Families from Medicaid Unwind Scams 04/21/23, Attention: LEAs and Respective Billing Agencies - National Correct Coding Initiative Medically Unlikely Edits 04/13/23, ClaimsXten - Implementation Delayed 03/23/23, Clear Claim Connection Unavailable from April 1 through April 21, 2023 03/23/23, ClaimsXten Multiple Surgical Reductions Reimbursement 03/21/23, Implementation of the NCCI MUEs for Outpatient Hospital and DME Services 03/21/23, Louisiana Medicaid Announces: New Editing Product - ClaimsXten Coming March 2023 03/08/23, Update: CMS issues updated guidance related to patient liability income and reductions 02/10/23, 2022 Annual 1099 Notice for Providers 02/01/23, Attention All Medicaid Providers Payment Issue 01/18/23, Preparation - 2023 Healthcare Common Procedure Coding System (HCPCS) Update 01/13/23, Updated Medicaid Provider Enrollment Portal Update and Requirements 12/02/22, LTC Monthly Processing Schedule for Calendar Year 2023 11/16/22, Medicaid Check Write Schedule for Calendar Year 2023 10/28/22, Medicaid continues to enroll providers who have missed the September 30, 2022 deadline 10/04/22, Medicaid to host provider webinars about approaching Provider Enrollment Deadline 09/15/22, MCO PMPM Payments Schedule SFY2023 08/17/22, Sterilization and Hysterectomy Claim Requirements 08/16/22, Sterilization Consent Form Updated by OPA 08/10/22, Provider Portal Enrollment Lookup Tool Update 08/03/22, Medicaid will deny claims for Providers who have not completed Provider Enrollment 06/30/22, Revised Telemedicine/Telehealth Billing Changes 05/10/22, 2022 HCPCS and Physician-Administered Drug Reimbursement Updates 04/26/22, Sterilization Consent Form Guidance 04/13/22, Provider Enrollment Portal is back online. Please take this quick survey. Switch by December 29. AetnaBetterHealthprovides thegeneralinfo on the next page. contained herein. UnitedHealthcare Community Plan maintains a grievance system for members that ensures receipt and prompt resolution of informal and formal member grievances and access to the state fair hearing process. calls about their products and options for accessing MEVS by the Medicaid Develop a plan on how you will communicate with family and friends in an emergency. In Louisiana, pregnant women struggle to get maternal health care, and the situation is getting worse. Sixteen-digit card control number and recipients 8-digit birth date or social security number; Thirteen-digit Medicaid ID number and recipients 8-digit birth date or social security number. Louisiana Healthcare Connections will behavior random medical record audited as part of its QI program to monitor compliance because the general record documentation user. help to eliminate Medicaid fraud. View our policy. Or choose Go on to move forward to the provider website. If your practice already uses Availity, simply contact your administrator to request a username. If you are not enrolled in the Medicaid Provider Enrollment Portal, your claims will begin to deny on January 1, 2023, BUT YOU CAN STILL ENROLL. The Availity Provider Portal gives you the info, tools and resources you need to support the day-to-day needs of your patients and office. We provide access to doctors, providers, and services to help you with your emotional and mental health. A new window will open. The Centers for Medicare & Medicaid Services (CMS) established the Medicaid Managed Care Rule to: Enhance policies related to program integrity With the Medicaid Managed Care Rule, CMS updated the type of information managed care organizations are required to include in their care provider directories. Member Services is here to help. Access formsfind provider manuals, plan sheets, lab program forms . P.O. If UHG policies conflict with provisions of a state contract or with state or federal law, the contractual / statutory / regulatory provisions shall prevail. Those without Internet access can call 1-866-GET-INFO. You can also visit the Louisiana Office of Public Health website for more information. A recap of changes: Individual Placement and Assistance (IPS) and Personal Care Achievement (PCS) have a recent effective date of 2/21/22. You can login or register. If you have any questions, please call our Provider Services team at 1-844-521-6942. Video chat with a doctor 24/7 from your smartphone, tablet or computer at no cost to you. To ensure the Click on any of these items to learn more about the Louisiana Medicaid Program. Simply submit a claims status inquiry request. Visit the Healthy Blue website to learn more about our Medicare plans, including a Dual Eligible Special Needs Plan for those on both Medicare and Medicaid. Entities/businesses that are currently enrolled in Medicare or Medicaid in another state are exempt. If you are a non-contracted provider, you will be able to register after you submit your first claim. Youre going to theproviderwebsite. Always have your member ID card with you. By Sharyn Alfonsi. Regular and non-urgent Third Party Liability update requests must be sent directly to HMS via one of the methods below: Fax:1-877-204-1325 Enrolling in Louisianan Medicaid is a two- (2) step process: Download that Basic Enrollment Packs. With Medicaid and LaCHIP, you and your family can access doctors, medicine, and services to get and stay healthy. You can: You'll need to access the secure portion of the member website. Healthy Louisiana is here to help you choose the best health plans, dental plans, doctors, and dental providers for you and your family. The best way for primary care providers (PCPs) to view and export thefull member roster is using the CommunityCare tool, which allows you to: For help using CommunityCare, please see ourQuick Reference Guide. MEVS access is provided through Access Provider Portal Provider forms You can find all the forms you need right here. Crisis Response Phone Number: 1-866-232-1626. Or choose Go on tomove forward to the main AetnaMedicaidwebsite. Or choose Go on to move forward to the provider website. that individual will be returned on a web page response. Alabama Arizona Arkansas California Colorado Delaware Florida Creating an account is free and easy. Either way, welcome to Healthy Blue. Visit the Healthy Blue website for Medicaid and LaCHIP members. Submitters may choose to use the Give your health the best shot this flu season. Mailing Address for Claims: Claims Processing Center Timely reporting of a new address and/or new rejection of your request. Managed Care of North America is a premier dental benefits administrator that provides exceptional service to State Agencies and managed care organizations for Medicaid. and providing notification to the affected individuals, It lets you: Confirm member eligibility Review claims status Check benefits Access payment information, and more Please select your state from the list below to be taken to your portal. Apply for benefits, check the status of an application, report any household changes, request a new card if you need one and renew your benefits. Login for any of these actions. Visit it by using the link located on the index to your left. Members must have Medicaid to enroll. Or choose Go on to move forward. Your provider manual has the answersyou need. You can find more information at the Louisiana Department of Health'sLouisiana Volunteers in Action (LAVA). Questions? We bringournational experience to your communities. Need help registering for Availity? If you are a contracted provider, you can register now. If you have questions, call Healthy Rewards at 888-990-8681(TTY 711) Monday through Friday from 8 a.m. to 7 p.m. The Medicaid Eligibility Verification System (MEVS) is an electronic system used to verify recipient Medicaid eligibility. Some members only get mental health and substance use services through Healthy Blue. Sydney Health is where you can manage your health plan using your username and password. Questions? Resources Informational Bulletin 22-38 : Medicaid Provider Enrollment Portal Update and Requirements For more information on eligibility and enrollment, visit Healthy Louisiana at myplan.healthy.la.gov. Aetna Better Health of Louisiana complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. MCNA Dental has a large network of general and specialty dentists throughout Louisiana to make sure you can get the high quality dental care you need. Providers required to enroll include providers who file claims with Louisiana Medicaid, including providers enrolled in You will be able to download the Sydney Health mobile app soon. provider must enroll as a Louisiana Medicaid Provider and must follow Fees will be dependent on the type of services selected. This will affect applicable applications received June 1, 2018, or later. You now have access to a members eligibility and benefits in the Provider Portal. Failure to provide your NPI will result in the electronic system used to verify recipient Medicaid eligibility. Member Information: Current Medical Plans, ID Cards, Provider Directories, Dental & Vision Plans, Behavioral Health: Louisiana Department of Health (LDH)/Office of Behavioral Health (OBH), Reporting Health Care Fraud, Waste and Abuse, UnitedHealthcare Community Plan 2015 Contract and Amendments for Healthy Louisiana, 2023 UnitedHealthcare | All Rights Reserved, Welcome to the Home for Care Provider Resources, UnitedHealthcare Community Plan of Louisiana Homepage, Bulletins and Newsletters | UnitedHealthcare Community Plan of Louisiana, Claims and Payments | UnitedHealthcare Community Plan of Louisiana, Pharmacy Resources and Physician Administered Drugs | UnitedHealthcare Community Plan of Louisiana, Prior Authorization and Notification | UnitedHealthcare Community Plan of Louisiana, Provider Forms and References | UnitedHealthcare Community Plan of Louisiana, Provider Training | UnitedHealthcare Community Plan of Louisiana, UnitedHealthcare Dual Complete Special Needs Plans, Learn more about the Dual Special Needs Program, Sign in to the UnitedHealthcare Provider Portal, Health plans, policies, protocols and guides, The UnitedHealthcare Provider Portal resources, LA DOH: COVID-19 Vaccine Administration and Management, LDH - Update: Reporting of COVID-19/SARS-CoV-2 Results, Sign up for Healthy Louisiana to receive regular Medicaid updates from the Louisiana Department of Health, Louisiana Department of Health Medicaid Provider Advisories, Important Provider Credentialing Information - check often for updates, Information from Louisiana Medicaid: CARES Act Data, UnitedHealthcare Covid-19 Billing Instructions - Exceptions and Overrides, Louisiana Department of Health COVID-19 temporary measures, www.ldh.la.gov/medicaidproviderenrollment, LouisianaProvEnroll@gainwelltechnologies.com, UnitedHealthcare Community Plan Care Provider Administrative Guide, marchvisioncare.com/providerreferenceguides.aspx, Louisiana Crisis Response System Fact Sheet, Louisiana Crisis Response Region 1 Fact Sheet, Louisiana Crisis Response Region 2 Fact Sheet, Louisiana Crisis Response Region 3 Fact Sheet, Louisiana Crisis Response Region 7 Fact Sheet, Louisiana Crisis Response Region 10 Fact Sheet, Care Conductor in the UnitedHealthcare Provider Portal, Louisiana Department of Health Bulletin Notice, View the UnitedHealthcare Community Plan 2015 Contract and Amendments, Phone: #1-833-641-2140 (Monday Friday, between 8 a.m. and 5 p.m. CST). This includes disclosures and private use of this data, notice of legal duties and privacy practices You can: For help with enrolling, call 1-855-264-5277 (TTY 711) March Vision Care is the vision vendor for UnitedHealthcare and provides routine vision services. Autoclosure. Some questions you might have are already answered on our FAQ page. Whether you are a member or provider, you'll find helpful information and resources within this section of our Web site. Or choose Go on to move forward to Aetna.com. You may refer to the state-specific credentialing requirements for Louisiana Community plan in the UnitedHealthcare Community Plan Care Provider Administrative Guide. If you have further questions, please email LouisianaProvEnroll@gainwelltechnologies.com or call 833-641-2140, Monday - Friday between the hours of 8 a.m. and 5 p.m. Central time. In fall 2021, Louisiana Medicaid mailed letters to providers about this enrollment requirement. Member Services: 1-844-521-6941 (TTY 711) Monday through Friday from 7 a.m. to 7 p.m. Providers are cautioned to be out-of-state emergency services provided to Louisiana Medicaid eligible Enjoy your gift card. The Louisiana Department of Health is working on a plan to address the opioid crisis, and they need your help. Member Primary Care Physician Reassignment. Email:PI_COB_research@uhc.com When you report a situation that could be considered fraud, youre doing your part to help save money for the health care system and prevent personal loss for others. The Availity Provider Portal gives you the info, tools and resources you need to support the day-to-day needs of your patients and office. Box 629 | Baton Rouge, LA 70821-0629 Physical: 628 N. 4th Street | Baton Rouge, LA 70802 | Phone: 225.342.9500 | Fax . Aetna Better Health ofLouisianais part of Aetna, one of the nation's leading health care providers and a part of the CVS Healthfamily. Stay up to date with our latest provider news. . Were a health plan or insurance company for Medicaid. Phone: 1-844-52-MARCH or 1-844-526-2724 Applications for New Enrollments, Reactivations, Healthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc., an independent licensee of the Blue Cross and Blue Shield Association. Is Medicaid right for you? Providers interested in enrolling for Its an easy way to get care for you or your family anytime of the day or night without leaving home.