Aetna provides info about COVID-19 on the next page. Healthy Louisiana members need to make sure their information stays current to ensure their Medicaid coverage. You can login or register. Make sure your details are up to date in our directories. 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. If UHG policies conflict with provisions of a state contract or with state or federal law, the contractual / statutory / regulatory provisions shall prevail. Or any twoof the following pieces of information: Providers can verify eligibility and You now have access to a members eligibility and benefits in the Provider Portal. To enter our secure portal, click on the login button. In Louisiana, pregnant women struggle to get maternal health care, and the situation is getting worse. Fee-for-Service (FFS) Medicaid before December 31, 2021, and providers enrolled with an MCO, DBPM, or Magellan before March 31, 2022. If you are a non-contracted provider, you will be able to register after you submit your first claim. phone number is necessary to avoid closure of your Provider Number. Visit the Healthy Blue website for Medicaid and LaCHIP members. Or choose Go on to move forward to Healthy Louisiana. Resources Informational Bulletin 22-38 : Medicaid Provider Enrollment Portal Update and Requirements Youre going to theproviderwebsite. Were a state-contracted health plan that offersHealthy Louisianaservices statewide. provider community. On receipt of a written grievance, appropriate personnel scan them into the tracking system and create a case file. Or choose Go on to move forward. password for this area of this website to access the applications that are Creating an account is free and easy. The Louisiana Department of Health (LDH)/Office of Behavioral Health (OBH) is in the process of expanding upon and restructuring the Medicaid service delivery system related to crisis services. This is due to the expanded scope of the services the Louisiana Board of Optometry now allowsOptometrists to perform in the office setting. 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. If you do not, your case may be closed and you may lose your Medicaid coverage, even if you are still eligible. Single Person or Entity Search This is a database containing all individuals and providers who are sanctioned, which may include exclusions, for-cause terminations, or disbarment through LDH Health Standards. Louisiana State Adverse Actions List Search It can help to eliminate Medicaid fraud. Members can call 1-844-209-5406(TTY 711) Monday through Friday from 8 a.m. to 8 p.m. The Medicaid Eligibility Verification System (MEVS) is an electronic system used to verify recipient Medicaid eligibility. and Change of Ownership. Members over 21 will be providedroutine dental exams, x-rays, cleanings, fillings andextractions with in-network providers limited to $500 per year. Questions? Providers having no billing activity the the last 18 monthly are subject to autoclosure of their Provider Numbers. When the system identifies the call as a grievance, the information is logged into the system, and forwarded to a triage team who puts the information into our tracking system where a case file is created and populated. Need access to the UnitedHealthcare Provider Portal? Louisiana Healthcare Connections will behavior random medical record audited as part of its QI program to monitor compliance because the general record documentation user. Providers - AmeriHealth Caritas Louisiana - Medicaid managed care plan Another group or vendor provides the info on the next page. The Medicaid Eligibility Verification System (MEVS) is an Be sure to check back frequently forupdates. submitter for the usage. Contact us About us The Louisiana Department of Health and Hospitals and Gainwell Technologies have created this website to make information more accessible to Medicaid providers. Language services at the office. Phone: 1-844-52-MARCH or 1-844-526-2724 Providers can report agency closure to Gainwell Provider Enrollment at LouisianaProvEnroll@gainwelltechnologies.com or 225-216-6370. Providers required to enroll include providers who file claims with Louisiana Medicaid, including providers enrolled in This will affect applicable applications received June 1, 2018, or later. Receiving calls and/or text messages from Aetna Better Health of Louisiana that are informational and relate to my health and benefits. I forgot my password or User ID. Booster shots are not included. You can find more information at the Louisiana Department of Health'sLouisiana Volunteers in Action (LAVA). Ithas infofor health care providers. PO Box 31364 Phone: 1-877-204-1324. Your Secure Provider Web Portal Our provider portal makes it easy for you to work with DentaQuest. If you have already been approved for Medicaid and need to enroll in a health plan, click here. Grievances may be filed orally by calling the toll-free number for our Member Services Call Center 1-866-675-1607or in writing by mailing the grievance to ourRegional Mail Operations (RMO) at: UnitedHealthcare certain they are contracting with an approved vendor. 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 Its important to us that you have the care you need to be healthy. If you get a letter from Medicaid asking for more information or asking you to verify your income, be sure to respond as soon as possible. Medicaid | Department of Health | State of Louisiana We administer the dental benefits for eligible children and adults. this website. Or choose Go on to move forward to Aetna.com. accident or illness, when the health of the recipient would be endangered if Give your health the best shot this flu season. 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, Healthy Louisiana provides the info on the next page. If you file claims with Louisiana Medicaid, you must enroll in the new Medicaid Provider Enrollment Portal or you run the risk of not being reimbursed for services rendered in the near future.In fall 2021, Louisiana Medicaid mailed letters to providers about this . Keep your Medicaid information up to date to maintain coverage. 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. help to eliminate Medicaid fraud. correspondence). More than 51,000 women in the state are left without easy . 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. Providers will be notified of any changes to the list of Or choose Go on to move forward. Medicaid provider enrollment. Steps to getting contracted plus plan information, Phone numbers and links for connecting with us, List of contracted, high-quality independent lab providers, Update, verify and attest to your practice's demographic data, Provider search for doctors, clinics and facilities, plus dental and behavioral health, Policies for most plan types, plus protocols, guidelines and credentialing information, Specifically for Commercial and Medicare Advantage (MA) products, Pharmacy resources, tools, and references, Updates and getting started with our range of tools and programs, Reports and programs for operational efficiency and member support, Resources and support to prepare for and deliver care by telehealth, Tools, references and guides for supporting your practice, Log in for our suite of tools to assist you in caring for your patients. You will need to create an account to make changes. The listed vendors are available for MEVS provides Medicaid Member Portal | Aetna Medicaid Louisiana Or choose Go on tomove forward to the main AetnaMedicaidwebsite. 3M AmeriHealth Caritas User Access Request Form (PDF) 3M Dashboard Step-by-Step User Guide (PDF) Log on or sign up for NaviNet. Members can contact UnitedHealthcare Community Plan Member Services at 1-866-675-1607 (TTY: 711) or contact the NurseLine at 1-877-440-9409. Providers with multiple provider types must complete enrollment for each type. For more information on eligibility and enrollment, visit Healthy Louisiana at myplan.healthy.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. Per our Member Grievance Policy, and on initial contact, we log and track criteria including member. electronic system used to verify recipient Medicaid eligibility. Email:PI_COB_research@uhc.com Your provider manual has the answersyou need. as change of address requests, group linkages, direct deposit, and any other eligibility for multiple recipients at one time. to the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, login Find a Doctor Use this tool to find doctors, hospitals, pharmacies and specialty providers in our network. Residency finished. Dont worry you can come back to Healthy Blue. Contact us anytime, day or night. Children with disabilities, who may not qualify for Medicaid, may be eligible for a new program created by the Louisiana Department of Health (LDH). certain they are contracting with an approved vendor. MCNA Dental is a Medicaid dental plan for the entire state of Louisiana. The Louisiana Department of Health is working on a plan to address the opioid crisis, and they need your help. You can also visit the Louisiana Office of Public Health website for more information. You can login or register. out-of-state emergency services provided to Louisiana Medicaid eligible In addition, providers can have direct contact with the Gainwell Technologies Field Analyst assigned to their area or find information on provider training. Browse tips, webinars and training to get on board. Medical school training. NaviNet - AmeriHealth Caritas Louisiana We help you get the care you need like doctor visits, medicines, therapy and more. Select the Registration directory link on the Home page to register. 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. 6701 Center Drive West, Suite 790 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 A new window will open. The Provider Portal helps you spend less time on administration.