Change Healthcare System Interruption
Change Healthcare, our electronic data interchange (EDI) clearinghouse for claims and payment cycle management, continues to address their network interruption related to a security incident. Below are updates for our systems and processes:
- Claims payments: We have resumed payments for claims submitted prior to the incident. Since Change Healthcare is still unable to accept claims submissions, providers who submitted claims during the outage may be able to resubmit them either through additional solutions once they are available or once Change Healthcare’s connectivity is restored, through Change Healthcare. We appreciate the inconvenience this is causing providers and are exploring other options for the submission of claims.
- Electronic remittance advice: Electronic remittance are available at this time. However, some individual remittance advices may not be available due to Change Healthcare’s security incident.
- Prior authorization submission and processing: The prior authorization systems continue to operate normally.
- Eligibility verification, claim status inquiry, and authorization inquiry: These capabilities continue to be available via NaviNet. If you do not have access to NaviNet provider portal, please visit https://register.navinet.net/ to sign up.
- Electronic claims submission: Our claims submission process relies on Change Healthcare transmitting the claim to AmeriHealth Caritas Louisiana. We are working on an alternate claims submission solution and will notify providers when the alternate solution is available.
Please note, in the interim, our Provider Services Department will not be able to assist with processing of your payments any sooner. If you have other questions, you may contact Provider Services at 1-888-922-0007. We thank you for your partnership and will continue to provide updates as we work to resolve the downstream impacts of Change Healthcare’s service interruption.
Medicaid provider enrollment
Providers who missed the initial deadline of September 30, 2022, please note that the Provider Enrollment Portal at www.lamedicaid.com remains open for providers required to enroll (see criteria listed below) who have not yet applied. Providers with multiple provider types must complete enrollment for each type.
Providers who did not complete enrollment by June 30, 2023, have been deactivated, their patients have been assigned to another primary care physician, and they will be terminated from the program. The Provider Enrollment Portal will remain open for providers who failed to enroll but wish to complete an application at a later date.
Providers who submitted provider enrollment applications to Louisiana Medicaid should allow several weeks for application processing.
Who is required to enroll?
- Providers who file claims with Louisiana Medicaid (providers enrolled in Fee-for-Service (FFS) Medicaid before December 31, 2021, and providers enrolled with an MCO, DBPM, or Magellan before March 31, 2022.)
- Ordering, Prescribing, or Referring Providers
- Ordering, prescribing, or referring (OPR) providers do not bill Medicaid for services rendered, but may order, prescribe, or refer services/supplies for Medicaid beneficiaries.
Providers can find additional information in IB 22-4 Medicaid Provider Enrollment Portal (PDF).
Medicaid urges enrollees to update information to maintain eligibility.
The Louisiana Department of Health (LDH) is seeking provider assistance to encourage their Medicaid patients to keep their case information (address, financial, and employment) updated to ensure eligibility. This can be done through Medicaid’s new Self-Service Portal.
Updated information is increasingly important as Medicaid is conducting more frequent eligibility verifications with its new eligibility and enrollment system. Previously, income was verified annually. Additionally, renewals will be handed by mail only, making it important that recipients keep their contact information updated so they do not miss important mail.
Providers are asked to remind their Medicaid patients to respond to any mail from Louisiana Medicaid in the timeline provided in the letter. Failure to respond could result in case closure.
Providers can now update demographic information via NaviNet
AmeriHealth Caritas Louisiana providers now have the ability to attest to the accuracy of practice data and submit demographic changes (PDF) directly through NaviNet via the Provider Data Information Form feature. This feature is only available to professional provider groups at this time.
Learn about the Louisiana State Opioid Response (LaSOR) Project
LDH-OBH in Partnership with LSUHSC–Dept. of Psychiatry is seeking office-based opioid treatment (OBOT) providers. If you are interested in participating, download the LaSor Flyer for more information (PDF).
Partners in Care
As an AmeriHealth Caritas Louisiana provider, you're our partner in member care. Our goal is to help you operate effectively and efficiently. Working with providers like you, we can deliver quality, cost-effective care and better health outcomes for our members.
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