Provider Newsletter

• Provider Newsletter Q2-13

Forms

• MemberConnections^® Referral Form
• Inpatient Clinical Review Form
• Notification of Pregnancy Form
• Prior Auth In-Patient Fax Form
• Prior Auth Out-Patient Fax Form
• Outpatient Treatment Request (OTR) Form - Specialty Therapy & Rehab Services
• Delivery Notification Form
• Non-Emergency Trip Request Form
• Claim Dispute Form
• CAQH Provider Data Form
• CAQH Provider Data Form with Credentialing Application
• Hospital/Ancillary Provider Credentialing Application
• DHH Sterilization Consent Form
• STL Medical Supply Breast Pump Request Form
• Alere Referral Form
• Louisiana Healthcare Connections OBGYN Plan Specific Information

Manuals & Handbooks

• Provider Handbook
• Provider Training Manual
• Provider Billing Manual
• Provider Manual – OptiCare (vision)
• PT, OT and ST Medical Necessity Criteria

General

• FAQ
• Prior Authorization List
• 2013 HEDIS Guide
• MemberConnections^® Brochure
• PaySpan Health–Payment & Remittance Overview
• Provider Quick Reference Guide
• Provider Authorization Information
• Provider Portal Offerings
• Website Offerings
• OT, PT, ST Outpatient Treatment Request (OTR) Training and FAQ
• Synagis 2012-2013 Authorization Guidelines
• CAQH Brochure

National Vendor Lists

• National Laboratory Vendors - Revised 2/13/12
• National DME, Orthotics & Prosthetics Vendors - Revised 2/17/12

Provider Updates

CLINICAL SUBMISSION DEADLINE NOTICE
PLEASE BE ADVISED:
Providers submitting clinical information to Louisiana Healthcare Connections for Concurrent Review now have a submission deadline of 3 PM.

Because Louisiana Healthcare Connections is accountable to DHH for meeting specified turnaround time deadlines, we require adequate processing time for clinical information submitted by Providers.

Providers must submit clinical information for our review by the specified “Next Review” date and 3 PM deadline. If clinical information is not submitted to us within the required timeframe, the length of stay extension request will be denied.

If you have any questions about this notice, please call Provider Services at 1-866-595-8133.

DHH Bulletins

Coming Soon

Policies and Procedures

Providers can request Provider Policies and Procedures by contacting our Provider Services Department at 1-866-595-8133 and a representative will assist you.

Clinical Guideline Resources

• American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care
• American Diabetes Association: Standards of Medical Care in Diabetes
• Center for Disease Control and Prevention (CDC): Adult and Child Immunization Schedules
• National Heart, Lung, and Blood Institute: Guidelines for the Diagnosis and Management of Asthma
• National Heart, Lung, and Blood Institute: Guidelines for Management of Sickle Cell
• U.S. Preventive Services Task Force Recommendations for Adult Preventive Health