Claims and Billing

Medicaid Recipient Insurance Information Update
The standardized form for updating third party liability (TPL) information for Medicaid recipients. The form includes instructions on where to send the TPL Update request and includes complete contact information prepopulated on the form.

LA Encounter Data Certification Form
As a requirement of the Balanced Budget Act, the form must be completed and uploaded to the MMIS SharePoint website concurrently along with the encounter data files sent to the Fiscal Intermediary for processing.

Health Plan Prior Authorization Requirements
Information from each of the five Health Plans about how to request prior authorization for a member.

Sample of e-MEVS screen for Health Coverage
This shows how to verify a Medicaid recipient's Health Plan in e-MEVS. If the member is enrolled in Managed Care, this information is reflected in the right column and lists the Health Plan.

EDI Submission Information for Health Plans
Information on how to sign up for electronic claims submission with each of the five Health Plans.

Medicaid Provider Billing
LDH has provided the links below to assist each Managed Care Organization in obtaining information regarding Medicaid Fee Schedules, Hospital Provider Per Diem Rates, Excluded Services Chart and most recently ICD-10 Implementation for Louisiana Medicaid Legacy Claims. 

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