Application Center Monthly Contact Update July 20, 2022
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Submitting Medical Records
•
Error Messages
•
No Decision Messages
•
Dental Services for Waiver Recipients
•
Train Your Brain
•
Reminders
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When submitting the fax cover sheet, please also
indicate the reason for submitting this additional
information, especially when dealing with an EMS
request.
-
Example- Notes: Medical records attached for
additional coverage request for DOS xx-xx-2022.
-
Example- Notes: Income verification for review.
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If you have an Outstation analyst assigned to your
site, please notify them prior/after you send the
medical records for additional DOS for EMS Claims.
•
Outstation analysts must be alerted to pull the
records to submit the MEDT request to the MEDT
Manager.
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Please provide screenshots of error messages that
are received in the Partner Portal to
ApplicationCenter.Service@la.gov
.
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In the past, we mentioned that “No Decision”
messages meant that a person has existing coverage.
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It has been discovered that the “No Decision”
message can also appear when an application needs
caseworker intervention of some kind.
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Beginning July 1, 2022, individuals ages 21 and older
with Intellectual/Developmental Disabilities who are
enrolled in the New Opportunities Waiver (NOW),
Residential Options Waiver (ROW), or the Supports
Waiver are eligible for comprehensive Medicaid
coverage for dental care.
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Comprehensive Medicaid coverage for dental care
includes:
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Q
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1
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How many days are application centers granted to
correct site deficiencies?
•
A. 15
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B. 30
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C. 45
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D. 60
B. 30
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Trusted Users are prohibited from submitting
applications for close friends or family members.
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A. True
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B. False
A. True
In these instances, the applicant should be referred to
another application center or the Customer Service
Unit.
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Which of the following are valid reasons for denial of
application reimbursement?
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A. Exceeds the five-day requirement for interviews
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B. Missing or incomplete situational forms
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C. Failure to complete all required fields
•
D. All of the above
D. All of the above
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AC Resource Library – Check it DAILY
•
Ensure you log into the PARTNER portal and not the Public or Provider portal.
•
Adhere to Medicaid guidelines
•
Trusted Users must conduct Face-to-Face interviews
•
For issues with newborns, email
NEU@la.gov
•
EMS
•
Submit medical records immediately upon receiving the denial due to non-citizenship.
•
For aged EMS claims, email the EMS Aged Claims Status Request form (found on the AC
Resource Library) to
MEDT@la.gov
.
•
AC Meetings are conducted on your behalf. Attendance is required and participation is
encouraged.
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OSS@la.gov
(225) 342 – 1646
Paige Logan
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Outstation@la.gov
(225) 342 – 1646
Paige Logan
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MedicaidOutreach@la.gov
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Darrell.Curtis@la.gov
Darrell Curtis
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ApplicationCenter.Service@la.gov
(225) 342 – 6312
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MEDT@la.gov
Shauna Meche
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NEU@la.gov
Antoinette Rubin
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Valerie McManus, AC Program Monitor, provides important updates for July 2022. Topics include submitting medical records with examples, error and no decision messages clarification, and new dental services for waiver recipients with comprehensive coverage details.
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Presentation Transcript
Application Center Monthly Contact July 20, 2022 Valerie McManus, AC Program Monitor
Agenda Items Submitting Medical Records Error Messages No Decision Messages Dental Services for Waiver Recipients Train Your Brain Reminders
Submitting Medical Records When submitting the fax cover sheet, please also indicate the reason for submitting this additional information, especially when dealing with an EMS request. - Example- Notes: Medical records attached for additional coverage request for DOS xx-xx-2022. - Example- Notes: Income verification for review.
Submitting Medical Records (con.) If you have an Outstation analyst assigned to your site, please notify them prior/after you send the medical records for additional DOS for EMS Claims. Outstation analysts must be alerted to pull the records to submit the MEDT request to the MEDT Manager.
Error Messages Please provide screenshots of error messages that are received in the Partner Portal to ApplicationCenter.Service@la.gov.
No Decision Messages In the past, we mentioned that No Decision messages meant that a person has existing coverage. It has been discovered that the No Decision message can also appear when an application needs caseworker intervention of some kind.
Dental Services for Waiver Recipients Beginning July 1, 2022, individuals ages 21 and older with Intellectual/Developmental Disabilities who are enrolled in the New Opportunities Waiver (NOW), Residential Options Waiver (ROW), or the Supports Waiver are eligible for comprehensive Medicaid coverage for dental care.
Dental Services for Waiver Recipients (con.) Comprehensive Medicaid coverage for dental care includes: Diagnostic Services Preventive Services Restorative Services Endodontics Periodontics Prosthodontics Oral and Maxillofacial Surgery Orthodontics Emergency Services
Question 1 How many days are application centers granted to correct site deficiencies? A. 15 B. 30 C. 45 D. 60
Question 2 Trusted Users are prohibited from submitting applications for close friends or family members. A. True B. False
A. True In these instances, the applicant should be referred to another application center or the Customer Service Unit.
Question 3 Which of the following are valid reasons for denial of application reimbursement? A. Exceeds the five-day requirement for interviews B. Missing or incomplete situational forms C. Failure to complete all required fields D. All of the above
Reminders AC Resource Library Check it DAILY Ensure you log into the PARTNER portal and not the Public or Provider portal. Adhere to Medicaid guidelines Trusted Users must conduct Face-to-Face interviews For issues with newborns, email NEU@la.gov EMS Submit medical records immediately upon receiving the denial due to non-citizenship. For aged EMS claims, email the EMS Aged Claims Status Request form (found on the AC Resource Library) to MEDT@la.gov. AC Meetings are conducted on your behalf. Attendance is required and participation is encouraged.
Optional State Supplement (OSS) OSS@la.gov (225) 342 1646 Paige Logan Outstation Outstation@la.gov (225) 342 1646 Paige Logan Medicaid Outreach MedicaidOutreach@la.gov EPO Programs Manager Darrell.Curtis@la.gov Darrell Curtis Application Centers (AC) ApplicationCenter.Service@la.gov (225) 342 6312 Valerie McManus Medical Eligibility Determinations Team (MEDT) MEDT@la.gov Shauna Meche Newborn Eligibility Unit (NEU) NEU@la.gov Antoinette Rubin US Consulting On-screen M WHT_R1.5V_1208.ppt
Questions US Consulting On-screen M WHT_R1.5V_1208.ppt
