Description: This chapter explains coverage, policies, procedures, and claims filing requirements applicable to the Pharmacy Program. DentaQuest is excited to expand our partnerships in Louisiana as we begin administration of the Louisiana Medicaid Dental Program January 1, 2021. Fillings & extractions. to receive additional information on joining FCL as a partnering provider. Each state operates its own Medicaid program All services marked with an underscored asterisk (*) in the code … Description: This chapter specifies the requirements for reimbursement for services provided through an approved waiver of the Title XIX regulations. Description: This chapter provides information on the covered services, eligibility criteria, provider and program requirements of the EPSDT Medicaid program and IDEA-related services for Medicaid recipients under 21 years of age. Issued March 15, 2012 . Amerigroup and Aetna contract with DentaQuest to manage the dental benefit. Each of these Plans is accountable to the Louisiana Department of Health (LDH). • When providers see one of our enrollees under the Medicaid Dental Health Program, they simply bill DentaQuest as usual. We emphasize early intervention and promote access to necessary dental care, thereby improving health outcomes for We want to make joining Louisiana Healthcare Connections easy. PROVIDER MANUAL Chapter Five of the Medicaid Services Manual ... Louisiana Medicaid offers support via the internet and telephone. Contact 1-877-587-9331, visit www.fcldental.com, or e-mail This email address is being protected from spambots. LOUISIANA MEDICAID PROGRAM ISSUED: 03/15/12 REPLACED: CHAPTER 16: DENTAL SERVICES SECTION: TABLE OF CONTENTS PAGE(S) 4 Page 1 of 4 Table of Contents CHAPTER 16 DENTAL SERVICES EPSDT, … Description: This chapter specifies the requirements of providing Non-Emergency Medical Transportation (NEMT), a non-ambulance transportation provided to Medicaid recipients to and from Medicaid covered services. You may also complete a Provider or Recipient Fraud Form, which is available online at www.ldh.la.gov.Scroll to bottom of … Description: Defines the services, limitations, provider and recipient requirements, and prior authorization rules regarding Durable Medical Equipment. To make an appointment, find a dentist near you or have a question about service limits, visit DentaQuest's website or call 1-844-234-9835 (TTY 1-800-466-7566). Because of this, there is an opportunity for dentists to participate in one or more of these Healthy Louisiana plans. Medicaid Provider Manuals and Other Resources. addyb9551a0c97f99822a00c83abd8093d13 = addyb9551a0c97f99822a00c83abd8093d13 + 'DentaQuest' + '.' + 'com'; Doc#: PCA-1-016543-05292020_ 2020 V42.12102019 2020 Care Provider Manual Physician, Health Care Professional, Facility and Ancillary Care Louisiana Description: This provider manual chapter specifies the requirements for reimbursement for services provided through an approved waiver of the Title XIX regulations. var path = 'hr' + 'ef' + '='; Alaska. This document is a combination of federal laws, state laws and Department of Health (LDH) policy. Click here to view the Alaska EPSDT web page, … 3 Table of Contents. It is easy to begin the application process using app central on our website - http://www.dentaquest.com/dentists/, Visit our website for additional information: http://www.dentaquest.com/state-plans/regions/louisiana/. Description: This manual chapter provides information relative to coverage policies for inpatient and outpatient hospital services. Each remaining chapter is dedicated to a specific program or service and outlines the policies, procedures, qualifications, services and limitations to that service or program. Description: Defines the waiver designed to decrease the rate of unintended pregnancies for women in the targeted population through access to family planning, and to decrease Medicaid expenditures for unintended pregnancy and related services through provision of family planning services. and Events, Annual Session/New Orleans Dental Conference, http://www.dentaquest.com/state-plans/regions/louisiana/, https://dental.envolvehealth.com/providers.html. HPSAs are defined service areas that demonstrate a critical shortage of primary care physicians, dentists, or mental health providers. PROVIDER MANUAL . The first chapter, "General Information and Administration," contains information applicable to all enrolled providers. Supported Employment, Day Habilitation, Prevocational, Habilitation, Respite, Housing Stabilization Transition, Housing Stabilization, Personal Emergency Response System, and Support Coordination are each defined in this chapter. Description: This chapter specifies the requirements in maintaining an ICF/DD. Description: The purpose of this chapter is to set forth the conditions and requirements of ESRD facilities for reimbursement under the Louisiana Medicaid program. Click here to access the CMS 2018 bulletin on aligning covered dental services with dental periodicity schedules. Description: Free-standing birthing centers (FSBCs) provide delivery services to eligible Medicaid recipients not requiring hospitalization and which the expected duration of services would not exceed 24 hours following an admission. If … Louisiana Medicaid Dental Health Program. You need JavaScript enabled to view it. You just need to be a Louisiana resident. Federally Qualified Health Centers (FQHC). In order to ensure your facility is listed in their provider directory, please complete each of the documents and fax them to 1-504-335-2263, or email them to This email address is being protected from spambots. The 2006 American Dental Association (ADA) Dental Claim Form is required when submitting hardcopy claims to Medicaid and will be the only dental … The first chapter, "General Information and Administration," contains information applicable to all enrolled providers. Description: Pursuant to the Louisiana Legislature’s passage of R.S. Dental groups are required to complete an … Cleanings and x-rays. . Description: Provides information to aid the provider in understanding and implementing federal and state Program of All-inclusive Care for the Elderly (PACE) policies and procedures. Dental groups must be enrolled in the Louisiana Medicaid program prior to rendering services to a Medicaid beneficiary. var addy_text3ed9254eeff26cffe7a32c2cb4a8aa34 = 'MCNALA' + '@' + 'mcna' + '.' + 'net';document.getElementById('cloak3ed9254eeff26cffe7a32c2cb4a8aa34').innerHTML += '
'+addy_text3ed9254eeff26cffe7a32c2cb4a8aa34+'<\/a>'; Description: Claims/authorizations for dates of service on or after October 1, 2015 must use the applicable ICD-10 diagnosis code that reflects the policy intent. var prefix = 'ma' + 'il' + 'to'; *This is an added benefit offered by UnitedHealthcare Community Plan. The intent of the service provider manual is to present useful information and guidance to providers participating in the Louisiana Medicaid Program. TABLE OF CONTENTS . This manual outlines the covered services, recipient and provider requirements for IHS. Members who need dentures or denture repairs may qualify for coverage through their Medicaid dental plan. var addy4edc4e3fea12e43e442933417287eaa4 = 'pr' + '@'; Personal Care Services (LT-PCS AND EPSDT-PCS). The MAC Program is a Medicaid program in which school districts can be reimbursed for medically related administrative functions which the school district staff performs on behalf of Medicaid eligible and potentially eligible students. Amerigroup and Aetna contract with DentaQuest to manage the dental benefit. This document is a combination of federal and state laws and LDH policy that provide support to such individuals. Interested in enrolling in the Healthy Louisiana Medicaid dental program? We are here to assist you in any way we can - 800-508-6785 – This email address is being protected from spambots. COVERED SERVICES SECTION 22.1 . document.getElementById('cloakb9551a0c97f99822a00c83abd8093d13').innerHTML = ''; Please refer to the EPSDT Dental Program section of the Dental Services Manual for complete guidelines, policies and limitations for each procedure. Dental services for members younger than age 21 are covered through MCNA Dental. All services marked with an asterisk (*) in the code column require prior authorization. There are no income requirements to become a patient at the dental school. PROFESSIONAL SERVICES PROVIDER MANUAL This provider manual, as part of your Provider Agreement and related addendums, … Description: Sets forth the conditions and requirements an ASC must meet in order to qualify for reimbursement under the Louisiana Medicaid program. Members younger than 21. document.getElementById('cloak3ed9254eeff26cffe7a32c2cb4a8aa34').innerHTML = ''; var prefix = 'ma' + 'il' + 'to'; For information relative to credentialing and benefits offered, go to. An HPSA can be a distinct geographic area such as a parish or grouping of census tracts, a specific population group within a defined geographic area (such as a population under 200% poverty), or a specific public or non-profit facility such a state hospital. This document is a companion to the fact sheet, Medicaid Adult Dental Benefits: An Overview, which outlines states’ coverage of dental benefits for adults in Medicaid. Off-Schedule Screenings . DENTAL SERVICES … You need JavaScript enabled to view it. So, don’t wait begin the process today to participate with DentaQuest as a provider for Medicaid Children and Adults. policies and limitations of the Medicaid of Louisiana, EPSDT Dental Program. Description: Outlines the regulations and requirements that providers must follow for participation in home and community-based waiver providers. These services are covered when you use an approved dental care provider. Description: This chapter offers the provider a description of the Residential Options Waiver (ROW), a 1915(c) waiver, which is a service system centered on the needs and preferences of the recipients and integration of recipients within their communities. HOW TO CONTRACT WITH HEALTHY LOUISIANA (Louisiana's medical Medicaid program managers, updated 10/23/19). To find an in-network dental provider in your area, use our Find a Provider tool. All services marked with an underscored asterisk (*) in the code … You need JavaScript enabled to view it. Healthy Louisiana features five health plans, and each offers dental benefits for Adults 21 years and older, beyond the traditional adult denture services and dental care for children and adolescents that have been available under Medicaid in Louisiana previously.
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