Bayou Health Plan Prepaid System

8 hours ago BAYOU HEALTH PLAN PREPAID SYSTEM COMPANION GUIDE vi Version 4.4 August 2014 Darlene White Appendix D Updated occurrences of CCN to BAYOU HEALTH, where applicable p. 60: changed schedule of Provider Registry submission from semi-weekly to weekly p. 76: changed CCN-O-010 and CCH-W-010 DETAIL LAYOUT FOR Prescriber NPI (1171-1180) to …

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8 hours ago Will be “carved in” to the three prepaid Bayou Health plans. Those three plans are: • Amerigroup • LaCare • Louisiana Healthcare Connections As a result, pharmacy services will be reimbursed through these plans for the Medicaid and LaCHIP recipients that have joined these three Bayou Health plans.

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8 hours ago BAYOU HEALTH by choosing a Health Plan. Some recipients will have the option to choose a Health Plan or keep their current Medicaid coverage, and some recipients are excluded from BAYOU HEALTH at this time. Health Plan Choice Required Medicaid and LaCHIP recipients under age 19 Parents of Medicaid recipients under age 19

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4 hours ago Prepaid Inpatient Health Plan (PIHP) Coordinated System of Care (CSoC) Systems Companion Guide Version 1.0: October 2015 i The Department of Health and Hospitals (DHH) will provide maintenance of all documentation changes to this Guide using the Change Control Table as shown below. Change Control Table Author of Change Sections Changed

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Just Now Attention All Pharmacy Providers – BAYOU HEALTH Prepaid Plan PBM Information. ATTENTION DENTAL - ORAL SURGEON - PROVIDERS - CORRECTION to 12/1/2015 Remittance Advice . ATTENTION DENTAL – ORAL SURGEON PROVIDERS REGARDING CLAIMS INAPPROPRIATELY PAID BY LEGACY MEDICAID FOR DOS …

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8 hours ago Bayou Health Plan Readiness Results. The following information is listed for historical purposes only. It will not be updated. The five Health Plans contracted under Bayou Health (Feb. 2012 - Jan. 2015) are fully prepared to manage health care for some 865,000 Medicaid and LaCHIP recipients, LDH announced.Operational and systems readiness reviews were conducted by …

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9 hours ago The Prepaid Health Plan model provides for a traditional, riskbearing managed care - organization. Prepaid health plans must establish networks of providers to cover the full range of Medicaid services, including primary, secondary, and hospital care. Providers are not required to be enrolled Louisiana Medicaid providers to participate.

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1 hours ago MCO System Companion Guide for 2015 Contract (Updated 5.20.21) Provider Network Companion Guide (Updated 5.20.21) Prepaid Inpatient Health Plan CSoC Systems Companion Guide (Updated March 2020) State Fair Hearing Companion Guide (Updated 6.25.14) System Companion Guides from February 2012 to January 2015 Bayou Health Contracts.

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7 hours ago Bayou Health Prepaid Plans - Ameri-group, LaCare and Louisiana Health-care Connections – are now managed by their respective Bayou Health Each Health Plan has its own formulary, preferred drug list and prior authorization requirements. It’s critical that prescribing behavioral health pro-viders and facilities are aware of the

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866-595-81338 hours ago Call us at 1-866-595-8133 ( Hearing Loss: 711 ). You can also view more information about Louisiana Healthcare Connections in our Member Handbook. All services must be medically necessary. Your Primary Care Provider will work with you …

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Just Now REMINDER TO BAYOU HEALTH PLAN PROVIDERS: Claims for enrollees in the Prepaid Plans must be billed to and will be paid by the Bayou Health Plan. Claims for enrollees in the Shared Plans must be billed to Bayou Health Plan for pre-processing and then submitted by the Plan to Molina for adjudication and payment.

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3 hours ago Prepaid Inpatient Health Plan (PIHP) Coordinated System of Care (CSoC) Systems Companion Guide Version 9 – November 2017 ii The Department of Health and Hospitals (LDH) will provide maintenance of all documentation changes to this Guide using the Change Control Table as shown below. Change Control Table Author of Change Sections Changed

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7 hours ago Bayou Health Prepaid plans, Bayou Health Shared Savings plans, and Dental managed care plan. In partnership with managed care contractor and providers, the program implements best practices for improving health outcomes for LA’s Medicaid population, increasing access to quality care and provided fiscal sustainability.

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1 hours ago An MCO model of Bayou Health Prepaid and an enhanced primary case management (ePCCM) fee- for-service model in Bayou Health Shared Savings. The State’s enhanced MCO Medicaid Program increased accountability for delivery of services and healthcare outcomes for patients.

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5 hours ago Bayou Health faces changes, and queries from legislators found the insurance-based “prepaidplan to be more cost-effective to the state. In the comparison, the agency performed a “risk

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6 hours ago In June, Secretary Greenstein and DHH Medicaid leadership released an initial concept paper outlining their plan to include pharmacy as a benefit of the Bayou Health prepaid plans. Additionally, DHH sought public input through seven regional forums, four of which took place after business hours so pharmacists and other providers could attend.

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8 hours ago Prepaid Plan: Traditional managed care model in which BAYOU HEALTH Plans establish networks of providers. The Health Plans receive a monthly fee for each enrollee covered to provide core benefits and services, with prior authorizations and claims payment handled directly through the entity.

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Frequently Asked Questions

How is bayou health transforming louisianas health care system?

Through BAYOU HEALTH, the Department of Health and Hospitals (DHH) is transforming the way health care services will be delivered to Louisiana’s Medicaid and LaCHIP (Louisiana Children’s Health Insurance Program) recipients going forward.

How do i select a bayou health plan?

• Choose a Health Plan via website: bayouhealth.com. • Choose a Health Plan, with counselor support, at one of the scheduled local area outreach meetings. Question: What if Medicaid/LaCHIP recipients do not select a BAYOU HEALTH Plan?

When did bayou health managed care organizations register for e mevs?

Behavioral Health Providers Enrolled Through Bayou Health Managed Care Organizations Registering to Use e-MEVS for Eligibility Inquiries for December 2015 October 29, 2013 ***Bayou Health Retro Enrollment/Disenrollment (DHH has delayed the implementation of this process. Further information will be forthcoming on this web site.)

What is a louisiana medicaid card used for?

One will be the standard Louisiana Medicaid card. This card can be used by providers to verify (through the Medicaid fiscal intermediary) eligibility and the patient’s current Health Plan. The second card will be a Health Plan card – providers can use information on this card to contact the Health Plan with questions and problems.

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