Louisiana Healthy Blue Retrospective Review
Listing Websites about Louisiana Healthy Blue Retrospective Review
Retrospective Review - LA - Louisiana Department of …
(1 days ago) WebRetrospective review determinations are made within thirty (30) calendar days of obtaining the results of any appropriate medical information that may be required, but in no instance later than one hundred and eighty (180) calendar days from the date of service. For service authorization approval, the provider (whether a healthcare …
https://ldh.la.gov/assets/medicaid/MCPP/7.16.2020/588-HBL-RetrospectiveReview.pdf
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Search Medical Policies and Clinical Guidelines - Healthy …
(4 days ago) WebThere are several factors that impact whether a service or procedure is covered under a member’s benefit plan. Medical policies and clinical utilization management (UM) guidelines are two resources that help us determine if a procedure is medically necessary. These guidelines are available to you as a reference when interpreting claim decisions.
https://provider.healthybluela.com/louisiana-provider/medical-policies-and-clinical-guidelines
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Full list of Medical Policies and Clinical Guidelines
(4 days ago) WebMedical Policy. Administrative. ADMIN.00006 Review of Services for Benefit Determinations in the Absence of a Company Applicable Medical Policy or Clinical Utilization Management (UM) Guideline. 09/27/2023. Medical Policy. Administrative. ADMIN.00007 Immunizations. 06/28/2023. Medical Policy.
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Forms Healthy Blue Louisiana
(9 days ago) WebHealthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc. an independent licensee of the Blue Cross and Blue Shield Association. Availity, LLC is an independent company providing administrative support services on behalf of Healthy Blue.
https://provider.healthybluela.com/louisiana-provider/resources/forms
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Louisiana Department of Health Informational …
(9 days ago) WebHealthy Blue - In cases where the members are retroactively eligible with Healthy Blue, the UM nurse will perform a post-service review on any services requiring prior authorization or pre-certification. Providers will be required to notify the National Customer Care (NCC) for all eligible retrospective cases by phone at 1-844-
https://ldh.la.gov/assets/docs/BayouHealth/Informational_Bulletins/15-05/IB15-05_revised_9.1.17.pdf
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Government Business Division Policies and
(3 days ago) WebHealthy Blue has developed a utilization management (UM) program for all Managed Care Organization (MO) overed Services that facilitates the delivery of high quality, cost‐ State of Louisiana (DOJ Agreement, ase‐3:18‐cv‐00608), and subsequent Post-Service or Retrospective Review
https://ldh.la.gov/assets/medicaid/MCPP/12.19.22/1/1717_HBL_Utilization_Management_LA_REG.pdf
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Retrospective Review Authorization Form - Blue Cross and …
(1 days ago) WebRetrospective Review Authorization Form. 18NW3245 09/22 Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross Blue Shield Association. Fax completed form to 1-800-515-1150. Complete this form to submit retrospective authorizations for Blue Cross and Blue Shield of Louisiana and HMO Louisiana, Inc. …
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Home Healthy Blue Louisiana Medicaid
(4 days ago) WebWe help you get the care you need like doctor visits, medicines, therapy and more. In Louisiana, the overall Medicaid program is called Healthy Louisiana. In Louisiana, we: Work with over 13,000 doctors. Have over 160 hospitals to choose from. Work with the top three hospitals in LA ranked by U.S. News and World Report.
https://www.myhealthybluela.com/la/louisiana-home.html
Category: Medicine Show Health
Referrals and Preapprovals Healthy Blue Louisiana …
(7 days ago) WebSome Healthy Blue services and benefits require preapproval. This means that your provider and/or you must ask Healthy Blue to approve those services or benefits before you get them. Preapproval is needed for some services like: Chiropractic services. Diagnostic testing. Some home health services. Nurse-midwifery services.
https://www.myhealthybluela.com/la/care/referrals-preapprovals.html
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Healthy Blue Louisiana Healthy Blue Louisiana Medicaid
(1 days ago) WebIf you have moved or changed addresses, update your information with the Louisiana Department of Health by calling 888-342-6207. If you have any questions about your benefits, we’re here for you. Call Member Services at 844-521-6941 (TTY 711), or log in to your account to. send us a secure message.
https://www.myhealthybluela.com/la/coronavirus.html
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Quality Assurance Healthy Blue Louisiana
(1 days ago) WebHealthy Blue maintains a comprehensive quality assurance program to objectively monitor and systematically evaluate the care and service provided to members. The scope and content of the program reflects the demographic and epidemiological needs of the population served. Studies are planned across the continuum of care and service, with …
https://provider.healthybluela.com/louisiana-provider/resources/quality-assurance
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Welcome Healthy Blue – Louisiana Medicaid
(4 days ago) WebPrint your member ID card. Download your member handbook. And more. You’ll need to access the secure portion of the member website. Member Services: 1-844-521-6941 (TTY 711) Monday through Friday from 7 a.m. to 7 p.m. Visit Medicaid Website. 1-855-264-5277 711. 1-844-209-5406 711. 1-844-521-6942.
https://www.healthybluela.com/healthyblue/welcome.html
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State of Louisiana Department of Health
(7 days ago) Web2022 Healthy Louisiana EQRO Compliance Audit . Healthy Blue of Louisiana . Period of Review: January 1, 2021 – December 31, 2021 . ISSUED NOVEMBER 2022 . REVISED FEBRUARY 2023 . Prior to the review, HBL submitted written policies, procedures and other relevant documentation to support its
https://ldh.la.gov/assets/medicaid/EQRO/2022/2022ComplianceReviewReport_HealthyBlue.pdf
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Retrospective Review Authorization Form - Blue Cross and …
(1 days ago) WebFax completed form to 1-800-515-1150. Complete this form to submit retrospective authorizations for Blue Cross and Blue Shield of Louisiana and HMO Louisiana, Inc. members for inpatient, outpatient and office services that require an authorization. Retrospective review requests have up to a 30-day response time.
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Reimbursement Policy - Louisiana Department of Health
(2 days ago) WebHealthy Blue Medicaid Managed Care https://providers.healthybluela.com Healthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc., an independent licensee of the Blue Cross and Blue Shield Association. BLA-RP-0133-19 April 20190215-21 [rdate] Reimbursement Policy Subject: Code and Clinical Editing Guidelines Effective Date:
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Independent Review Provider Reconsideration Form
(1 days ago) WebHealthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc., an independent licensee of the Blue Cross and Blue Shield BLAPEC-1909-20 July 2020 Return completed form by mail or email to: Healthy Blue ATTN: Independent Review 10000 Perkins Rowe, Suite G-510 Baton Rouge, LA 70810 …
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Medicaid Healthy Blue Louisiana Medicaid
(2 days ago) WebHealthy Blue covers extra benefits eligible members cannot get from fee-for-service Medicaid. These extra benefits are called value-added services. We offer the following: To make an appointment or find a dentist near you, call DentaQuest at 844-234- 9835 (TTY 800-466-7566) or MCNA Dental at 855-702-6262 .
https://www.myhealthybluela.com/la/benefits/medicaid-plan.html
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Find a Doctor Healthy Blue Louisiana Medicaid
(8 days ago) WebVisit the Superior Vision member website. On the website, enter your Healthy Blue member ID — this will help make sure you find a provider who works with Medicaid. Need more help? Call Superior Vision at 1-800-787-3157 (TTY 1-800-735-2258) Monday through Friday from 7 a.m. to 7 p.m.
https://www.myhealthybluela.com/la/care/find-a-doctor.html
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Manuals, Forms and Resources Louisiana Healthcare Connections
(9 days ago) WebContracting and Credentialing. Note: If you need help opening files, see Instructions for Downloading Viewers and Players. Louisiana Healthcare Connections offers Louisiana Medicaid and affordable health plans. Get covered with …
https://www.louisianahealthconnect.com/providers/resources/forms-resources.html
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State of Louisiana Department of Health Healthy Blue
(Just Now) WebState of Louisiana Department of Health Healthy Blue Annual External Quality Review Technical Report Review Period: July 1, 2018 – June 30, 2019 independent evaluation of the services provided by Healthy Blue for review period July 1, 2018–June 30, 2019. (Retrospective Performance Indicator reporting): November 6, 2014–
https://ldh.la.gov/assets/medicaid/EQRO/AnnualTechnicalReport2018-2019HealthyBlueFinal.pdf
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Behavioral Health Concurrent Review Form for Inpatient, RTC, …
(3 days ago) Web* Availiy, LLC is an independent company providing admnistrative support services on behalf of Healthy Blue . https://providers.healthybluela.com . Healthy Blue is the trade name of Communty Care Health Plan of Louisiana, Inc. an independent lcensee of the Blue Cross and Blue Shield Association. BLAPEC-1990-20 August 2020
https://provider.healthybluela.com/dam/publicdocuments/LALA_CAID_BHConcurrentReviewForm_6.pdf
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How to Renew Healthy Blue Louisiana Medicaid
(4 days ago) WebYou can also renew by calling the Louisiana Department of Health at 1-888-342-6207 Monday through Friday from 8 a.m. to 4:30 p.m. or visiting a local Medicaid regional office. Need this video in Spanish?
https://www.myhealthybluela.com/la/benefits/renew.html
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