Together, we can improve health care quality
The Louisiana Department of Health (LDH) is seeking provider assistance to encourage their Medicaid patients to keep their case information (address, financial and employment) updated to ensure eligibility. This can be done through Medicaid’s new Self-Service Portal at https://sspweb.lameds.ldh.la.gov/selfservice/.
Updated information is increasingly important as Medicaid is conducting more frequent eligibility verifications with its new eligibility and enrollment system. Previously, income was verified annually. Additionally, renewals will be handed by mail only, making it important that recipients keep their contact information updated so they do not miss important mail.
Providers are asked to remind their Medicaid patients to respond to any mail from Louisiana Medicaid in the timeline provided in the letter. Failure to respond could result in case closure.
At Aetna Better Health of Louisiana, we value our provider partners. We want to work with you to provide timely, safe and effective health care to our members.
On this site you’ll find:
- ABHLA Quick Guide 2019
- Provider Manual
- Behavioral Health – Provider Manual
- The forms and resources you need
- The latest provider news and notices
- Information about clinical practices
Good communication among our providers and our plan administrators is key to the delivery of quality health care services to our members. Please don’t hesitate to contact us any time with any questions you have.
We will post information for our providers that may be useful.
- 2019 New SUD Requirements
- Admission Criteria by ASAM Level
- LaSOR Recruitment flyer
- ADHD Provider Toolkit
- LaHIPP Re-implementation
- LAHIPP Sub-Specialty-Group
- Managing updates to enrollees' TPL files, March 7. 2016
- Instructions for processing voided emergency ambulance transportation claims
- Improving Care Transitions Summit April 8, 2015 Metairie, LA
Overview of population served
Medicaid eligibility is determined using the Federal Poverty Level income guidelines.
In Louisiana, people qualify to receive Medicaid if they:
- Receive Supplemental Security Income (SSI) from the Social Security Administration (SSA)
- Get financial help from the Office of Family Support (OFS) through the Family Independence Temporary Assistance Program (FITAP)
A person may also qualify for Medicaid coverage if he or she:
- Is disabled according to the Social Security Administration’s definition
- Has corrected vision no better than 20/200
- Is a low-income parent of children under age 19
- Is a child under age 19
- Is pregnant
- Has no insurance and need treatment for breast and/or cervical cancer
- Receives Medicare coverage and is low-income
Adverse Incident Reporting
Notification of Pregnant Members
Completing the Notification of Pregnancy form as early as possible allows us to best service our members to achieve a healthy pregnancy outcome. Please fill out this electronic form and submit so that it may directly reach our care management team in an expedited manner.
The completion of this form will help to identify high-risk pregnancies and assist in linking these members to case management enrollment. If you have any questions, please contact our Provider Services department at 1-855-242-0802.
If you prefer to fax this form, you may fax to 1-866-776-2813
Attn: Case Management
HEDIS Tips & Billing Guides
We strongly encourage you to print and post our HEDIS Tips for Pediatricians and PCPs to assist you with claims submission and adjudication concerns.
- HEDIS 2019 Billing Guide and Tips
- HEDIS 2019 Tips for Behavioral Health Measures
- HEDIS 2019 Tips for PCPs
- HEDIS 2019 Tips for Pediatricians
- HEDIS 2019 Tips for Women's Health