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Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary

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Statewide Initiatives



211 - Get Connected. Get Answers.

DHH Offers Resources to Assist Providers During Pharmacy Integration

Wednesday, October 31, 2012  |  Contact: Bayou Health (225) 342-7878

BATON ROUGE—Medicaid leadership have established resources in place to assist pharmacists and prescribing providers during the Bayou Health pharmacy integration.

To ensure questions are answered quickly and accurately, pharmacists are encouraged to first direct pharmacy integration specific questions to the appropriate plan. Questions can be directed by plan as follows:

Amerigroup

  • General Provider Issues - Call Provider Relations - 1-800-454-3730
  • Pharmacy Contracting Issues - Call CVS/Caremark - 1‐480‐391‐4623
  • Amerigroup Member with Issues - Have the Member Call Member Services - 1-800-600-4441
  • Claims/Billing Issues - Call CVS/Caremark - 1‐800-364-6331

LaCare

  • General Provider Issues - Call Provider Relations - 1-888-922-0007
  • Pharmacy Contracting Issues - Call PerformRx - 1‐800‐555‐5690
  • LaCare Member with Issues - Have the Member Call Perform Rx Member Services - 1-866-452-1040
  • Claims/Billing Issues - Call PerformRx - 1-800-684-5502

Louisiana Healthcare Connections

  • General Provider Issues - Call Provider Relations -1-866-595-8133
  • Pharmacy Contracting Issues - Call USScript - 1‐877‐690‐9330
  • Louisiana Healthcare Connections Member with Issues - Have the Member Call Member Services - 1-866-595-8133
  • Claims/Billing Issues - Call Provider Relations - 1-866-595-8133

Providers should note that pharmacy services will remain in legacy Medicaid for recipients in the Community Health Solutions and United Healthcare plans, and Molina, the Medicaid fiscal intermediary, will provide pharmacy provider relations support.

Community Health Solutions

  • General Provider Issues - Call Provider Relations - 1-855-247-5248
  • Pharmacy Contracting Issues - Call Molina Provider Relations - 1‐877‐690‐9330
  • Community Health Solutions Member with Issues - Have the Member Call Member Services - 1-855-247-5248
  • Claims/Billing Issues - Call Provider Relations 1-855-247-5248

United Healthcare

  • General Provider Issues - Call Provider Relations - 1-866-675-1607
  • Pharmacy Contracting Issues - Call Molina Provider Relations - 1‐877‐690‐9330
  • United Healthcare Member with Issues - Have the Member Call Member Services - 1-866-675-1607
  • Claims/Billing Issues - Call Provider Relations 1-866-675-1607

Any other pharmacy-related questions can be directed to the Medicaid Pharmacy Program at 1-800-437-9101. Pharmacists seeking clarification on average acquisition costs in the fee-for-service Medicaid program should contact the Myers & Stauffer Pharmacy Reimbursement Help Desk at 1-800-591-1183

As DHH's Bayou Health team finalizes the infrastructure needed for the pharmacy integration to go live, they have engaged a "Readiness Response" mode of operation to quickly answer questions and address concerns. A "Readiness Response Center" at DHH headquarters will be staffed throughout the day to respond to issues as they arise. Bayou Health leaders and staff from the Medicaid pharmacy program will be available to help resolve any concerns or answer questions brought to their attention related to the transition. Providers can call 1-800-437-9101 to contact the Readiness Response Center.

Providers can also submit questions by email to bayouhealth@la.gov, and the appropriate staff will address any issues or concerns. Staff are typically able to respond within one business day.

DHH continues to hold a provider phone call at noon each weekday to address Bayou Health questions, with the Monday, Tuesday and Friday calls focused on pharmacy. Any provider is welcome to call in, and pre-registration is not required. The call in number is 1-888-278-0296, and the access code is 6556479#. The Wednesday call at this number is for hospitals and other provider types.

The Thursday call, administered by Magellan, focuses on specialized behavioral health services offered through the Louisiana Behavioral Health Partnership. The call-in number for Thursday is 1-888-205-5513 and the access code is 827176. Any provider can call in on any day, but priority will be given to questions about that day's topic, and the Medicaid staff who work in a particular area will participate in the calls on that scheduled day.

Pharmacists and prescribing providers are encouraged to review Informational Bulletin #27, Provider Issue Escalation and Resolution, to see how Bayou Health providers are instructed to address issues as they arise. Informational Bulletins are available at www.MakingMedicaidBetter.com under the "Informational Bulletins" tab.

Bayou Health members  who have questions about their Bayou Health enrollment or who want to know which plan they are in can call 1-855-BAYOU-4U (1-855-229-6848) or visit www.bayouhealth.com. Questions about the legacy Medicaid program can be directed to the eligibility hotline, 1-888-342-6207.