Providers

Attention Providers

Change Healthcare System Interruption

Change Healthcare, our electronic data interchange (EDI) clearinghouse for claims and payment cycle management, continues to address their network interruption related to a security incident. Below are updates for our systems and processes:

  1. Claims payments: Providers who were unable to successfully submit claims during the outage may now submit them either through Availity or PCH Global, or, through Change Healthcare, once connectivity is restored. We have extended the claims timely filing deadline for claims that would have been rejected due to untimely filing during the service interruption. For more details, see the Claims Timely Filing Deadline Extension (PDF) provider notice.
  2. Electronic claims submission through Availity: If you or your clearinghouse do not currently use Availity to submit claims, you must  register with Availity at: https://www.availity.com/Essentials-Portal-Registration. Please choose the registration option that aligns with your business: Healthcare or Atypical Provider.
    • For registration process assistance and other resources, access the training site link on the Availity registration page.
    • If you are currently registered with Availity for another payor, or if you use another clearinghouse, you must request that they route your electronic claims for AmeriHealth Caritas Louisiana to Availity.
    • For additional information and resources see the recent Additional Information for Availity provider notice (PDF).
  3. Manual claims submission through PCH Global: To enroll for claims submission through PCH Global, please go to https://pchhealth.global and click the Sign-Up link in the upper right-hand corner to register.
  4. Complete the registration process and log into your account. You will be asked how you heard about PCH Global; select Payer, then AmeriHealth. Access your profile by clicking on Manage User and then My Profile. You will need to complete all the profile information. When you go to the Subscription Details screen, select the More option on the right-hand side to see how to enter the promo code Exela-EDI.
    When you are ready to submit claims, use the following information to search for our payer information:
    a. Payer name: AmeriHealth
    b.  PO Box: PO BOX 7322
    For a detailed walk through of the registration process, refer to the PCH Global Registration manual, found on the PCH Global website in the Resource Menu.
  5. Electronic remittance advice (ERA/835) files:  Providers can view and download an electronic remittance pdf via the NaviNet provider portal. Providers may also access the ERA/835 file through ECHO Health. For additional information, please see the recent 835 Access provider notice. NOTE: Due to the Change Healthcare security incident, remittance advices generated after February 21, 2024 may not include all of the information previously provided.  As Change Healthcare continues to restore services, this information will become available.
  6. Prior authorization submission and processing: The prior authorization systems continue to operate normally.
  7. Eligibility verification, claim status inquiry, and authorization inquiry: These capabilities continue to be available via NaviNet. If you do not have access to NaviNet provider portal, please visit https://register.navinet.net/ to sign up.
  8. Please note, in the interim, our Provider Services Department will not be able to assist with processing of your payments or obtaining your 835 files any sooner. If you have other questions, you may contact Provider Services at 1-888-922-0007.

We thank you for your partnership and patience, We will continue to provide updates as we work to resolve the downstream impacts of Change Healthcare’s service interruption.

Medicaid provider enrollment

ACT NOW — Enroll in the Medicaid Provider Enrollment Portal Opens a new window Opens a new window

Providers who missed the initial deadline of September 30, 2022, please note that the Provider Enrollment Portal at www.lamedicaid.com remains open for providers required to enroll (see criteria listed below) who have not yet applied. Providers with multiple provider types must complete enrollment for each type. 

Providers who did not complete enrollment by June 30, 2023, have been deactivated, their patients have been assigned to another primary care physician, and they will be terminated from the program. The Provider Enrollment Portal will remain open for providers who failed to enroll but wish to complete an application at a later date. 

Providers who submitted provider enrollment applications to Louisiana Medicaid should allow several weeks for application processing.

Who is required to enroll?

  • Providers who file claims with Louisiana Medicaid (providers enrolled in Fee-for-Service (FFS) Medicaid before December 31, 2021, and providers enrolled with an MCO, DBPM, or Magellan before March 31, 2022.)
  • Ordering, Prescribing, or Referring Providers
    • Ordering, prescribing, or referring (OPR) providers do not bill Medicaid for services rendered, but may order, prescribe, or refer services/supplies for Medicaid beneficiaries.

Providers can find additional information in IB 22-4 Medicaid Provider Enrollment Portal (PDF).

Medicaid urges enrollees to update information to maintain eligibility.

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.

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.

Providers can now update demographic information via NaviNet

AmeriHealth Caritas Louisiana providers now have the ability to attest to the accuracy of practice data and submit demographic changes (PDF) directly through NaviNet via the Provider Data Information Form feature. This feature is only available to professional provider groups at this time.

Learn about the Louisiana State Opioid Response (LaSOR) Project

LDH-OBH in Partnership with LSUHSC–Dept. of Psychiatry is seeking office-based opioid treatment (OBOT) providers. If you are interested in participating, download the LaSor Flyer for more information (PDF).

Partners in Care

As an AmeriHealth Caritas Louisiana provider, you're our partner in member care. Our goal is to help you operate effectively and efficiently. Working with providers like you, we can deliver quality, cost-effective care and better health outcomes for our members.

Get your health plan news via e-mail. Sign up for our free Network News service to receive important health plan communications from AmeriHealth Caritas Louisiana.

Quick contact numbers:

  • Provider Services: 1-888-922-0007
  • Provider Network Management: 1-877-588-2248
  • Credentialing: 1-888-913-0349

Important information:


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