CONTACT/REFERRAL INFORMATION
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1 CONTACT/REFERRAL INFORMATION Fiscal Intermediary: Molina Medicaid Solutions (formerly UNISYS Corporation) Electronic Data Interchange (EDI) Electronic claims testing and assistance P.O. Box Baton Rouge, LA Phone: Fax: Pharmacy Point of Sale (POS) P.O. Box Phone: (Toll Free) Phone: (Local) *After hours please call REVS line Pre-Certification Unit (Hospital) Pre-certification issues and forms P.O. Box Baton Rouge, LA Phone: Fax: Prior Authorization Unit (PAU) Prior authorization issues, requests and forms. Provider Enrollment Unit (PEU) Provider Enrollment, direct deposit problems, reporting of provider file changes and ownership changes, NPI, and EDI submitter enrollment Provider Relations (PR) Billing and training questions P.O. Box Baton Rouge, LA Phone: Op 1(Home Health) Phone: (Dental) Phone: (DME & All Other) P.O. Box Baton Rouge, LA Phone: Fax: P.O. Box Toll Free: (800) Phone: (Local) Fax: Page 1 of 5
2 Recipient Eligibility Verification (REVS) Web Technical Support e-cdi technical support Phone: (Toll Free) Phone: (Local) Phone: (Toll Free) Department of Health and Hospitals (DHH) Division of Administrative Law (DAL) Health and Hospitals Section Appeals P.O. Box Phone: Fax: Health Standards Section (HHS) Licensing Standards Louisiana Medicaid Website Provider Web Portal Louisiana Children s Health Insurance Program (LaCHIP) General Medicaid and card questions P.O. Box 3767 Phone: Fax: hss.mail@la.gov General Medicaid Hotline: General Medicaid Hotline: LaCHIP: (Local) LaCHIP: (Toll Free) Page 2 of 5
3 Office of Aging and Adult Services (OAAS) Office for Citizens with Developmental Disabilities (OCDD) State Office P.O. Box Phone: Fax: P.O. Box 3117 Phone: (Local) Phone: (Toll Free) Fax (225) Office of Management and Finance (Bureau of Health Services Financing) MEDICAID Office of Public Health Food and Drug Program Program Integrity (PI) Section Report Fraud Baton Rouge, LA Phone: Fraud and Abuse Hotline: Fax: Page 3 of 5
4 Supplemental Payments Section/Rate and Audit (R&A) Unit Recipient Assistance for Authorized Services Phone: Fax: Take Charge (Family Planning Waiver) P.O. Box Phone: (888) Fax: (877) Recovery and Premium Assistance Third Party Liability (TPL) TPL Recovery, Trauma P.O. Box 3558 Phone: Fax (225) Other Helpful Contact Information Centers for Medicare and Medicaid Services (CMS) OASIS, CMS-485 Form Governor s Office of Homeland Security and Emergency Preparedness (GOSHEP) Home Health Emergency Model Plan Page 4 of 5
5 Other Helpful Contact Information Accreditation Organizations (DME) Accreditation Commission for Health Care, Inc. American Board for Certification in Orthotics, Prosthetics & Pedorthics, Inc. (ABC) Board of Certification/Accreditation, International (BOC) Commission on Accreditation of Rehabilitation Facilities (CARF) Community Health Accreditation Program (CHAP) Healthcare Quality Association on Accreditation (HQAA) National Association of Boards of Pharmacy (NABP) The Compliance Team, Inc. The Joint Commission (JC) Page 5 of 5
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