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Claims and Billing
Medicaid Recipient Insurance Information Update (Medicare Only)
The standardized form for updating third party liability (TPL) information for Medicaid recipients. The form includes instructions on where to send the TPL Update request and includes complete contact information prepopulated on the form.
LA Encounter Data Certification Form As a requirement of the Balanced Budget Act, the form must be completed and uploaded to the MMIS SharePoint website concurrently along with the encounter data files sent to the Fiscal Intermediary for processing.
Sample of e-MEVS screen for Health Coverage
This shows how to verify a Medicaid recipient's Health Plan in e-MEVS. If the member is enrolled in Managed Care, this information is reflected in the right column and lists the Health Plan.
Medicaid Provider Billing
LDH has provided the links below to assist each Managed Care Organization in obtaining information regarding Medicaid Fee Schedules and Hospital Provider Per Diem Rates.
- Louisiana Medicaid Fee Schedules
- Hospital Provider Per Diem Rates (Updated 11.6.2024)
Medicaid Enterprise Systems
The Medicaid Enterprise Systems (MES) Division administers the contract and monitors the budget of the Medicaid Fiscal Intermediary (Gainwell Technologies), which is responsible for the payment of claims to providers and the timely and accurate reporting to state and federal personnel and private sector partners.MES processes 51 million Medical claims annually for more than 30,000 Medicaid providers.
To best accommodate business partners, the MES Division consists of two key operation units:
The responsibilities in these sections are required by the Centers for Medicare and Medicaid Services (CMS) for a certified Medicaid Management Information System (MMIS).
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