May 25, 2012 BAYOU HEALTH Newsletter 5.25.2012

Medicaid and LaCHIP Recipients in Southwest, Central and North Louisiana Have Until May 29 to Select a Health Plan for June 1 Go-Live Date

Eligible Medicaid and LaCHIP recipients in Geographic Service Area C, the last part of the state to transition to BAYOU HEALTH, who have not yet selected a Health Plan have until Tuesday, May 29 at 5 p.m. Central Daylight Time to choose a Health Plan and be enrolled in that Plan effective for the go-live date of June 1.

Recipients can call 1-855-BAYOU-4U and have an enrollment specialist assist them in finding the plan that is a good fit or follow the automated phone cues to select a Plan, enroll online at www.bayouhealth.com, or fill out the paper forms that come in the BAYOU HEALTH Enrollment Packet and mail or fax these back to the Enrollment Center.

As of this week, 32 percent of eligible recipients in GSA C have selected their own BAYOU HEALTH Plan. BAYOU HEALTH outreach staff held multiple Choose Health events in GSA C throughout the past month to give enrollees an opportunity to meet with representatives of the Health Plans, speak in person with an enrollment specialist and select a Health Plan for their families.

This week, the BAYOU HEALTH Enrollment Center finished auto-enrolling eligible recipients in GSA C who did not select a Plan so they will be in a BAYOU HEALTH Plan effective June 1. Recipients who were auto-assigned can still choose their own Health Plans as long as they make a choice by May 29. Recipients who select a different Health Plan after May 29 will have an effective start date of July 1, and will be in the original Plan they selected or were auto assigned to for the first month of BAYOU HEALTH in their area.

When recipients are enrolled in a Health Plan, either by choice or through auto-assignment, they receive a welcome letter from the Plan to which they are assigned, including information about the services and benefits available through that Plan. Recipients have 90 days from the date on their welcome letters to contact the BAYOU HEALTH staff and select another Health Plan.

After the 90-day enrollment period, recipients can change Plans at any time for cause.

When GSA C goes live on June 1, BAYOU HEALTH will be fully implemented statewide.

FOR PROVIDERS

Providers Should Verify Information Listed in BAYOU HEALTH Plan Directories

As BAYOU HEALTH is implemented statewide, each of the five Health Plans is submitting an electronic Provider Registry to LDH with key information regarding their network providers such as specialty, whether the provider is a PCP, parish, physical address(es) of all practice locations for that provider and phone numbers.

The accuracy and completeness of the information is critical, as it is used to populate the web-based interactive Provider Search on the enrollment website, www.bayouhealth.com, and is also used by BAYOU HEALTH Enrollment Agents to assist recipients in determining the Health Plans with which a provider is "in network." This is important because when choosing a Health Plan, many recipients want to enroll in one in which they can continue seeing their current doctors.

Following the initial implementation of BAYOU HEALTH, as new Medicaid and LaCHIP recipients enroll, they will view this information to choose a Health Plan. Waiver recipients who are transitioning to BAYOU HEALTH on July 1 will also view this information, as well as recipients in GSA C who want to change Plans within their 90-day windows.

The BAYOU HEALTH staff urges providers to check the accuracy and completeness of information by going to www.BayouHealth.com, clicking on "Search for Provider" and reviewing their information listed. Please verify that this information is correct, as this will help your patients find you easily as they choose their BAYOU HEALTH Plans. If your information is not correct for any of the Plans, you are advised to contact that Health Plan and request an immediate correction. Updates to the electronic Provider Registry are made weekly on Mondays, no later than early afternoon.

While printed copies of each Plan's Provider Registry are available through the Enrollment Broker, the most up-to-date information for a Plan's network providers is available in the electronic listing.

Providers who know there is incorrect information listed for them or their practice in a Health Plan's registry should bring this to that Health Plan's attention immediately. Please review the recent Informational Bulletin that BAYOU HEALTH issued on the Provider Registry for information about how to report data errors.

Providers who have trouble getting their information correctly listed with the BAYOU HEALTH Plans should report this to bayouhealth@la.gov so a LDH staff member can follow up with that Plan appropriately.

Providers are reminded that they can tell their Medicaid patients which BAYOU HEALTH Plans they will accept so Medicaid recipients can use this information in picking their Plans. The BAYOU HEALTH team has created a one-sheet flier that providers can use to identify the names of all the BAYOU HEALTH plans in which they will participate.  Providers can distribute this flier to all their Medicaid patients. Providers can download the flier in color or black and white.

Resources Available to Assist Providers During BAYOU HEALTH Transition

LDH is committed to working with providers during the Medicaid program's transition to BAYOU HEALTH, and is offering several resources to assist in answering common questions and provide information.

In general, providers who have questions about a specific Health Plan or are interested in contracting with a Plan should contact the Provider Relations staff of that Health Plan. The contact information for all Plans, including Provider Relations information, is available at www.MakingMedicaidBetter.com.

Medicaid staff continue to hold a call for providers each week day from noon until 1 p.m. The toll-free number to call is 1-888-278-0296, and the Access Code is 729-9088#. It is not necessary to pre-register, and any interested provider can participate.

In addition, the Medicaid staff members who are implementing BAYOU HEALTH have developed a series of numbered Informational Bulletins for providers and stakeholders, which answer frequently asked questions about the initiative and/or consolidate information from each of the five BAYOU HEALTH Plans into a single document. These bulletins cover a range of topics, including recent additions on billing for behavioral health services for BAYOU HEALTH members, hospital observation hours and situational fax numbers for hospitals to submit clinical information and/or prior authorization requests. The bulletins are available at www.MakingMedicaidBetter.com, through the tab "Informational Bulletins." Providers are advised to check the site frequently to see the latest information, and BAYOU HEALTH will send an email alert when a new Information Bulletin is posted or an existing bulletin is revised. Providers who wish to sign up to receive these alerts can sign up with an email address at www.MakingMedicaidBetter.com using the "Subscribe to newsletter" list on the right side of the page, or can email bayouhealth@la.gov and request to be added to the email distribution list.  

If you have questions about BAYOU HEALTH, please email bayouhealth@la.gov, and the appropriate Medicaid staff member will respond. Typically, questions are answered within one business day. Providers who have complaints about BAYOU HEALTH can send these to LDH via the form on the Medicaid program website.

DHH's BAYOU HEALTH website, www.MakingMedicaidBetter.com, contains abundant information about the program, including specific information for providers. This site is updated daily to provide the latest details on BAYOU HEALTH implementation.

Contact Us

BAYOU HEALTH is the State's new approach to delivering and financing health care for nearly 900,000 Medicaid and LaCHIP recipients. Under BAYOU HEALTH, LDH has contracted with five private Health Plans responsible for coordinating and managing the care of their members to improve health outcomes while controlling costs in the program.

For the latest information about BAYOU HEALTH, please visit www.MakingMedicaidBetter.com or the enrollment website, www.bayouhealth.com. To share your comments or ask questions, email bayouhealth@la.gov. Call toll-free 1-855-BAYOU4U (1-855-229-6848) to speak with an enrollment counselor for assistance in picking a Health Plan.