Medicaid Provider Enrollment Portal

Applications must be submitted by September 30, 2022. Enroll Now!

Louisiana Medicaid hosted a series of provider webinars regarding the upcoming Provider Enrollment deadline. Click here to view a recording of the webinar presentation and webinar slide deck.

 

Providers that file claims with Louisiana Medicaid must enroll in Medicaid's new web-based provider enrollment portal. Federal laws enforced by CMS, including the Affordable Care Act and the 21st Century Cures Act, require states to screen and enroll all providers. 

The enrollment portal must be used by Medicaid providers. This includes fee-for-service, managed care organization (MCO) only, Dental Benefits Program Manager (DBPM), and Coordinated System of Care (CSoC) providers. 

The deadline to submit an enrollment application is September 30. Providers must allow several weeks from the time of the application submission to the time that enrollment is considered complete. Claims will be denied beginning December 31, 2022 for providers who have not completed the enrollment process.

The September 30 deadline applies to:

  • Providers enrolled with Fee for Service (FFS) Medicaid prior to December 31, 2021
  • Providers enrolled with an MCO, DBPM or Magellan prior to March 31, 2022

Providers should visit www.lamedicaid.com to enroll. Providers will need several data points to complete enrollment, including Louisiana Provider ID, NPI, city, state and zip code. This information is included in a letter from Gainwell Technologies.

New FFS Medicaid providers should continue to follow the enrollment process outlined for FFS Medicaid and will be invited to enroll in the portal at a later date.

New MCO, DBPM & Magellan providers should continue to follow the enrollment processes outlined for MCO, DBPM and Magellan and will be invited to enroll in the portal at a later date.

If providers are unsure of their enrollment status, a Provider Portal Enrollment Lookup Tool is available at www.lamedicaid.com. Data elements that may be used for lookup include:  NPI, provider name, provider type, specialty, address, city and state, or zip code. Results given will show provider’s status as either enrollment complete, action required or currently in process by Gainwell. Providers that are not shown in results are not required to enroll at this time. Invitation letters for those providers will be sent at a later date. The Lookup Tool is updated daily and the results may be downloaded. If your information has not been processed within 15 business days, please contact Gainwell Technologies by emailing louisianaprovenroll@gainwelltechnologies.com or contacting  1-833-641-2140 for a status update on enrollment and any next steps needed to complete the process.

When should I enroll?

The deadline to submit an enrollment application is September 30. Providers must allow several weeks from the time of the application submission to the time that enrollment is considered complete. Claims will be denied beginning December 31, 2022 for providers who have not completed the enrollment process.

The September 30 deadline applies to:

  • Providers enrolled with Fee for Service (FFS) Medicaid prior to December 31, 2021
  • Providers enrolled with an MCO, DBPM or Magellan prior to March 31, 2022

Who does this requirement apply to?

This requirement applies to Medicaid providers. This includes any provider that cares for Medicaid members. Providers include, but are not limited to:

  • Individual practitioners — such as physicians, nurse practitioners, and physical therapists
  • Any physicians and other professionals who may only order or refer beneficiaries to services, but do not render services – for example, providers who only prescribe medications or order imaging services, such as an x-ray.
  • Provider organizations such as hospitals, group practices, and skilled nursing facilities
  • Providers and suppliers of medical equipment or goods, for example, pharmacy providers and medical equipment providers
  • Dental providers
  • Behavioral health providers
  • Out-of-state providers who treat Louisiana Medicaid members
  • Waiver providers and support coordination agencies
  • Providers who enter single case agreements with a managed care organization for claims payment

How does this enrollment and screening process on the state portal differ from enrollment and screening as a managed care provider or a fee-for-service provider?

Under the current process, managed care providers have not been required to enroll directly with Louisiana Medicaid through the fiscal intermediary. A provider that becomes a managed care provider is credentialed and contracted with an MCO, DBPM and/or Magellan. If the provider is a fee-for-service provider, they must enroll as a Louisiana Medicaid provider and complete a screening process through the state’s fiscal intermediary, Gainwell.  

The enrollment and screening process will be managed for all providers through the web-based portal. This will bring the state into compliance with current federal requirements. Completing this enrollment process through the fiscal intermediary does not require a provider to participate in the fee-for-service model. Providers may continue with their current business model and will not be mandated to provide care through the fee-for-service model, unless that is their preference.  Managed care providers must still be enrolled, credentialed and contracted with the MCOs, DBPMs and/or Magellan. Fee-for-service providers will not have to complete additional enrollment forms with Gainwell.

Per CMS requirements, all providers must be screened by the state at the following intervals:

  • When they initially apply for and submit an application to become a Medicaid provider;
  • Upon reenrollment (reactivation of a previously closed provider number) in the state’s Medicaid program; and
  • At least once every five years to revalidate their enrollment, which is similar to the recredentialing process that all MCOs, DBPMs and Magellan complete every three years. Providers also must still complete the recredentialing process with MCOs, DBPMs and/or Magellan every three years.

 

What information do I need to enroll?

Providers will need several data elements from their Gainwell letter to complete their enrollment, including: Louisiana Provider ID, NPI, city, state and zip code.

How do I request a reprinted letter?

If a provider does not have their Gainwell letter or the information needed to enroll, they can email louisianaprovenroll@gainwelltechnologies.com to request a reprinted letter be mailed. Email requests must include the provider name and the NPI. Providers may send multiple provider requests in a single email.

Reprinted letter requests will only be accepted by email. No other form of submission is accepted. Providers will receive a confirmation email from Gainwell when the submission is received. That email will include an anticipated turnaround time for the response.

What happens if I don’t complete this process?

Any existing Medicaid provider that does not submit an enrollment application in the Louisiana Medicaid Provider Enrollment Portal by September 30, 2022 will have their claims denied beginning December 31,2022. These providers must complete the state’s enrollment process for claims to be approved by fee-for-service Medicaid, the MCOs, the DBPMs, and/or Magellan.

How do I check my enrollment status?

If providers are unsure of their enrollment status, a Provider Portal Enrollment Lookup Tool is available at www.lamedicaid.com. Data elements that may be used for lookup include:  NPI, provider name, provider type, specialty, address, city and state, or zip code.  Results given will show provider’s status as either enrollment complete, action required or currently in process by Gainwell. Providers that are not shown in results are not required to enroll at this time. Invitation letters for those providers will be sent at a later date. The Lookup Tool is updated daily and the results may be downloaded. If your information has not been processed within 15 business days, please contact Gainwell Technologies by emailing louisianaprovenroll@gainwelltechnologies.com or contacting  1-833-641-2140 for a status update on enrollment and any next steps needed to complete the process.

What if my Provider Type, Provider Specialty or Taxonomy is listed incorrectly on my provider portal file?

Provider Specialty, Provider Type and Taxonomy change features are now available in the Medicaid Provider Portal.  Please continue your enrollment by logging back in to https://www.lamedicaid.com/account/login.aspx                                

Details about the new feature are available in the Provider Enrollment Portal Manuals located at https://www.lamedicaid.com/Provweb1/Forms/Forms_PES.htm

You may also contact Gainwell Technologies by email or phone at louisianaprovenroll@gainwelltechnologies.com or (833) 641-2140, for questions.

What does this mean for my credentialing with an MCO, DBPM and/or Magellan?

Providers enrolled with Fee for Service (FFS) Medicaid prior to December 31, 2021, and MCO, DBPM or Magellan prior to March 31, 2022, are required to complete the enrollment process through Phase 1 of the Louisiana Medicaid Enrollment Portal by September 30, 2022.

  • New FFS Medicaid providers should continue to follow the enrollment processes outlined for FFS Medicaid and will be invited to enroll in the portal at a later date.

New MCO, DBPM & Magellan providers should continue to follow the enrollment processes outlined for MCO, DBPM and Magellan and will be invited to enroll in the portal at a later date.

Questions?

If you have further questions, please email LouisianaProvEnroll@gainwelltechnologies.com or call 833-641-2140, Monday – Friday between the hours of 8 a.m. and 5 p.m. Central time.

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