Blue Cross and Blue Shield of Louisiana and HMO Louisiana have temporarily lifted some medical and pharmacy policy requirements for members in the following 43 parishes:
| Acadia |
Evangeline |
Orleans |
St. Martin |
| Allen |
Franklin |
Plaquemines |
St. Mary |
| Ascension |
Grant |
Pointe Coupee |
St. Tammany |
| Assumption |
Iberia |
Rapides |
Tangipahoa |
| Avoyelles |
Iberville |
Sabine |
Terrebonne |
| Beauregard |
Jefferson |
St. Bernard |
Vermilion |
| Calcasieu |
Jefferson Davis |
St. Charles |
Vernon |
| Cameron |
Lafayette |
St. Helena |
Washington |
| Catahoula |
Lafourche |
St. James |
West Baton Rouge |
| East Baton Rouge |
Lasalle |
St. John the Baptist |
West Feliciana |
| East Feliciana |
Livingston |
St. Landry |
The period for the temporary changes has been extended through Tuesday, Sept. 30, 2008, in accordance with Emergency Rule 25 issued by the Department of Insurance.
Effective Saturday, Aug. 30, 2008, through Tuesday, Sept. 30, 2008, affected members may:
- Receive in-network benefits for care out of their network. This also applies for Medicare Select members.
- Refill prescriptions even if they are not due to be filled for 30 days.
- Receive treatment covered under their plan without prior authorization. This includes authorizations handled by American Imaging Services (AIM).
Please note: Other Blue Plans may request clinical information or medical necessity reviews for your out-of-state BlueCard® patients.
This does not suspend the application of any exclusions in the subscriber's policy, such as those for pre-exisiting conditions, investigational services, or other policy limitations. Additionally, members are still responsible for their normal copayments, coinsurances and deductibles.
Lost Medications
If any member has lost medications or cannot receive mail-order medications because they relocated, they may call our pharmacy benefits manager, Express Scripts, Inc., at the number listed on their ID card or toll-free at 866.781-7533. This phone line is available 24 hours a day, seven days a week.
Patient Admission Information Needed
Updated 09/12/2008
- All facilities should fax a list or face sheet of their BCBSLA and HMOLA member patient admits that occur between Aug. 30, 2008, and Sept. 30, 2008
- This information is needed to coordinate case management and disease management efforts
- Fax to: 800.267.6547
Attn: Requested Admit Listing/Hurricane Gustav
Phone Service Issues
Updated 09/12/2008
- Hurricane Ike may cause intermittent phone line issues similar to what happened Aug. 30-Sept. 8, 2008, with Hurricane Gustav. Please monitor your electronic submissions carefully to ensure successful transmission. Some acknowledgement reports may be delayed.
- Providers who submitted claims to Blue Cross between Aug. 30, 2008, and Sept. 8, 2008, using a “dial-up” Internet service should verify that your claims were properly submitted.
- Telecommunications problems during that time included dropped calls and fast busy signals, which could have affected delivery of submissions via dial-up.
- As of Sept 10, 2008, the phone system issues have been corrected; we apologize for any inconvenience.
Business Operations and Building Status
Updated 09/15/2008
- Our corporate headquarters and all district offices are open and following regular business hours, effective Monday, Sept. 15.
- A satellite location in Baton Rouge that housed some of our employees was damaged due to the hurricane. This will have no impact on our claims operations.
Claims and Provider Payment Delays
Updated 09/22/2008
- Office closure Sept. 1-5, 2008, resulted in delays in claims processing and provider reports. We are working diligently to process all delayed as well as current claims and to minimize impacts to our members and providers.
- Following is the status of claims, electronic funds transfer (EFT) and hard copy payments, payment registers and electronic remittance advices (835 ERAs) for Blue Cross and HMOLA.
9/1/08 Payment Cycle
Completed on schedule
Payment registers and EFT notifications were posted in iLinkBLUE on 9/9/08
835 ERAs were generated and available to submitters on 8/31/08
9/1/08 EFT Deposits
Facets claims: Deposits were made on schedule and should be in your accounts
Legacy claims: Delays were encountered with the 9/1/08 EFT deposits. We have reissued these EFT transactions and have confirmed that transmission was successful. You should have received these monies by 9/10/08
9/1/08 Hard Copy Checks
For providers who receive hard copy checks, the 9/1/08 payment cycle was completed by 9/10/08
9/8/08 Payment Cycle Updated 09/22/2008
Blue Cross will not make EFT payments, make hard copy payments, create remittance advices or create 835 ERAs for the week of 9/8/08
We will bypass our normal "payment hold" for all processed claims received from 8/31/08 through 9/19/08
Payment for these claims was released on 9/15/08 or will be released in the 09/22/08 payments
Please check the Hurricane Information webpage for periodic updates. We also will be sending additional information as updates are available. We greatly appreciate your patience as we work to recover from Hurricane Gustav.
For More Information
provider.communications@bcbsla.com
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