Managed Care Ambulance Provider Issue Resolution (IB 24-4)
Date: 02/06/24
Louisiana Healthcare Connections is sharing with providers the options available to providers for ambulance providers for all managed care organizations. Managed Care Ambulance Provider Issue Resolution (IB 24-4) was issued on February 2, 2024.
| MediTrans | Verida | MediTrans | MediTrans | MTM | Madivcare |
|---|---|---|---|---|---|
| Aetna Better Health of LA | AmeriHealth Caritas of LA | Healthy Blue | Humana Healthy Horizons | Louisiana Healthcare Connections | United Healthcare Community Plan |
| NEAT | NEAT | NEAT | NEAT | NEAT | NEAT |
Email: Billing@med Phone: MediTrans Provider Help Desk 844.349.4326, | Phone: Mail: | Email: Billing@Medi Trans.com | Email: Billing@MediTrans. Manager LLewis@meditrans. Mail: | Phone: Region 3, 4, 5 & 6: Region 7, 8 & 9: Web: | Phone: Email: Jennifer.Baker@ Website: www.modivcare. |
Claim Appeal: Ambulance Provider Issue Escalation and Resolution
| MediTrans | Verida | MediTrans | MediTrans | MTM | Madivcare |
|---|---|---|---|---|---|
| Aetna Better Health of LA | AmeriHealth Caritas of LA | Healthy Blue | Humana Healthy Horizons | Louisiana Healthcare Connections | United Healthcare Community Plan |
| NEAT | NEAT | NEAT | NEAT | NEAT | NEAT |
| An appeal must be received from the provider within 180 calendar days of the Remittance Advice paid date or original denial date. A determination will made by the broker within 30 days of receipt. | Provider has 365 days from the date of denial to correct and resubmit denied claims. An appeal must be received from the provider within 180 calendar days of the Remittance Advice paid date or original denial date. A determination will made by the broker within 30 days of receipt. | An appeal must be received from the provider within 180 calendar days of the Remittance Advice paid date or original denial date. A determination will made by the broker within 30 days of receipt. | An appeal must be received from the provider within 180 calendar days of the Remittance Advice paid date or original denial date. A determination will made by the broker within 30 days of receipt. | An appeal must be received from the provider within 180 calendar days of the Remittance Advice paid date or original denial date. A determination will made by the broker within 30 days of receipt. Provider has 30 days from the date of occurrence to submit a claim appeal. | Claim appeal must be received within 60 calendar days of the date of the determination letter from the original request for claim reconsideration. A determination will be made by the MCO within 30 calendar days of receipt. |
How to Submit: All Request may be submitted in writing or thorught the web portal (if applicable).
Claim Appeal: Ambulance Provider Issue Escalation and Resolution
| MediTrans | Verida | MediTrans | MediTrans | MTM | Madivcare |
|---|---|---|---|---|---|
| Aetna Better Health of LA | AmeriHealth Caritas of LA | Healthy Blue | Humana Healthy Horizons | Louisiana Healthcare Connections | United Healthcare Community Plan |
| NEAT | NEAT | NEAT | NEAT | NEAT | NEAT |
| Email: billing@medi trans.com Mail: MediTrans 102 Asma Blvd. Ste. 200 Lafayette, LA 70508 | Email: claimdispute@ Mail: | Email: Mail: | Email: Appeals@medit Mail: Escalations: Providers@medi | Email: Mail: | Email: Mail: |
For additional MCO Escalation providers can refer to pages 4-9 of IB 24-04 to file formal complaint, Independent review information for the six MCOs.