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Provider Alerts 2017

Emails relevant to rules, Medicaid provider guides, and policies


Provider Alert


Orthodontic Information Form, HCA 13-666


Tribal Health Billing Guide
1-11-17 Vivitrol®  no longer requires prior authorization
1-12-17 Prior Authorization Requests for Extraction
1-19-17 Mental Health service Billing Guide eff. 1/1/17
1-31-17 Prior Authorization Requests for Extractions eff. 1/12/17
1-31-17 Expedited Authorization list eff. 3/1/17
1-31-17 Preferred Drug List eff. 3/1/17
2-3-17 Preferred Drug list eff. 3/1/17
2-10-17 EAPG Grouper Version
2-15-17 Nonemergency ground ambulance transportation requires EPA for some services
2-15-17 Family Planning Billing guide
2-17-17 Preferred Drug list
3-15-17 Health Outpatient Provider Guide
3-24-17 Orthodontic Information form update
3-27-17 Dental Orthognathic prior authorization requests 
3-27-17 Dental prior authorization for extractions
3-28-17 Quarterly billing guide updates - April
3-31-17 Fee-for-service Preferred Drug List eff. 5/1/17
4-5-17 Drug classes added to Generics First program eff. 5/1/17
4-6-17 Pharmacy Metformin SR policy change
4-14-17 Pharmacy Point-of-Service (POS) Temporary Outage
4-14-17 Pharmacy (POS) Temporary Outage CORRECTION
4-14-17 Crossover Claims Only-Use Modifier JW for Splitting Single-Dose Vials
4-14-17 Duration of use and dose limits for Proton Pump Inhibitors (PPIs)
4-28-17 Fee-for-service Preferred Drug List
5-12-17 Duration of use and dose limits for Proton Pump Inhibitors (PPIs)
5-12-17 Ambulance Transportation quick reference tool
5-12-17 Enteral Nutrition Billing Guide eff. 5/1/17
5-18-17 Requirement for servicing providers to be listed on claims
5-31-17 Prescription Drug Billing Guide
6-1-17 Duration of use and dose limits for Proton Pump Inhibitors (PPIs)
6-2-17 Expedited Authorization for Smoking (Tobacco) Cessation Products
6-2-17 Expedited Authorization (EA) list update
6-2-17 Fee-for-Service Preferred Drug List (PDL)
6-14-17 Orthodontic Information form (HCA 13-666)
6-14-17 Process for Billing Commercial Insurance Information
6-23-17 Fee-for-Service Preferred Drug List (PDL)
6-28-17 Quarterly Billing Guide update July
6-28-17 Process for Billing Commercial Insurance Information - Clarification
6-29-17 Fee-for-Service Preferred Drug List (PDL)
6-29-17 Expedited Authorization List (EA) update
7-7-17 Enteral Nutrition Grace Period Announcement 
7-7-17 Billing for contraceptive implant procedure eff. 7/1/17
7-7-17 Clarification of the CPE Benchmarking Process
7-12-17 Hospital Inpatient Special Claims Indicator - Correction
7-13-17 Dental-related Services Billing Guide
7-17-17 Outpatient Hospital Billing Guide - Correction
7-19-17 Updated Birthing Centers Facility Fee
7-20-17 Dental-related prescriptions and prescriptions covered under fee-for-service
7-25-17 Dental-related services Billing Guide eff. 7/24/17 
7-25-17 Ambulance Transportation claim submissions
7-26-17 Fee-for-Service Preferred Drug List (PDL)
7-31-17 Vision Hardware Program Billing Guide
7-31-17 Mental Health Services Billing Guide
8-9-17 Prosthetic and Orthotic (P&O) Devices Billing Guide
8-15-17 Outpatient Rehabilitation Provider Guide Update
8-17-17 ALS transports - Trip report/run sheets are not required
8-18-17 Fee-for-Service Preferred Drug List (PDL) eff. 9/1/17
9-7-17 Fee-for-Service Preferred Drug List (PDL) eff. 10/1/17
9-7-17 Ambulance supplemental payment program coming soon, informational seminars available
9-22-17 Quarterly Billing Guide updates - October
9-25-17 Fee-for-Service Preferred Drug List (PDL) eff. 10/1/17
9-28-17 Orthognathic prior authorization requests eff. 10/1/17
10-2-17 Prescription Drug Program Billing Guide eff. 11/1/17
10-4-17 Seats still available for information seminars on ambulance supplemental payment program
10-11-17 Fee-for-Service Preferred Drug List (PDL) eff.11/1/17
10-20-17 Access to Baby and Child Dentistry (ABCD) 
10-26-17 Implementation of opioid clinical policy eff. 11/1/17
11-3-17 Orthodontic Services Billing Guide update eff. 11/3/17
11-3-17 Dental-Related Services Billing Guide eff. 11/3/17
11-3-17 Access to Baby and Child Dentistry (ABCD) Billing Guide update eff. 11/3/17
11-9-17 Newborn delivery services to Apple Health clients eff. 1/1/18 
11-9-17 Drug pricing update and additional EPA code for genomic oncology testing - eff. 11/12/17
11-15-17 Fee-for-Service Preferred Drug List (PDL) eff. 10/1/17
11-15-17 Fee-for-Service Preferred Drug List (PDL) eff. 11/1/17
11-22-17 CPT Codes G0482 and G0483 covered for drug testing eff. 11/12/17
12-7-17 Ground Emergency Medical Transportation (GEMT) Provider Participation Agreement
12-14-17 How you bill for ambulance services is changing January 1, 2018