PA Requests for Case Managers User Manual
Contents
1. PA Provider Name THE ARC OF NORTH WEBSTER Case Mgmt ID _ Case Mgmt Name EASTER SEALS LOUISIANA Recipient Name 698080 Return to Search Results Warning DIAGNOSIS Code Description Prima 3439 CEREBRAL PALSY NOS e n EE Erea pasro H of this site or of Secondary the information contained hereinis SERVICE DATES prohibited bythe From 10 17 2006 Thru 4 17 2007 Louisiana Department of PA Status Approved Health amp Hospitals Date submitted 10 16 2006 PRESCRIBING PROVIDER DATA Physician Number SERVICE LEVEL DATA Physician Name Line Br Modifiers EUM Requested Requested Units Amount 2 T1019 EP 00 PERSONAL CARE SERVICE EACH 15 MIN 2912 0 00 2 E pu 4 5 6 7 8 9 10 11 12 2006 Unisys Corporation All Rights Reserved v 1 0 Clicking on the PA number link displays the Case Manager ePA Details page which is the individual PA record for that particular PA number Click the Return to Search Results link to go back to the previous listing of all records that match the search criteria NOTE Text cannot be entered into fields on this page They are for display only Date Revised 07 28 2010M PA Requests Transfer to Case Managers2. Logout From Date sj Thru Date g MM ODAPYY 0870172006 EE 0870172007 PA Status Select All vj quiin Sort by PA Number EI 3 Unauthorized use of this site or of the information contained herein is prohibited by the 73 Louisiana recipient ID 2A oe Status om Date aru Date Submit ete Department of Recipient ID e Status From Date Thru Date Submit ate Health amp Hospitals Approved 8 9 2006 2 8 2007 DME Approved 8 26 2006 2 22 2007 DME Approved 8 26 2006 11 25 2006 DME Approved 8 7 2006 9 6 2006 8 7 2006 DME Approved 9 7 2006 8 10 2006 DME Approved 9 3 2006 8 17 2006 EPSDTPCS Approved 9 1 2006 8 23 2006 DME Approved 8 24 2006 8 24 2006 EPSDTPCS Approved 9 12 2006 8 25 2006 DME Approved 8 21 2006 pf 10 31 2006 8 25 2006 1of8 First Page Next Page Last Paqe Search Clear Total Records E Bj internet Date Revised 07 28 2010M 12 PA Requests Transfer to Case Managers Application User Manual 3 4 Print Friendly View For ease of printing a printer friendly version is located in the top right corner of every page within the application F Case Manager Microsoft Internet Explorer e Click the Print File Edit View Favorites Tools Help O O 86 drm 92 3 a Das Friendly link Medicaid Case Manager Department of ePA Search Health and Hospitals Please enter at least one of the follo
3. l Please enter at least one of the following C XU nme EG mes 4 ECCL Mecoent names COCOG Select All s Additional Search Criteria Thru Date Har 117017229 A 7 Toate 8 Select All PA Number 0 Home Health Approved 10 2006 1 2 2009 EPSOT PCS Approved 11 17 2005 12 2 2008 3 9 2003 EPSOT PCS Approved 11 25 2005 5 8 2006 3 1 2009 OME Approved 11 1 2005 1 17 2000 INNO Horne Health Approved 11 30 2005 5 30 2006 3 34 03 OME Approved 12 13 2005 2 2006 1 14 2009 EPSDT PCS Approved 12 13 2005 6 12 2006 1 14 2003 OME Approved 11 19 2005 12 18 200 1 14 2009 Horne Health Approved 12 17 2005 6 16 2006 3 34 2003 EPSOT PCS Apacoved 12 17 2005 6 17 2006 1 14 2009 Field Field Link Name Description A Home Takes the user to LA Medicaid Home page and displays the welcome screen B Case Manager Home Take the user to the Case Manager home page C Search Takes the user to the Case Manager search page where users enter search criteria D Help Take the user to a brief search overview E Logout Exits the program 1 PA Provider ID A unique 7 digit identifier that is specific to the provider who is requesting prior authorization 2 PA Number Automatically generated number used to identify prior authorizations 3 SSN The recipient s social security number 4 Recipient ID A unique identifier that is specific to a particular recipient 5 Recipient Name The name
4. Health and Hospitals Welcome Providers to the LA MEDICAJE PA Request for Case Managers System The purpose of the PA Request for Case Managers Syst is to provide Case Management Agencies the capability to view PA Requests associated with t Warning Unauthorized use of this site or of the information contained herein is prohibited by the Louisiana Department of Health amp Hospitals 2006 Unisys Corporation All Rights Reserved v 1 0 Bj internet Case Manager Microsoft Internet Explorer File Edit View Favorites Tools Help a Om O HAG P Zeene 60 3 uL 3 https 192 60 37 68 sprovweb 1 CaseManager BasePage aspx Eje ins Qs EI Print Friendly Louisiana Medicaid Case Manager Department of Help Health and Hospitals Using Case Manager Web System Searching a PA Request Searching a Case Manager s Prior Authorization Request through the Case Manager web application involves the following steps Log on to LAMEDICAID com with your username and password Select Case Managers from the secured menu options Select Search from the Options menu located on the left side of the page You can enter the search criteria as indicated PA Provider ID PA Number Recipient SSN Recipient ID Recipient Name use last name e g Smith or use characters e g Sm Select the type of PA Request that you wish to enter From Date Please use slashes whe
5. IW PA Type Select All Additional Search Criteria From Date Thru Date MM DD YYrY MM DD YYYY PA Status Select All Sort by ecipient Name Search Help Logout Warning PA Number sj Unauthorized use of this site or of the information contained herein is Search Clear prohibited by the Louisiana Department of Health amp Hospitals 2006 Unisys Corporation All Rights Reserved v 1 0 amp Done A Case Manager Microsoft Internet Explorer D internet BEI D File Edit View Favorites Tools Help Qu o x a Le Pp search Shy Favortes e B d s jw gt LJ rel 8 Address Si https 192 60 37 68 sprovweb1 CaseManager BasePage aspx lt ER e Louisiana Medicaid Department of Health and Hospitals Case Manager ePA Search Please enter at least one of the following Search Criteria PA Provider ID PA Number Home Case Manager SSN Home Select AII Recipient ID PA Type Recipient Name Search M Help Additional Search Criteria Logout GE ps701 2006 1 D 08 01 2007 PA Status Select All v Warning Sort by PA Number v Unauthorized use of this site or of the information contained herein is prohibited by the Louisiana Department o
6. Select All I Additional Search Criteria From Date Ei Thru Date ri EM 5 01 2006 EE 08 01 2007 PA Status Select All D I Warning OB E Unauthorized use of this site or of Search Clear the information contained he is prohibited by the Total Records 73 Louisiana x DE TR Departamento us Tc e Thru Date Sumit Date Health amp Hospitals Approved 8 9 2006 2 8 2007 23 2006 Approved 8 26 2006 7 24 2006 Approved 8 26 2006 7 31 2006 Approved 8 7 2006 8 7 2006 Approved 9 7 2006 8 10 2006 Approved 9 3 2006 8 17 2006 EPSDT PCS Approved 9 1 2006 8 23 2006 DME Approved 8 24 200 9 23 2006 8 24 2006 EPSDTPCS Approved 9 12 2986 3 12 2007 8 25 2006 DME Approved 10 31 2006 8 25 2006 1of8 First Page Next Page Last Pane EI B internet lager Microsoft Internet Explorer t IEJ Cli k h L P lew Favorites Tools Help IC t e ast age link to view the last group of results O Il AG JO see germs O R Z m LJ M 39 ttps j 192 60 37 68 sprovwebl CaseManager BasePage aspx Louisiana Medicaid Case Manager Department of ePA Search Health and Hospitals Please enter at least one of the following Search Criteria PA Provider ID PA Number Home Case Manager SSN Home Recipient ID Recipient Name PA Type Select All E Additional Search Criteria Search Hel g
7. 1 2 2007 8 17 2006 u og EPSOTPCS Approved 9 1 2006 3 1 2007 8 23 2006 aR DnE Approved 8 24 2006 9 23 2006 8 24 2006 mens SR EPSDTPCS Approved 9 12 2006 3 12 2007 8 25 2006 mene DME Approved 8 21 2006 10 31 2006 8 25 2006 Click the column heading labeled PA for a second time to view the results in their original ascending order TIP The direction of the red triangle near the column heading indicates whether you are currently seeing ascending or descending order Done Bj internet Date Revised 07 28 2010M 11 PA Requests Transfer to Case Managers Application User Manual 3 3 Navigate Results Only ten search results per page are displayed If a search returns more than one page of matches you can switch between pages using Next Page Previous Page Last Page and First Page links at the bottom of the page i EE EE E Click the Next Page Aen Favorites Tools Help O HAD zeen ere O IB a JE 3 link to view the next ten matches ttps 192 60 37 68 sprovweb CaseManager BasePage aspx s Louisiana Medicaid Case Manager Department of ePA Search Health and Hospitals Options Please enter at least one of the following Search Criteria Home PA Provider ID PA Number Case Manager SSN Recipient ID Recipient Name PA Type
8. Application User Manual If a search returns no EL LRL records matching your Q gi D yr BS 5 DUgd 3 criteria the No Address El htts 192 60 37 68 sprovwebl CaseManagerlBesePage aspx Be v Ge EI Search Results SE Found message is St Case Manager displayed Department of ePA Search Health and Hospitals Options Please enter at least one of the following In this example no um a ee INNEEEE Adult Dental Prior eme so Authorizations are aa rt sl chien ame found for the Recipient Seach PA Type Adult Dental v ID during these dates tiee Additional Search Criteria m Wem Buses 3 m a n TIP You may need to Unauthorized use EE perform a new search GC Ser Se using fewer search prohibited by the Total Records 0 criteria to get more Louisiana Department of z results Click the Health amp Hospitals Clear button to clear all fields and search First Page Last Page ag al n D far 2006 Unisys Corporation All Rights Reserved v 1 0 E Done D internet Date Revised 07 28 2010M PA Requests Transfer to Case Managers Application User Manual 3 1 1 Page Element Descriptions Search VEP cass Mi Health and Hospitals Search Criteria PA Provider ID SSN Reament ID PA Type From Date MG PA Status Sort by
9. Managers Application User Manual Field Field Name Description 13 Service Date The beginning date of service s provided From 14 Service Date The ending date of service s provided Thru 15 PA Status The status of the PA Request 16 Submit Date The date the PA Request was received and entered into the system 17 Physician Name The name of the referring physician 18 Physician The unique identifier for a particular referring physician Number 19 Procedure Code The procedure code for which prior approval is being requested 20 Modifiers Adds additional information regarding services For example identifies which tooth is involved for a dental procedure 21 Description The description of the procedure code 22 Requested Units Number of units requested for a service 23 Requested Dollar amount requested for a service Amounts Date Revised 07 28 2010M PA Requests Transfer to Case Managers Application User Manual 3 2 2 Case Manager Microsoft Internet Explorer Help Fie E Q 2 f JO seah She Favortes GG kn Was https 192 60 37 68 sprovweb 1 CaseManager BasePage aspx Address Sort Results You can choose to sort the search results by PA Recipient ID PA Type From Date Thru Date and Submit Date using the column headings idit View Favorites Tools Louisiana Medicaid Department of Case Manager Health and Hospitals O
10. THE APPLICATION 3 4 Search amp View Detail 2 Case Manager Microsoft Internet Explorer File Edit view Favorites Tools Help BE After you select the Q 0 x a JO search she Favorites 9 9 3m Ce a DA Requests for Address https 192 60 37 68 sprovweb 1 CaseManagerBasePage aspx wl Eco ins Qse Pi Case Managers link S printr from the previous Louisi Medicaid Case Manager page the Case TAE Manager Home Reauen for Cave Managers Systems to DEET page is displayed Case Manager Home BEES Click the Search link omm to find PA Requests associated with your mem agency of this site or of the information contained herein is prohibited by the Louisiana Department of Health amp Hospitals 2006 Unisys Corporation All Rights Reserved v 1 0 8 nene Date Revised 07 28 2010M PA Requests Transfer to Case Managers Application User Manual A Case Manager Microsoft Internet Explorer EER File Edt View Favorites Tools Help m Qe Q x a JO search hp Favortes e a 2 ER m rel 33 Address a https 192 60 37 68 sprovweb1 CaseManager BasePage aspx wi Jc ws Get EI A Louisiana Case Manager Medicaid ePA Search Department of Health and Hospitals Please enter at least one of the following Search Criteria PA Provider ID PA Number Case Manager SSN Home Recipient ID
11. functions of this Web application are Electronic PA request searches User selectable search criteria Sort and page search results View selected PA requests information Restrict Case Managers view of PA requests to cases assigned only to their Provider ID Allow authorized state of Louisiana Department of Health and Hospitals DHH personnel to inquire on all PA requests DROPA 1 2 Case Management Process Description The Case Management process illustrated below begins with the user DHH or Case Management Agency accessing the case management application and selecting the desired search criteria Depending on a user s access rights DHH or Case Manager the application will display either all PA requests DHH or only those PA requests that have the same Provider ID as the provider logged in Case Manager Agency _ B XN N Case Case PA Management Management Requests Agency Web Search Or authorized Application Results DHH User Date Revised 07 28 2010M PA Requests Transfer to Case Managers Application User Manual 2 0 ACCESSING THE APPLICATION 1 Open your web browser and enter the URL for the Louisiana Medicaid main menu http www lamedicaid com 2 Login in to the Provider Applications area in accordance with the instructions located on the Provider Web Account Registration Instructions link at http www lamedicaid com provweb1 Provweb_ Enroll website enrollment htm If you do not already have
12. Reserved v 1 0 Bj internet Aase Mar 3 https 192 60 37 68 sprovweb1 CaseManager PrintFriendly htm Microsoft Internet Explorer ls WE Click the Close link to ei Pare ee ee exit the print friendly window and return to the search page Please enter at least one of the following Search Criteria PA Provider ID PA Number SSN Recipient ID Recipient Name PA Type Select All EI Additional Search Criteria WE 09 01 2006 IE 08 01 2007 PA Status Select all ei Sort by PA Number E Search Clear Total Records 73 Recipient ID From Date Thru Date Submit Date Required REVIEW 3 20 2007 4 19 2007 4 23 2007 Approved 4 20 2007 4 20 2007 4 27 2007 Required beca 4 27 2007 5 26 2007 5 2 2007 8of8 First Page Prev Paqe Last Page 2006 Unisys Corporation All Rights Reserved v 1 0 Bj internet B internet Date Revised 07 28 2010M PA Requests Transfer to Case Managers Application User Manual 3 5 Help with Search The option to access Help is available on any page within the application E Case Manager Microsoft Internet Explorer Edit File View Favorites Tools Help Q 3 d JO seh petes 2 a 5 m a Addr https 192 60 37 68 sprovweb1 CaseManager BasePage aspx Louisiana Medicaid Case Manager Department of
13. a web account this guide will explain how you get a web account to access provider applications If you do already have an account the guide explains how to login to the provider application area 3 Once you login the Provider Applications Area screen is displayed Select the PA Requests for Case Managers link LOUISIANA MEDICAID Microsoft Internet Explorer File Edit View Favorites Tools Help zech e EN a Le p gt Search Slip Favortes Address https 192 60 37 68 sprovweb default htm EI E ay Links snagtt EI Yr EE Change Passworfl Change Account Info Provider Logout Help For Technical Support call Provider Applications Area toll free 1 877 598 8753 Stored Cookie Values are Provider Logout The application s listed below ar application Provider Applications LAMEDICAID COM Fact Shee Restricted Provider Applications Administrative Tools Claim Status Inquiry Electronic Prior Authorization Provider Ownership I Medicaid Eligibility Verificatigh S National Provider Identifier PA Requests for Case Managers TieBreaker 0 amp NPI 1568581437 Prouf escriber 0 amp ProvlD 1547913 amp ProvSpecialty 81 amp LoginID EasterSeals amp LoginType 1 amp for authorized use only Click on an application link to access the Bj internet Date Revised 07 28 2010M PA Requests Transfer to Case Managers Application User Manual 3 0 USING
14. ate Submitted 46 10 16 2006 PRESCRIBING PROVIDER DATA 48 Physician Name 17 Physician Number SERVICE LEVEL DATA Line Procedure Code 19 Modifiers 20 Description gay Requested Requested Amount ER Go Links Snagit psy PERSONAL CARE SERVICE EACH 15 MIN 2212 E mn Irm amp Done B internet Field Field Name Description 1 PA Number Automatically generated number identifying the prior authorization 2 PA Type Type of prior authorization 3 PA Provider ID Uniquely identifies the provider requesting prior authorization 4 PA Provider Name of the provider requesting prior authorization Name 5 Case Mgmt ID ID number associated with a specific case manager 6 Case Mgmt Name of the case manager for this prior authorization Name 7 SSN Recipient Social Security Number 8 Recipient ID A unique identifier that is specific to a particular recipient 9 Recipient Name The name of the individual receiving the services requested in the prior authorization 10 Primary The primary diagnosis code s related to the service requiring Diagnosis Code prior authorization 11 Secondary The secondary diagnosis code s related to the service requiring Diagnosis Code prior authorization 12 Diagnosis A description of the primary and secondary diagnosis code s Description Date Revised 07 28 2010M PA Requests Transfer to Case
15. be DEPARTMENT OF oo s X HEALTH Ben MOLINA AND HOSPITALS e e e Medicaid Medicaid Solutions Louisiana Medicaid Management Information System LMMIS Prior Authorization Requests Transfer to Case Managers Application User Manual Date Created 04 22 2006 Date Revised 07 28 2010M Prepared By Technical Communications Group PA Requests Transfer to Case Managers Application User Manual MOLINA MEDICAID SOLUTIONS and the Louisiana Department of Health and Hospitals Proprietary Data Notice The information contained in this document is proprietary to Molina Medicaid Solutions Corporation and the Louisiana Department of Health and Hospitals The information in this document shall not be reproduced shown or disclosed outside the Molina Medicaid Solutions Corporation or Louisiana DHH BHSF without written permission Information contained in this document is highly sensitive and of a competitive nature NO WARRANTIES OF ANY NATURE ARE EXTENDED BY THIS DOCUMENT Any product and related material disclosed herein are only furnished pursuant and subject to the terms and conditions of a duly executed license or agreement to purchase services or equipment The only warranties made by Molina Medicaid Solutions if any with respect to the products programs or services described in this document are set forth in such license or agreement Molina Medicaid Solutions cannot accept any financial or other responsibility that may be the result of your
16. date returned in the search results listing 19 Submit Date The date the PA Request was received and entered into the system 20 Page of A maximum of 10 records are listed per page This is the current page of the total pages returned Date Revised 07 28 2010M PA Requests Transfer to Case Managers Application User Manual 3 1 2 Page Element Descriptions View Detail A Case Manager Microsoft Internet Explorer Ciel File Edit View Favorites Tools Help Q Back v Ac x ig N H 4l ca M Le Search She Favorites aa La e gr LJ A amp https 192 60 37 68 sprovweb1 CaseManager BasePage aspx Louisiana Medicaid Department of E Ki int Friendly Case Manager ePA Details Health and Hospitals Home Case Manager Home Search Help Logout Return to Search Results Warning Unauthorized use of this site or of the information contained herein is prohibited by the Louisiana Department of Health amp Hospitals PA Number 1 PA Type 2 EPSDT PCS PA Provider 1D 3 zz PA Provider Name 4 8 8 5 J Case Mamt ID B Case MomtName g MEER ssn 7 RecpientiD 8 Recipient Name mg DIAGNOSIS Code Description 12 Primary 10 3439 CEREBRAL PALSY NOS Secondary 44 SERVICE DATES From 43 10 17 2006 Thru 14 PA Status 45 Approved es D
17. f B Health amp Hospit DME Approved 8 7 2006 9 6 2006 8 7 2006 DME Approved 9 7 2006 3 5 2007 8 10 2006 EPSDTPCS Approved 10 17 2006 4 17 2007 10 16 2006 Search Total Records 3 Thru Date Submit Date First Page 2006 Unisys Corporation All Rights Reserved v 1 0 Done Bj internet The Case Manager ePA Search page is displayed You may enter any search criteria from the top section such as Recipient ID In the bottom section the From Date and Thru Date are required fields You must click the calendar buttons or enter dates in the MM DD YYYY format Click the Search button All records matching the search criteria are displayed at the bottom of the page TIP When possible enter at least one search criteria from the top section to get fewer more specific search results If you do not have the data needed to limit the search and an extremely large number of results are expected then perform the search near the end of the business day or late in the evening to help prevent server problems Click on any PA number link in the list to view its details Date Revised 07 28 2010M PA Requests Transfer to Case Managers Application User Manual Louisiana Medicaid Department of Health and Hospitals Case Manager ePA Details Options PA Number PA Type EPSDT PCS PA Provider ID
18. ick the column heading labeled PA to view the results in reverse order Done 2 Case Manager Microsoft Internet Explorer Bj internet Pie E dit View Favorites Tools Help Q x ZOD D see gere 2 1 a 3 Address https 192 60 68 spravwebl CaseManager BasePage aspx Louisiana Medicaid Department of Case Manager Health and Hospitals Options Home Case Manager Home Search Help Logout Warning Unauthorized use of this site or of the information contained herein is prohibited by the Louisiana Department of Health amp Hospitals Please enter at least one of the following Search Criteria PA Provider ID SSN Recipient ID PA Number Recipient Name ePA Search PA Type select all Additional Search Criteria From Date MM DD YYYY PA Status 8 01 2006 MM DD YYYY ru Date Sort by Total Records 73 d PA Type Erom Date Thru Date Submit Date m DE Approved 8 9 2006 2 8 2007 6 23 2006 OME Approved 8 26 2006 2 22 2007 7 24 2006 CC e m Cut Approved 8 26 2006 11 25 2006 7 31 2006 C O Approved 8 7 2006 9 6 2006 8 7 2006 CC enm Dne Approved 9 7 2006 3 5 2007 8 10 2006 e egen DME Approved 9 3 2006
19. itional Search Criteria Rie 08 01 2006 MESS 08 01 2007 PA Status Select all E Sort by PA Number v Search Clear Total Records 73 Recipient ID A us FromDete ThruDate Submit Date Required Review 3 20 2007 4 19 2007 4 23 2007 Approved 4 20 2007 4 20 2007 4 27 2007 Required SC 4 27 2007 5 26 2007 5 2 2007 8of8 First Page Prev Page Last Page 2006 Unisys Corporation All Rights Reserved v 1 0 Bj internet ei Bj internet Date Revised 07 28 2010M 13 PA Requests Transfer to Case Managers Application User Manual EE rosoft Internet Explorer i E A Print window pops up to select your print w LJ Osas EE options General Options Select Printer Microsoft Office Live Meeting Document Writer amp oc Printer on NASPUBLIC r met 6 Click the Print button i i E Status Beach l t to file Preferences Location 2nd floor main bldg Comment Quality Control shared Find Printer Page Range GI Number of copies O Pages 1 Enter either a single page number or a single page range For example 5 12 From Date Required Do 3 20 2007 4 19 2007 4 23 2007 Approved 4 20 2007 4 20 2007 4 27 2007 Required REVIEW 4 27 2007 5 26 2007 5 2 2007 8of8 First Page Prev Page Last Page 2006 Unisys Corporation All Rights
20. n entering the date for example 01 01 2000 Required Thru Date Please use slashes when entering the date for example 01 01 2000 Required Select the status of PA Request that you wish to enter Select which column to sort by When you have completed entering the search criteria click the Search button Tf there any problems with your input you will see a list of errors that need to be corrected before the Search can continue Warning Unauthorized use of this site or of the information contained herein is prohibited by the Louisiana Department of Health amp Hospitals 0000000000 7 The Case Manager s PA Request will be displayed 8 Click a PA Number to display the details 9 Use the column headings to sort PA Type and PA Status are sorted by its code representation 10 To return to the search results page click the Return to Search Results option that is now available on the left side menu beneath the Options box 2006 Unisys Corporation All Rights Reserved v 1 0 Done Bj internet Click the Help link The Case Manager Help page displays brief instructions on searching a PA request Date Revised 07 28 2010M PA Requests Transfer to Case Managers Application User Manual 3 6 Case Manager Logout When you have completed your work in the PA Requests for Case Managers application you should logout to properly exit the system Case Manager Microsoft Internet Explore
21. of the individual receiving the services 7 Search From Date Beginning date for the search range This is a required field 8 Search To Date End date for the search range This is a required field Date Revised 07 28 2010M PA Requests Transfer to Case Managers Application User Manual Field Field Link Name Description 9 Search PA Status Indicates the status of a prior authorization Selections include PA not required Procedure code is non payable PAC 820 Approved Denied Required Review Rejected due to invalid data or Select All The default is Select All 10 Sort by Indicates the order in which results are displayed Select from the drop down list PA Type Recipient ID Type Status From Date Thru Date or Submit Date The default is PA Type 11 Search Performs the search using the selected criteria 12 Clear Clears all data previously entered into all fields Use should be limited to whenever the user wants to start a fresh search 13 PA Returned The Prior Authorization Number returned in the search results listing 14 Recipient ID The Recipient ID returned in the search results listing Returned 15 PA Type Returned The PA Type returned in the search results listing 16 Status Returned The PA Status returned in the search results listing 17 From Date Beginning date returned in the search results listing Returned 18 Thru Date Returned Ending
22. pao Go RES EE DEC caduibensubskdet uebeidunaniubdelguboalaniiedusanaiude 1 Mah al E 1 1 2 Case Management Process Description eesssssss 1 20 ACCESSING THE APPLICATION siisicisiieecicccceciccccdastnasddenccasavenunanadeacdacedesevenavensdens 2 3 0 USING THE APPLICATION sisisessvsccsicassnandeassuaidcartvanduansuaudvacdvavduansuasduaudvacdeavauantunads 3 Sali Search amp VIEW A UE 3 3 1 1 Page Element Descriptions Search ceeeereeeee eee 7 3 1 2 Page Element Descriptions View Detail 9 3 2 Sort ET IC 11 34 3 Navigate E CN 12 3 4 Print Friendly EE 13 35 Help with Search irren ee re enr e rena cene 15 3 6 Case Manager Logout ice eerr ean inita np en cuna rana ka nain ENEE 16 Date Revised 07 28 2010M iii PA Requests Transfer to Case Managers Application User Manual 1 0 OVERVIEW Support Coordination Service Providers Case Managers have access to the Prior Authorization PA Requests for Case Managers computer system on the Louisiana Medicaid Provider Support Center Web site at http www lamedicaid com The purpose of this computer system is to provide Case Managers the capability to view PA requests for Medicaid recipients who are linked to their agencies that are submitted via the electronic Prior Authorization ePA computer system by the servicing provider 1 4 Objectives The principal
23. ptions Home Case Manager Home Search Help Logout Warning Unauthorized use of this site or of the information prohibited by the Louisiana Department of contained herein is Health amp Hospitals Please enter at least one of the following Search Criteria PA Provider ID SSN Recipient ID PA Number Recipient Napa ePA Search PA Type Select all Additional Search Criteria From Date MM DD YYYY 8 01 2006 Thru Date MM DD YYYY 08 01 2007 E PA Status Select All vj Sort by E Search Clear DME Total Records 73 From Date Thru Date ate 6 23 2006 os Approved 8 9 2006 2 8 2007 Cor Approved 8 26 2006 2 22 2007 7 24 2006 j e Cut Approved 8 26 2006 11 25 2006 7 31 2006 emm a Cut Approved 8 7 2006 9 6 2006 8 7 2006 Cr DME Approved 9 7 2006 3 5 2007 8 10 2006 LL amen Cut Approved 9 3 2006 1 2 2007 8 17 2006 emm anete EPSOT PCS Approved 9 1 2006 3 1 2007 8 23 2006 ur Approved 8 24 2006 9 23 2006 8 24 2006 aman SPIE EPSDT PCS Approved 9 12 2006 3 12 2007 8 25 2006 wegen OME Approved 8 21 2006 10 31 2006 8 25 2006 The default display is in ascending order by PA number Cl
24. r P Click the Logout link File Edit View Favorites Tools Help Q x AOD Preah gero 2 1 m JE 3 Address https 192 60 37 68 sprovwebi CaseManager BasePage aspx pi 4 ouisiana Medicaid Case Manaczr Department of ePA Scarch Health and Hospitals Please enter at least one of the folleg Search Criteria Home PA Provider ID PA Number Options Case Manager Home Recipient Name Search Select all sl Kei Additional Search Criteria From Date Eg Thru Date 08 01 2007 MM DD YY ipo 01 2006 MM DD YYYY PA Status v Warning v Unauthorized use of this site or of Search Clear the information ed herein is Total Records 73 Recipient ID A Type From Date Thru Date Submit Date DME Approved 8 9 2006 2 8 2007 6 23 2006 DME Approved 8 26 2006 2 22 2007 7 24 2006 DME Approved 8 26 2006 11 25 2006 7 31 2006 DME Approved 8 7 2006 9 6 2006 6 7 2006 DME Approved 9 7 2006 3 5 2007 8 10 2006 Department of Health amp Hospitals DME Approved 9 3 2006 1 2 2007 8 17 2006 EPSDT PCS Approved 9 1 2006 3 1 2007 8 23 2006 DME Approved 8 24 2006 9 23 2006 8 24 2006 EPSDT PCS Approved 9 12 2006 3 12 2007 8 25 2006 DME Approved 8 21 2006 10 31 2006 8 25 2006 E Done Bj internet Date Revised 07 28 2010M 16
25. use of the information in this document including but not limited to direct indirect special or consequential damages Exercise caution to ensure the use of this information and or software material complies with the laws rules and regulations of the jurisdictions with the respect to which it is used The information contained herein is subject to change without notice upon DHH approval Revisions may be issued to advise of such changes and or additions Molina Medicaid Solutions is a registered trademark of Molina Healthcare Inc Copyright 2010 MOLINA MEDICAID SOLUTIONS Corporation All rights reserved Date Revised 07 28 2010M i PA Requests Transfer to Case Managers Application User Manual PROJECT INFORMATION Louisiana Medicaid Management Information System LMMIS PA Requests Transfer to Case Managers Application User Manual Author Technical Communications Group Molina Medicaid Solutions LMMIS QA Boegen Dae BesionofChanpg ur 08 31 07 Third draft Steve Brunet Melissa Goldmond 12 22 2008 Removed Appendix A which dealt with account R Sheehan management Reformatted in accordance with latest user manual template Modified 2 0 to accommodate NPI 07 28 2010 Logo Conversion and Updated Company Information 7017 Date Revised 07 28 2010M ii PA Requests Transfer to Case Managers Application User Manual TABLE OF CONTENTS 1 0 OVERVIEW i uc iccesigisuaa oo segre Dra daPRe i
26. wing Search Criteria PA Provider ID Home PA Number Case Manager SSN Home Recipient ID Recipient Name PA Type Select All EN Additional Search Criteria From Date Thru Date T MM DD YYYY 0870172006 l MM DD YYYY 0870172007 PA Status Select All ei Warning Sort by PA Number v Unauthorized use of this site or of Search Clear the information contained herein is prohibited by the Louisiana Department of Total Records 73 ient ID A FromDate Thru Date Submit Date Health amp Hospitals EE equire Ranen 3 20 2007 4 19 2007 4 23 2007 Approved 4 20 2007 4 20 2007 4 27 2007 Required esch 4 27 2007 5 26 2007 5 2 2007 8 of 8 First Page Prev Page Last Page 2006 Unisys Corporation All Rights Reserved v 1 0 e Bj internet SL Mat A https 192 60 37 68 sprovweb1 CaseManager PrintF riendly htm Microsoft Internet Explorer sae A printer friendly Edt View Favorites Tools Help Ar d Q gt x a Lei J search she Fovortes e 2 m w LJ Fol Osat EI version pops up ina sem new window Case Manager ePA Search Please enter at least one of the following Search Criteria Click the Print link PA Provider ID PA Number SSN Recipient ID Recipient Name PA Type Select All EN Add
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