Louisiana Healthcare Connections Claims Appeal In order to file an appeal the provider must have received an unsatisfactory response to a request for reconsideration. Submit the following items when filing an appeal: Claim Appeal Form (www.LouisianaHealthConnect.com) Original Request for Reconsideration letter and response Any supporting documentation supporting the request for an appeal The medical records … Read More →
Claims Disputes Requests for Reconsideration of a Claim All claim requests for claim reconsideration must be received within 180 calendar days from the date of notification of payment or denial was issued. A Request for Reconsideration is a communication (i.e., a typed letter) from the provider about a disagreement in the way a claim was … Read More →
Difference between Encounters VS Claims (Louisiana Healthcare Connections Explained) An encounter is a claim which is paid at zero dollars as a result of the provider being pre-paid or capitated for the services he/she provided Louisiana Healthcare Connections members. For example, if you are the PCP for a Louisiana Healthcare Connections member and receive a … Read More →
Coding of Claims/Billing Codes Louisiana Healthcare Connections requires claims to be submitted using codes from the current version of ICD‐9‐CM, ICD‐10, ASA, DRG, CPT4, and HCPCS Level II for the date of service was rendered. These requirements may be amended to comply with federal and state regulations as necessary. Below are some code-related reasons a … Read More →