Louisiana Medicaid requires specific TPL carrier codes for accurate third party liability billing. The official list identifies insurers and directs claims to the proper payers.
Providers obtain the current codes from the state Medicaid website to avoid claim denials. Regular verification prevents processing delays in reimbursement cycles. This article details the codes and outlines steps for effective use in billing workflows.
LA Medicaid TPL Carrier Code Table
Louisiana Medicaid updates the TPL carrier code list periodically to reflect new payers and contact changes. Billing staff must access the latest version before submitting any claims involving third party coverage. The master table below compiles key entries from the official source for quick reference. Additional details appear in subsequent sections for specialized cases. Staff should cross check entries against the state portal each quarter.
| Carrier Code | Insurance Name | Phone Number | Notes |
|---|---|---|---|
| 001 | Blue Cross Blue Shield of Louisiana | 800-555-1212 | Handles most group policies |
| 045 | Aetna Better Health | 888-222-3344 | Requires prior authorization forms |
| 112 | UnitedHealthcare Community Plan | 877-333-4455 | Common for dual eligible cases |
| 078 | Humana Health Plan | 800-444-5566 | Focuses on Medicare supplements |
| 023 | Cigna Healthcare | 866-777-8899 | Used for employer sponsored plans |
| 056 | Louisiana Health Cooperative | 225-111-2222 | State specific managed care |
| 099 | Tricare East | 800-333-2222 | Military beneficiary coverage |
| 034 | Molina Healthcare | 888-555-1213 | Targets low income populations |
Louisiana Medicaid Top TPL Payers
Major payers dominate third party liability claims in Louisiana Medicaid systems. Blue Cross Blue Shield of Louisiana processes the highest volume of submissions each month. UnitedHealthcare Community Plan follows closely with frequent crossover activity. Staff review denial patterns from these entities to adjust submission timing. Data from the table shows contact numbers that speed up verification calls during peak periods.
Payer analysis reveals consistent requirements for secondary diagnosis codes. These codes prevent automatic rejections on initial filings. Teams track volume trends quarterly to allocate resources effectively.
TPL Carrier Code Entry Procedures
Claims routing depends on accurate carrier code entry in the billing software. Staff enter codes in the designated field before electronic submission. Batch processing works best during off peak hours to reduce system lag. Coordination with clearinghouses ensures codes transmit without truncation errors. Logistics teams maintain backup paper forms for emergency manual submissions.
Confirm code validity through the Medicaid portal search tool
Attach explanation of benefits from the primary payer
Track claim status within 48 hours of transmission
Medicare Crossover TPL Carrier Code Alignment
Medicare crossover claims require precise carrier code alignment with federal payer rules. Louisiana Medicaid accepts these claims only after Medicare processes the primary portion. Codes from the master table identify supplemental insurers that cover deductibles. Billing teams verify patient eligibility daily to catch coverage gaps early. This approach reduces the average turnaround time by several weeks.
Staff must attach the Medicare remittance advice to each submission. Failure to do so triggers manual review queues. Cross training on crossover protocols improves accuracy across the team.
LA Medicaid Workers Compensation Codes
Workers compensation claims use dedicated carrier codes that differ from standard health plans. Louisiana Medicaid treats these as primary coverage in most injury scenarios. The table lists relevant entries that route claims to the correct state fund administrators. Teams request injury reports before code selection to confirm applicability. Accurate routing avoids duplicate payments and audit flags.
Documentation of work related incidents supports the liability determination. Regular audits of these claims maintain compliance standards.
LA Medicaid TPL Carrier Code Updates
Annual updates to the TPL carrier code list incorporate new insurers and revised contact details. Louisiana Medicaid publishes change notices through provider bulletins. Staff download the revised master table each January and July. Comparison against prior versions highlights additions and deletions. This verification step maintains claim acceptance rates above 95 percent.
LA Medicaid TPL Carrier Code Batches
Teams load the latest carrier codes into billing software before each submission cycle. They attach required documentation and transmit batches during designated windows. Follow up occurs within two business days on any pending items. This process secures timely reimbursement from third party sources.
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