This webinar will cover the Louisiana Medicaid managed care organization (MCO) provider appeal and LDH Independent Review processes. Each MCO has its own internal claim reconsideration and appeal procedures. The panelists will provide an overview of the appeals process and discuss pertinent timelines, supporting documents, and external appeal options. The panelists will discuss recommendations for providers to navigate various MCO disputes, including payment delays, records request responses, MCO investigator visits, and appeal preparation.
• Describe MCO claim appeals process;
• Discuss the options for the LDH Independent Review process;
• Tips for responding to record request notices;
• Recommendations for drafting appeals.