Dear Peach State Hospital Providers:

This bulletin serves as notification that effective September 1, 2009, Peach State Health Plan’s (Peach State) Authorization requirements will change for certain services. Listed below are details related to the authorization changes.

Authorization required:

•  Sleep Studies performed in an outpatient setting

 Notification Required:

•  Notification of Healthy Newborns Only FAX to: 1-866-532-8834

Please fax the newborn delivery notification forms along with the newborn’s Medicaid Identification number by the discharge date from the hospital.

Hospitals are not required to fax or call into the plan information regarding the delivery when the patient is initially admitted for delivery.

 The following information is required once the delivery is complete in order to review the claim for reimbursement approval:

•   Member Name and Medicaid Number (mother)
• Newborn Name (Note: In the event, a name has not been selected for the Newborn at the time of discharge, please submit with the Newborn’s gender: Baby boy or Baby Girl and Last Name, ex. Baby boy Smith)and Medicaid Number
• Facility Name, Physician Name
• Admit date, delivery date, type of delivery
• Gender, weight and Apgar score of the Newborn, and Gestational age of the newborn (if known)

Newborns that are not discharged home with the mother (admitted to NICU, Special Care Nursery, etc.) require admission notification by the next business day.

 As always, thank you for your participation with Peach State Health Plan. If you have questions or need additional information about these changes, please contact the Provider Services Department at 1-866-874-0633.

 Sincerely,

 Peach State Health Plan

This entry is filed under News.