August 1, 2009

 Dear Peach State Provider:

 
Peach State is making an important change in policy to improve quality of care for our members, and we are writing to communicate this change to you. Beginning August 17, 2009, Peach State will require prior notification to bill Mirena and ParaGard and the placement of these Intrauterine Devices (IUD). You will not be paid for the IUD or the placement unless the prior notification form is completed, returned to Peach State, and a reference number is issued prior to the date of service.

You must provide the IUD from your office stock and bill for the device with the insertion.

• If your office does not stock IUDs, then you may purchase them directly from Caremark. Please contact Caremark Mirena Support at (p) 866-647-3646 (f) 888-281-8199 or on online at www.mirenasupport.com if you do need to purchase a Mirena from Caremark. Once you purchase the Mirena and have it in stock, then you can fax the prior notification form to Peach State at 1-866-374-1579 to receive your reference number to be used in billing the Mirena and the insertion.
• If you already have the IUD in stock and do not need to purchase it from Caremark, then you can fax the prior notification form directly to Peach State at 1-866-374-1579.

 IUD Checklist Form (PDF)

Once Peach State receives the completed form, we will send a fax to you communicating a reference number. This number must be included in your claim submission in order for payment to be made. If you have any questions about the new process, please contact the Peach State Pharmacy Department at 1-800-514-0083 (option 2). We will be happy to assist you.

 
Thank you,

Dean Greeson, MD MBA
VP of Medical Affairs
Peach State Health Plan

This entry is filed under News.