Air Ambulance Transportation (AAT) - MEDICAID - LOUISIANA (New)

REQUIREMENTS: - Immediately: Billing team must update authorization workflows in the billing system to implement split requirements: (1) NO prior auth for emergency air ambulance transportation, (2) REQUIRED prior auth for all non-emergency air ambulance transportation. - Before next air ambulance claim submission: Train billing staff and providers on the distinction between emergency vs. non-emergency air ambulance services. Update claim submission procedures to flag non-emergency air ambulance claims for prior authorization review before billing. - Update encounter forms and authorization request templates to clearly identify transport type (emergency vs. non-emergency) and document that outpatient air ambulance services are NOT covered regardless of emergency status. - Implement system logic to route emergency air ambulance claims directly to claims processing without authorization hold, while routing non-emergency claims to Utilization Management for medical necessity review against the two criteria: (1) speedy admission essential with inaccessible pickup point, or (2) great distances/obstacles to nearest appropriate hospital. - Communicate to all providers that clinical documentation for emergency air ambulance is NOT required at time of claim submission but may be requested during post-payment review. - CONSEQUENCE: Failure to obtain prior authorization for non-emergency air ambulance will result in claim denials. Emergency air ambulance claims delayed for authorization will result in improper denials of covered services.