State of Louisiana______

Office of Group Benefits

P. O. Box 44036

Baton Rouge, Louisiana70804November 30, 2004

Dear Provider:

We are currently soliciting contracts from physicians who wish to participate in the Office of Group Benefits Provider Network for the 2005 Plan Year beginning on July 1, 2005. Enclosed is your contract for execution. It is imperative that your contract is received by January 15, 2005 to guarantee inclusion in the provider directory that we distribute during annual enrollment. Please be sure to sign and return the original endorsed document to OGB.

The Provider Information Sheet and W9 affixed to your contract should be completed including license numbers and expiration dates. Attach a copy of your current malpractice insurance certificate. OGB will not process your contract without the required information. Return your contract in the enclosed prepaid UPS shipping envelope, which has been provided for your convenience. Any changes or corrections made to the agreement will render it null and void.

A report of contracted physicians is also enclosed for your review to ensure that we have an accurate record of physicians enrolled in our network. Enter the Federal DEA# in the space provided for each listed physician. If additional changes are necessary, offer comments as needed in the space provided and return with your contract.

If you have any questions regarding these instructions, please contact your regional provider representative or our Provider Service Department at 1.800.215.1093.

Thank you again for your continued service to our members. We look forward to working with you.

Best regards,

Scott Thevenot

Provider Services Director

Cc: Malcolm Veazie, Deputy Assistant Secretary

December 13, 2006December 29, 2006

February 14, 2007558

JuneNovember 27February 23,May 6 21, 2007December 7, 2007

Dear Provider:

Thank you for your participationinterest in participatingon within the Office of Group Benefits (OGB) PPO network. As you may be aware, your OGB provider contract ends on June 30, 2007. We once again invite you to continue your participation in our PPO network for the upcoming fiscal year. Attached is a new contract that will be effective untilfor the next two years beginning July 1, 1, 2007 and ending J June 30, 2009.Please be advised of the following procedures that now require Outpatient Procedure Certification (OPC).

  • Hyperbaric Oxygen
  • Treatment of swallowing dysfunction and/or oral function for feeding (92526)
  • MRI when diagnosis is related to the breast

The following procedures still require outpatient precertification.

  • Speech Therapy - CPT codes 92506-92508 allows one (1) unit per day
  • All Therapy performed in the a home setting

The Outpatient procedures listed below also now require Pre-certification:

Hyperbaric Oxygen

Treatment of swallowing dysfunction and/or oral function for feeding (92526)

MRI when diagnosis is related to the breast

Changes to provider reimbursement are reflected in Exhibit A of the attached provider contract. Please review Exhibit A carefully since reimbursement has been updated to align OGB with current market rates. We believe that you will continue to find OGB competitive with other Louisiana health plans with which you may be contracted.

It is important that your contract and all required documentation be submittedOnFor services performed by a contracted provider, it is the provider’s responsibility to obtain OPC. The plan member cannot be billed if the provider fails to obtain prior authorization.

as soon as possible, so that you can be listed on the OGB website as a contracted provider to OGB by February 8, 2007 so that you can be listed in the OGB Interim Provider Directory. This website is utilized by directory is distributed during annual enrollment meetings to Louisiana state employeesThe Pre-Certification Contact Phone number is 1-800-432-3432.

For more detailed information please refer to our provider manual located on our website: or you can request a provider manual from your regional representative. We appreciate your service to our members and look forward to an extended relationship with you.

, retirees and their families when choosing a network provider. It is equally as important that the application be completed as described inon the attached checklist to avoid processing delays. OGB will be unable to process your contract without all required information.

Please contact your regional provider representative with any questions you may have regarding your contract. We appreciate your continued service to our members and look forward to an extended contractual relationship with you.

Sincerely,

Scott Thevenot

Director - Provider Services

C: Malcolm Veazie

Deputy Assistant Secretary