For Providers F.A.Q.
As a PCP, do I need authorization from Peoples Health to perform services in my office?
As a specialist, do I need to have services authorized before I perform them?
How do I verify member eligibility and information?
What if I have questions about my Explanation of Payment (EOP)?
How often are the Referral Guide updated? How can I get a copy?
What if I need forms and/or other documents?
What lab should I use?
What if I can't get in touch with my Provider Relations Representative?
What health plans does Peoples Health administer?
How do I know which Physicians Team the member is in?
Q: As a PCP, do I need authorization from Peoples Health to perform services in my office?
A: No. None of the procedures performed in the PCP's office require authorization. Laboratory work may be drawn in your office, but all laboratory specimens must be sent to Quest for testing. An exception exists for the following procedures that may be performed in your office: Glucose Finger Stick 82947, 82948, 86585 and Urinalysis 81000-81099.
Q: As a specialist, do I need to have services authorized before I perform them?
A: Yes. If you determine that your patient needs medical services, you must request prior authorization from Peoples Health to ensure those services will be covered. Before rendering services, you must complete and submit an Authorization Form to Peoples Health. We will respond within 72 hours of your request.
Q: How do I verify member eligibility and information?
A: You can send a request to confirm eligibility and information directly from our Web site or you can call us at (504) 849-4500, ext. 2 Monday through Friday from 8 a.m. to 6 p.m..
Q: What if I have questions about my Explanation of Payment (EOP)?
A: Please Contact Us to request an explanation of your EOP.
Q: How often are the Referral Guide updated? How can I get a copy?
A: Referral Guides that include provider names and phone numbers are updated weekly and are sent to your office via fax. Complete Referral Guides that include the provider names, phone numbers and addresses are updated on a monthly basis. Your Provider Representative will deliver an updated copy to you. In addition, you can use the on-line search to verify provider participation.
Q: What if I need forms and/or other documents?
A: If you need additional forms and/or documents, you can either download plan documents or you can call your Provider Relations Representative.
Q: What lab should I use?
A: Peoples Health uses Quest Diagnostics for all laboratory services. Please refer all Peoples Health members to Quest.
Q: What if I can't get in touch with my Provider Relations Representative?
A: If you cannot reach your provider representative, feel free to call Lorraine Mylie, Director of Provider Relations at (504) 681-8858 or Paula Crain, Provider Services Manager at (504) 681-8807.
Q: What health plans does Peoples Health administer?
A: Peoples Health currently administers four health plans in Louisiana.
Q: How do I know which Physicians Team the member is in?
A: To find out which Physicians Team the member is in, you can look on their Member ID card or call Member Services at (504) 849-4500, ext. 2 Monday through Friday from 8 a.m. to 6 p.m..