Peoples Health Online Provider Directory – Network Providers

Introduction to Network Providers

 

Our online directory is current as of:


This directory provides information about Peoples Health current network providers.

This directory is for Peoples Health plan members. Peoples Health offers plans in all Louisiana parishes.

For any questions about the information contained in this directory, please call our member services department toll-free at 1-800-222-8600, seven days a week, from 8 a.m. to 8 p.m. TTY users should call 1-800-846-5277.

Peoples Health is a Medicare Advantage organization with a Medicare contract to offer HMO plans. Enrollment depends on annual Medicare contract renewal.

The formulary, pharmacy network or provider network may change at any time. You will receive notice when necessary.

If you identify an error with any of the provider information in our online directory, use the Report Incorrect Information button on the provider’s search results screen, or call member services.

Introduction to Network Providers

This directory provides information about Peoples Health network providers. To get detailed information about your health care coverage, please see the Evidence of Coverage.

The network providers in this directory have agreed to provide you with your health care services. You will have to choose one of our network providers in this directory to be your primary care physician (PCP). Generally, you must get your health care services from your PCP. You can search for PCPs in the Physician Search. In the search, check the box for Search Only for Primary Care Physicians, then enter your other search criteria.

You may go to any of our network providers in this directory; however, some services may require prior authorization. This means your provider needs to get approval from us before giving you the services. Our clinical staff will review your provider’s request for approval. They use nationally recognized criteria to make sure the service is appropriate for both your condition and the setting (e.g., inpatient, outpatient, etc.). The services that may need prior authorization are noted in the Evidence of Coverage.

Please note that some providers may not be accepting new patients. The directory provides this information.

This directory is updated each month. Providers may have been added or removed since this directory was last updated, or some providers may have changed whether they are accepting new patients. This means that some providers may no longer be in our network or there may be newer providers in our network that are not yet listed.

This list is current as of:

 

For Peoples Health Choices 65 #14 (HMO), Peoples Health Secure Choice #011 (HMO SNP) and Peoples Health Secure Health (HMO SNP) members: You must use network providers except in emergency or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers, neither Medicare nor Peoples Health will be responsible for the costs.

For Peoples Health Choices Gold (HMO-POS) and Peoples Health Group Medicare (HMO-POS) members: You can use network providers or out-of-network providers. With the exception of emergency care and urgently needed care, it may cost more to get care from out-of-network providers. Some services may not be covered from an out-of-network provider. Most out-of-network services must be medically necessary and may need prior authorization. See the Evidence of Coverage for information on costs, benefits and authorization requirements.

How do you find Peoples Health providers in your area?

You can search for network providers in this directory using our three provider search tools—Physician Search, Hospital Search or Other Provider Search.

  • The Physician Search lets you search for network doctors, including PCPs and specialists.
  • The Hospital Search lets you search for network hospitals.
  • The Other Provider Search lets you search for all other network providers, for example, skilled nursing facilities and outpatient mental health providers.

Each search tool lets you look for providers by name, city or parish. Each tool offers additional search criteria. Provider search results will display in alphabetical order by provider name.

If you have questions about your Peoples Health plan or require assistance selecting a PCP, please call our member services department toll-free at 1-800-222-8600, seven days a week, from 8 a.m. to 8 p.m. TTY users should call 1-800-846-5277.

Providers available in the Peoples Health network:
What is a PCP and what does a PCP do for you?
Your PCP is your main contact for health care. Your PCP can offer most of your care. Examples of PCPs are internal medicine, general practice and family practice doctors. In some areas or cases, you may be able to choose a nurse practitioner as your PCP.

If you need specialist care or hospital services, your PCP can help set up services for you. You can also set up services yourself by directly getting care from any provider in our network.

How do you choose a PCP?
If you did not choose a PCP during enrollment, we assigned one to you.
How can you switch to another PCP?
You may change your PCP for any reason, at any time. Also, it’s possible that your PCP might leave our network of providers and you would have to find a new PCP.

You may choose a new PCP, who is accepting new patients, from any of the providers listed in the Physician Search. In the search, check the box for Search Only for Primary Care Physicians, then enter your other search criteria.

You can change your PCP by logging in to MyPeoplesHealth, our member portal, at mypeopleshealth.com, calling member services or emailing phn.member@peopleshealth.com. If you need to choose a PCP or need more information, we can help. We will also help make sure you continue the specialty care and other services (for example, home health care or durable medical equipment) you are getting at the time you change your PCP.

PCP changes start the first day of the month after you give us your request. This is when you can start seeing your new PCP. We will send you an updated plan ID card within two weeks of your PCP change. The ID card will show your PCP information. If you see your new PCP after the first day of the month following your request but before you have your updated ID card, tell the new PCP’s office that you recently selected the PCP and Peoples Health member services can confirm the change.

What should you do if you have bills from out-of-network providers?
If an out-of-network provider sends you a bill asking you to pay for covered services, you should not pay the bill directly. Ask the provider to bill us first. We may pay the provider for our share of the bill, and we will let you know if you must pay anything. If you have already paid the provider, we may reimburse you for our share of the cost. Please call member services with any questions.
What if you have a medical emergency?
You can get emergency care from the closest available provider. As soon as possible, make sure that we know about your emergency. We need to follow up on your emergency care. You or someone else should call to tell us about your emergency, usually within 48 hours.

Some plans offer worldwide coverage for emergency care up to a combined annual maximum amount when members travel outside of the United States and its territories. See the Evidence of Coverage to find out if your plan offers coverage and for information on costs and the annual maximum amount.

What if you need urgent medical services?
You should always try to get urgently needed services from network providers when you are in the plan’s service area. If you are not in the plan’s service area or providers in our network are not available, you may get urgently needed services from any qualified provider.
What is the service area for Peoples Health?
The parishes in our service area are listed below:

Peoples Health Choices 65 #14 members: Ascension, Assumption, East Baton Rouge, East Feliciana, Iberville, Jefferson, Lafourche, Livingston, Orleans, Plaquemines, Pointe Coupee, St. Bernard, St. Charles, St. Helena, St. James, St. John the Baptist, St. Mary, Terrebonne, West Baton Rouge and West Feliciana parishes

Peoples Health Choices 65 #14 for Northshore members: St. Tammany, Tangipahoa and Washington parishes

Peoples Health Choices Gold members: Acadia, Bossier, Caddo, Calcasieu, Cameron, Evangeline, Iberia, Lafayette, Ouachita, St. Bernard, St. Landry, St. Martin and Vermilion parishes

Peoples Health Secure Health: Acadia, Ascension, Assumption, Bossier, Caddo, Calcasieu, Cameron, East Baton Rouge, East Feliciana, Evangeline, Iberia, Iberville, Jefferson, Lafayette, Lafourche, Livingston, Orleans, Ouachita, Plaquemines, Pointe Coupee, St. Bernard, St. Charles, St. Helena, St. James, St. John the Baptist, St. Landry, St. Martin, St. Mary, St. Tammany, Tangipahoa, Terrebonne, Vermilion, Washington, West Baton Rouge and West Feliciana parishes

Peoples Health Secure Choice #011: Allen, Avoyelles, Beauregard, Bienville, Caldwell, Catahoula, Claiborne, Concordia, DeSoto, East Carroll, Franklin, Grant, Jackson, Jefferson Davis, LaSalle, Lincoln, Madison, Morehouse, Natchitoches, Rapides, Red River, Richland, Sabine, Tensas, Union, Vernon, Webster, West Carroll and Winn parishes