Certain services and procedures require prior authorization before they can be rendered, and these are listed on the back of the Medical Necessity Form. If you determine that your patient needs one of these services or procedures, you must request prior authorization from Peoples Health to ensure those services will be covered. To request authorization, you must complete and fax a Medical Necessity Form to the Peoples Health Medical Management department at one of the numbers listed on the form before rendering services.
There are some exceptions to this listing, which can be determined by using the Authorization Requirements Search. You can search the database by selecting a place of service code and inputting a CPT code to determine if the procedure requires prior authorization.
Medical Necessity Form
Download Medical Necessity Form – PDF
You can send a request to confirm eligibility and information directly from our website or you can call us toll-free at 504-849-4690, 225-346-5705 or toll-free at 1-866-553-5705, Monday through Friday, from 8 a.m. to 5 p.m.
Referral Guides, which include the names, phone numbers and addresses of the physician providers in each physician team, are updated on a monthly basis. Your provider relations representative will deliver an updated copy to you for the physician team(s) in which you participate.
If you need additional forms or other documents, you can either download them from the Plan Documents and Forms page or you can call your provider representative to receive printed copies.
The Peoples Health network lab provider is Quest Diagnostics for all laboratory services unless it is otherwise noted in your Provider Reference Guide that you can perform the laboratory service in your office or at your facility. Please refer all Peoples Health plan members to Quest Diagnostics.
If you cannot reach your provider representative, you may contact Meg Courtney, assistant vice president of network development operations, at 504-681-8812.
To find out which physician team the member is in, you can call us at 504-849-4690, 25-346-5705 or toll-free 1-800-553-5705, Monday through Friday, from 8 a.m. to 5 p.m.
A disaster can damage your ability to conduct your practice. Peoples Health requests that you complete our Evacuation Communication Information form to help ensure that we can maintain contact with you in the event of an emergency. You can download the form below and return it via fax to your provider representative at 504-849-6916.
Evacuation Communication Information Form
Download Evacuation Communication Information Form – PDF