Frequently Asked Questions
Q: As a PCP, do I need authorization from Peoples Health to perform laboratory services in my office?
A: All lab work must be sent to Quest Diagnostics for testing except for certain procedures that you are authorized to perform in your office. For a listing of procedures that you can perform in your office, please refer to the Peoples Health Provider Reference Guide or the Physician Quick Reference Guide.
Q: As a specialist, do I need to have services authorized before I perform them?
A: Certain services/procedures require prior authorization before they can be rendered, and these are listed on the back of the Medical Necessity Form. There are also certain exceptions to these procedures/services that do not require prior authorization, and these are listed on the Authorization Exceptions List. If you determine that your patient needs one of these services/procedures, you must request prior authorization from Peoples Health to ensure those services will be covered. To do this, before rendering services, you must complete and fax a Medical Necessity Form to the Peoples Health Medical Management department at (504) 849-6979, or toll-free at (866) 464-5709.
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) 849-4690, or toll-free at (866) 553-5705, Monday through Friday from 8 a.m. to 8 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 Guides updated? How can I get a copy?
A: 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.
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 Diagnostics.
Q: What if I can't get in touch with my Provider Relations representative?
A: If you cannot reach your Provider Relations representative, you may contact Paula Crain, Provider Services Manager, at (504) 681-8807.
Q: What health plans does Peoples Health administer?
A: Peoples Health currently administers five health plans in Louisiana.
Q: How do I know which physician team the member is in?
A: To find out which physician team the member is in, you can look on their plan ID card or call Member Services at (504) 849-4690, or toll-free at (866) 553-5705, Monday through Friday, from 8 a.m. to 8 p.m.