- Provider Reference Guide
- Administrative Info
- Provider Initiatives
- Forms
- Referral Guides
- Educational Resources
- Plan Documents
- Policies and Guidelines
- Administrative Information
Administrative Information
Translated Resources and Materials One-Pager
Remote Access to Medical Records Frequently Asked Questions
ERA Enrollment Instructions
EFT Enrollment Instructions
Authorization Portal Instructions 2021
2023 Provider Benefit Packet
2021 Provider Portal User Guide
Peoples Health Authorization Requirements Link
Peoples Health Authorization Requirements
Search authorization requirements for specific procedure codes
- Provider Forms
Provider Forms
Medical Necessity Form
Home Health Recertification Form
EFT Enrollment Form
Provider Information Change Form (PICF) Link
Provider Information Change Form (PICF)
Use the PICF to update your provider profile and demographic details
Provider Initiatives
Review the attached overview sheets, which provide a short summary of each initiative’s purpose, as well as step-by-step instructions for how you can help make each initiative a success.
- Provider Initiatives
Provider Initiatives
Comprehensive Wellness Assessment (CWA)
Below are additional resources to help encourage your eligible patients to complete the Comprehensive Wellness Assessment (CWA). There is a call script that your staff can use to reach out to patients, a letter that you can send, as well as talking points to help explain the benefits of completing a CWA.
- Comprehensive Wellness Assessment (CWA)
Comprehensive Wellness Assessment (CWA)
- Forms
Forms
Request for Redetermination of Medicare Prescription Drug Denial
Request for Medicare Prescription Drug Coverage Determination Form
Provider Information Change Form
Medicare Outpatient Observation Notice (MOON)
Instructions for the Medicare Outpatient Observation Notice (MOON)
Detailed instructions for how to complete the MOON; CMS requires providers to follow these instructions when completing and distributing the notice.
Access Instructions
Medical Necessity Form
Instructions for the Notice of Medicare Non-Coverage
Instructions for the Detailed Notice of Discharge
Important Message from Medicare (IM)
Instructions for the Important Message (IM) From Medicare
Detailed instructions for how to complete the IM; CMS requires providers to follow these instructions when completing and distributing the notice.
Access Instructions
Home Health Recertification Form
FWA Allegation Referral Form
Compliance Referral Form
- Guides
Guides
Northern Louisiana (S1) Area - Primary Care Physicians
- Advance Care Planning
Advance Care Planning
- Dual Eligible Cost Sharing Information
Dual Eligible Cost Sharing Information
Peoples Health Secure Complete (HMO-POS D-SNP) Cost-Sharing Reference Sheet for Providers and Employees
Model of Care for Special Needs Plans (SNPs)
Details about our model of care for our SNPs
- Health and Chronic Conditions
Health and Chronic Conditions
Identifying and Documenting Heart Failure, Chronic Obstructive Pulmonary Disease and Chronic Kidney Disease
Evidence-Based Practice Guidelines Quick Reference- Prediabetes Diabetes Heart Failure CKD Alzheimer’s Disease and Dementia and COPD
Blood Pressure Documentation and Hypertension Treatment Quick Guide
- HEDIS and Stars
HEDIS and Stars
- Medications
Medications
Medication Adherence Discussion Guide - High Cholesterol
Medication Adherence Discussion Guide - High Blood Pressure
- Online Authorizations
Online Authorizations
Authorization Portal Instructions
Use these tip sheets to ensure your authorization request is accurately entered, reducing processing time.
- Tip Sheets
Tip Sheets
- Risk Adjustment
Risk Adjustment
- Social Determinants of Health
Social Determinants of Health
2022 Provider Reference Materials
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2022 In-Network Physician Office Visit Cost-Sharing 2022 Provider Benefit Packet
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2022 Provider Quick Reference Guides Physicians Ancillary Facilities Hospitals |
2021 Plan DocumentsPeoples Health Choices 65 (HMO) Orleans, Jefferson, East Baton RougeAnnual Notice of Changes Evidence of Coverage Peoples Health Choices 65 (HMO) NorthshoreAnnual Notice of Changes Evidence of Coverage Peoples Health Choices 65 (HMO) SouthlandAnnual Notice of Changes Evidence of Coverage Peoples Health Choices 65 (HMO) Rural SoutheastAnnual Notice of Changes Evidence of Coverage Peoples Health Choices Gold (HMO)Annual Notice of Changes Evidence of Coverage Peoples Health Choices (PPO)Evidence of Coverage Peoples Health Patriot (PPO)Evidence of Coverage Peoples Health Secure Health (HMO D-SNP)Annual Notice of Changes Evidence of Coverage Summary of Benefits Peoples Health Secure Choice (HMO D-SNP)Annual Notice of Changes Summary of Benefits Peoples Health Secure Complete (HMO D-SNP)Annual Notice of Changes Summary of Benefits Peoples Health Group Medicare (HMO-POS)Annual Notice of Changes Evidence of Coverage Peoples Health Group Medicare (HMO-POS) for Office of Group Benefits (OGB)Annual Notice of Changes Evidence of Coverage Peoples Health Choices Value (HMO)Annual Notice of Changes Evidence of Coverage Summary of Benefits Covered Drugs
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2022 Plan DocumentsPeoples Health Choices 65 (HMO) Greater New Orleans and Baton Rouge AreaAnnual Notice of Changes For members with permanent residence in Ascension, East Feliciana, Iberville, Livingston, St. Charles, St. Helena or West Baton Rouge parish: Evidence of Coverage Peoples Health Choices 65 (HMO) NorthshoreAnnual Notice of Changes Evidence of Coverage Summary of Benefits Peoples Health Choices 65 (HMO) SouthlandAnnual Notice of Changes Evidence of Coverage Summary of Benefits Peoples Health Choices 65 (HMO) Rural SoutheastAnnual Notice of Changes Annual Notice of Changes Evidence of Coverage Summary of Benefits Peoples Health Choices Gold (HMO)Annual Notice of Changes Annual Notice of Changes for Choices Value Evidence of Coverage Summary of Benefits Peoples Health Choices (PPO)Annual Notice of Changes Evidence of Coverage Summary of Benefits Peoples Health Patriot (PPO)Annual Notice of Changes Evidence of Coverage Summary of Benefits Peoples Health Secure Health (HMO D-SNP)Annual Notice of Changes Evidence of Coverage Summary of Benefits Peoples Health Secure Choice (HMO D-SNP)Annual Notice of Changes Summary of Benefits Peoples Health Secure Complete (HMO D-SNP)Annual Notice of Changes Summary of Benefits Peoples Health Group Medicare (HMO-POS)Annual Notice of Changes Evidence of Coverage Peoples Health Group Medicare (HMO-POS) for Office of Group Benefits (OGB)Annual Notice of Changes Evidence of Coverage
Covered Drugs |
- Evidence Based Practice Guidelines
Evidence Based Practice Guidelines
- Medical Policies