Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary

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Statewide Initiatives

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Common Questions - Provider FAQ: Health Plan Management

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If I contract with a Health Plan and do not like the service, what is the procedure for dropping that Health Plan?
What is the length of each provider's tenure with a Health Plan?
Are the transactions and payments between the Health Plan and the provider smooth and flawless?
Are Health Plans required to reimburse the current rates for provider based RHCs, or are they required to reimburse based on the cost + 10% formula for the duration of the contract?
What programs are available?
If I contract with a Health Plan, can I request exclusion from the plan's provider directory?
How does Bayou Health affect dentists?
What do the Bayou Health Plans do that Medicaid hasn’t done in the past?
What is the mediation process between providers and the Health Plans?
How will the Health Plans handle my complex patients who have multiple specialists across GSA lines?
How do school-based health clinics function within the Health Plans?
How will Health Plans ensure that their patients use their regular doctor's office when patients may have easy and unregulated access to urgent care clinics?
If I practice in multiple parishes/Geographic Service Areas, will I need to be credentialed in both service areas, i.e. more than one Health Plan?
If my patient lives in one service area but comes to see me in another service area, how can that patient be sure to specify my practice?
Do I need to give the Health Plans I am contracting with all of my current Medicaid provider ID numbers?
Why is there open access to in-network specialists in some of the Health Plans?
Do the patient's ID cards look different for each Health Plan?
How does DHH assign Medicaid patients to the Health Plans?