FAQ - General Questions
Health Plan Assignment
- Are patients able to call to preselect a Plan they know a provider contracts with so they will be placed in that Plan effective 7/1?
No, our systems do not have this capability. LDH explored doing this but the multiple system changes to do this were prohibitive.
- How will auto assign be done?
We have an algorithm in our State Plan and approved by CMS. If the individual was previously in Medicaid and in one of our Plans, they will be auto assigned to this Plan. Second thing we look at is other household members. As you know most enrollees for full service Medicaid in Louisiana are children, so if we are looking at the parents of a child and can identify relationship, the parents will be enrolled in the same Plan as their children. If we have claims info on someone, we can make sure the provider is in the Plan we assign. We do a round robin assignment, no balancing, no preference.
- Does LDH anticipate a shortage of providers with this expansion?
The five Healthy Louisiana Plans have been working successfully to increase their provider network capacity; LDH intends to closely monitor access to care and work with Health Plans to identify and address gaps.
- Can we see a list of Medicaid Providers in our area?
Provider list will be on every Healthy Louisiana Plan; there is a search engine. Real time resource is go to provider search for Healthy Louisiana and you can get it by provider type and parish (currently www.bayouhealth.com)
- In the Lake Charles area, I am concerned we will not have enough doctors. We may need to educate the recipients on who accepts Medicaid.
The five Health Plans will provide information and outreach on those doctors who open their panels. It is recommended that you work with patients to contact Member Services for their Health Plan.