Providers

• Training
  • Schedule an Orientation in Your Office
• Resources
  • Cultural Competency and Language Services
  • Credentialing
  • NaviNet
  • PCP Auto Assignment
  • Provider Directory
  • Provider Forms
  • Provider Grievances
  • Provider Handbook
  • Provider Marketing Guidelines
  • HIPAA
  • QAPI Program
• Clinical Information
  • Clinical Practice Guidelines
  • Preventive Health Guidelines
  • Preventive Pediatric Health Care
  • Member Rights and Responsibilities
  • Prior Authorization
  • Provider Reference Guide
  • Referrals
  • Flu Information
  • Pediatric Preventive Health Care Program (EPSDT)
• Billing
  • Billing Manual
  • Electronic Funds Transfer
  • Electronic Claims Submission (EDI)
  • Electronic Remittance Advice (ERA)
• Non-Contracted Providers
  • Continuity of Care for Non-participating Providers
  • Contracting Information
  • Non-Participating Provider Demographic Information Form
  • Prior Authorizations
• Communications
  • Contact Account Executive
  • DHH Information
  • ICD-10
  • LaCare Provider Letters
  • Newsletters
• Pharmacy

Provider Handbook

• Complete Provider Handbook (PDF)

View/Print sections of the Provider Handbook

• Table of Contents (PDF)

• Introduction (PDF)
  About LaCare, NPI Number, Telephone Numbers and Definitions

• Section I (PDF)
  Physician Office Standards & Requirements

• Section II (PDF)
  Member Eligibility

• Section III (PDF)
  Covered Benefits

• Section IV (PDF)
  Referral & Authorization Requirements

• Section V (PDF)
  Claims Disputes and Provider Complaints

• Section VI (PDF)
  Provider Services

• Section VII (PDF)
  Quality Management, Credentialing, and Utilization Management

• Section VIII (PDF)
  Special Needs & Case Management

• Section IX (PDF)
  Member Rights and Responsibilities

• Section X (PDF)
  Provider Medical Necessity Appeals, Member Appeals, Complaints & Grievances

• Section XI (PDF)
  Regulatory Provisions

• Section XII (PDF)
  Accessing Other Medicaid Covered Services and Community Resources not covered by LaCare

• Appendix (PDF)
  • 1 - KIDMED Periodicity Schedule (PDF)
  • 2 - Immunization Policies and Procedures Manual (PDF)
  • 3 - Louisiana Department of Health and Hospitals Immunization Schedule (PDF)
  • 4 - Recommended Immunization Schedule for Persons Aged 0 Through 6 Years (PDF)
  • 6 - Referral Form (PDF)
  • 8 - Observation Billing Guidelines (PDF)
  • 9 - Hospital Notification of Emergent/Urgent Admissions (PDF)
  • 10 - Medicaid Program Acknowledgment of Receipt of Hysterectomy Information (PDF)
  • 11 - Consent for Sterilization (PDF)
  • 12 - Certification of Informed Consent - Abortion (PDF)
  • 13 - Department of Health and Hospitals Newborn Eligibility System User Manual (PDF)
  • 14 - Obstetrical Needs Assessment Form (PDF)
  • 16 - Mobile Phlebotomy Service Providers (PDF)
  • 17 - National Quality Forum Serious Reportable Events in Health Care (PDF)
  • 18 - Preventable Serious Adverse Event Screening Codes (PDF)
  • 19 - Multiple Claims Project Sheet (PDF)
  • 20 - Provider Change Form (PDF)
  • 21 - Patient Consent for Provider to File a Grievance (PDF)
  • 22 - Louisiana Domestic Violence Facts (PDF)
  • 23 - Non-Participating Provider Emergency Services Payment Guidance (PDF)
  • 24 - Provider -Reference - Guide (PDF)
  • 26 - Claim Filing Instructions (PDF)