CareSource product lines include Medicaid, Marketplace, and Medicare Advantage programs. Download the free version of Adobe Reader. Call us at1-800-704-1484(TTY/TDD 1-800-255-0056). P4HB members renew every 12 months. Need help or your renewal date? That change is a result of the state's effort to reassess the Medicaid eligibility of Georgians who . How you know. Members can apply for this free benefit. The Department of Community Health employs a care management approach to organize its system of care, enhance access, achieve budget predictability, explore possible cost containment opportunities, and focus on systemwide performance improvements. In partnership with Georgia Families,Peach State will help educate both the Georgia Medicaid members and healthcare providers about the enhancements to the Medicaid and PeachCare for Kids programs. Peach State Health Plan's plan is called Ambetter. Medicaid Provider Search Medicare Provider Search Machine Readable Directories Georgia Medicaid & Health Insurance | Peach State Health Plan An official website of the State of Georgia. Thank you for choosing Peach State Health Plan as your Office of Analytics and Program Improvement, Medicaid Promoting Interoperability Program. Backed by our parent company, Centene Corporation, Peach State draws on financial stability and national expertise to deliver local services and programs. Contact Georgia Medicaid | Georgia Medicaid Thank you for participating in our network of high-quality physicians, hospitals, and other healthcare professionals. Georgia - Envolve Dental Peach State Health Plan does not accept responsibility or liability for any loss or damage arising from the use of email. Product lines include Medicaid, Medicare Advantage, Medicare Prescription Drug Plans, State Children's Health Insurance Programs, and others. An official website of the State of Georgia. For example, surgery. Last Updated On: 1/28/2020 People age 65 and older, under 65 with certain disabilities, and any age with End-State Renal Disease ESRD (permanent kidney failure requiring dialysis or a kidney transplant) may be eligible for coverage through Peach State Health Plan Advantage. Backed by our parent company, Centene Corporation, Peach State draws on financial stability and national expertise to deliver local services and programs. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. Contact Medicaid Care Management Organizations (CMOs), File a Complaint about a Licensed Facility, File a Mental Health Parity Complaint Form, CMO Encounter Report - Amerigroup April 2021 thru March 2023, CMO Encounter Report - Amerigroup February 2021 thru January 2023, CMO Encounter Report - Amerigroup December 2020 thru November 2022, CMO Encounter Report - Amerigroup October 2020 thru September 2022, CMO Encounter Report - Amerigroup August 2020 thru July 2022, CMO Encounter Report - CareSource April 2021 thru March 2023, CMO Encounter Report - CareSource February 2021 thru January 2023, CMO Encounter Report - CareSource December 2020 thru November 2022, CMO Encounter Report - CareSource October 2020 thru September 2022, CMO Encounter Report - CareSource August 2020 thru July 2022, CMO Encounter Report - Peach State April 2021 thru March 2023, CMO Encounter Report - Peach State February 2021 thru January 2023, CMO Encounter Report - Peach State December 2020 thru November 2022, CMO Encounter Report - Peach State October 2020 thru September 2022, CMO Encounter Report - Peach State August 2020 thru July 2022, CMO Encounter Report - Wellcare October 2020 thru September 2022, CMO Encounter Report - Wellcare August 2020 thru July 2022, State Health Plan HS&R Quarter 4 2022 Report, State Health Plan HS&R Quarter 3, 2022 Report, State Health Plan HS&R Quarter 2, 2022 Report, State Health Plan HS&R Quarter 4, 2021 Report, State Health Plan HS&R Quarter 3, 2021 Report, State Health Plan - HS&R Quarter 1, 2021 Report, State Health Plan - HS&R Quarter 4, 2020 Report, of Ownership and Control Interest and Criminal Conviction Information, of Ownership Control Interest Criminal Conviction Information, State-Disclosure of Ownership and Control Interest and Criminal Conviction Information, Facebook page for Georgia Department of Community Health, Twitter page for Georgia Department of Community Health, Linkedin page for Georgia Department of Community Health, YouTube page for Georgia Department of Community Health, Planning for Healthy Babies Member Handbook, Planning for Healthy BabiesMember Handbook, Georgia Families and PeachCare for Kids Member Handbooks, Medicaid Sign-Up Portal (Georgia Gateway). To apply for Medicaid, please apply online https://gateway.ga.gov or in person at your local DFCS county office or or request an application by calling 877-423-4746. Providers with the following specialtieshave different participation requirements. Amerigroup Community Careis a wholly-owned subsidiary of Amerigroup Corporation, the nation's largest company solely focused on low-income families and people with disabilities. CareSource-Brand-Logo-Vert-RGB-resize.png. Both programs include fee-for-service and managed care components. must be checked before submitting. How do I know if I am in the right place? How you know. Tell them you want to choose Peach State Health Plan. If you are a non-contracted provider, you will be able to register after you submit your first claim. Medicaid A health insurance program for low-income families, pregnant women and women with breast or cervical cancer. Choose Peach State Health Plan. Before sharing sensitive or personal information, make sure youre on an official state website. Product lines include Medicaid, Medicare commercial, federal employees, and specialty services. With a regional headquarters located in Atlanta, CareSource is ready to welcome new Georgia members and health providers. In-patient hospital services. Georgia Familiesis a program that delivers health care services to members of Medicaid and PeachCare for Kids. The threeCMOs toll-free numbers for health care providers to learn more about enrollmentwith Georgia Families are provided below: Amerigroup Community Careis a wholly-owned subsidiary of Amerigroup Corporation, the nation's largest company solely focused on low-income families and people with disabilities. For further information regarding the new CVO credentialing process, please visit GAMMISor contact HP Provider Call Center at 1-800-766-4456. To learn more, please select from the following options: I'm a Medicaid Member I'm a Medicare Member I'm a Provider Do you have questions? Provider Portal If you are a contracted provider, you can register now. You can also call member services at 1-800-704-1484 (TTY/TDD 1-800-255-0056) Monday-Friday, 7 a.m. to 7 p.m. Or call Provider Services at 1-866-874-0633 Monday-Friday, 7 a.m. to 7 p.m.We are closed on holidays. Peach State Health Plan (Peach State) is a physician-driven, Georgia-based Medicaid managed care plan. Be sure to receive the services listed below from a Peach State Health Plan provider. Specifically, the Medicaid and CHIP Managed Care Rule requires states and managed care plans to provide the following information: The State of Georgia introduced the Georgia Families managed care program in 2006 and contracts with private Care Management Organizations to deliver services to enrolled members. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Hospital Providers - For hospitals in our state, youll find links to DCHs Division of Healthcare Facility Regulation and their Office of Health Planning as well as information about the Indigent Care Trust Fund, Diagnosis Related Groups, the Outpatient Settlement Repayment Policy, Out-of-State Services, Transplants and more. REGULATORY MATTERS 94. HealthPlan - redirect.centene.com Per federal regulations, the Department of Community Health must periodically, but no less frequently than once every three years, conduct or contract for an independent audit of the accuracy, truthfulness, and completeness of the encounter and financial data submitted by, or on behalf of each Care Management Organization and post the results of these audits on our website. In Georgia, WellCare and Peach State Health Plan are bringing our health plans together to better serve our members, providers, partners and communities. "Confirm Year of Birth" must be completed properly before submitting. been Medicaid-eligible or unable to access care due to financial challenges. Provider Performance Monitoring and Incentive Programs 92. You will have 30 days to enroll in Georgia Families and choose a health plan. Visit gateway.ga.gov to check your contact information. Authorization for Cancer Treatment/New Century Health, How to Create Positive New Habits in our New World. Amerigroup is dedicated to offering Georgia Medicaid families and PeachCare for Kidsmembers the standard Medicaid benefits plus extra value-added services. You will need Adobe Reader to open PDFs on this site. Local, state, and federal government websites often end in .gov. You will need Adobe Reader to open PDFs on this site. Physicians - This section of our site focuses on matters of significance to Physicians enrolled in our Medicaid and PeachCare for Kids programs. Georgia Healthcare Solutions | Centene Corporation (Exception: No Prior Approval required when Sleep Study is performed in the home). Try to take moments to breathe and be kind to yourself. The Department of Community Health is responsible for administering the Medicaid program and CHIP in the State of Georgia. More information can be found on this page. We encourage you to log into your secure account where many of your questions may be answered. "Confirm Street Address" must be completed properly before submitting. The State refers to its CHIP as PeachCare for Kids. Speech and hearing services. For more information about Peach State or how to join our growing network of providers, call us at 1-866-874-0633 or visit our website athttps://www.pshpgeorgia.com/. To request a package by mail or a visit by one of our Georgia provider representatives, call us at 1-800-249-0442. View List Join Our Network Interested in becoming an Ambetter provider? Peach State Health Plan must approve some treatments and services before our members can receive the service. Transplant procedures and related services, regardless of age. View claims, get a new ID card, update your information and more! Program eligibility depends on your age, income, family size and any special health needs you may have. These hospitals are listed in your Provider Directory. Georgia Families members need to renew each year. Georgia Medicaid An official website of the State of Georgia. You will get renewal note in the mail before the deadline. Authorization for Cancer Treatment/New Century Health. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Georgia Medicaid Prior Authorizations and Referrals | Peach State Learn about how you can keep yourself and your family healthy. An official website of the State of Georgia. All services must be medically necessary. Georgia----- 183 Illinois . National Network 97 This will help keep your healthcare costs affordable. "Confirm NPI Number" must be completed properly before submitting. Peach State Health Plan offers health insurance plans that fit your unique needs. How to Apply for Medicaid in Georgia | Peach State Health Plan Mail or fax it to Georgia Families . This will take you to more information about that program. How do I know if I am in the right place? "Confirm City" must be completed properly before submitting. CareSource was founded in 1989 and is a nonprofit model of managed care. DCH has moved! An official website of the State of Georgia. Source: Advantage Suite, 6/26/2023, HD;This report is based on Medicaid and Peachcare for Kids members in May 2023. Read More Please take a moment to check that your contact information is up to date so you can keep your Medicaid coverage. We can help! Once you have created an account, you can use the Peach State Health Plan provider portal to: Thank you for your interest in becoming a Peach State Health Plan network provider. Take care of your family with full healthcare coverage, programs, and services from Peach State Health Plan. To learn more about Amerigroup Community Care: CareSourceis one of the nations largest Medicaid managed care plans, CareSource has been providing life-changing health care coverage to people and communities for nearly 30 years. Local, state, and federal government websites often end in .gov. An official website of the State of Georgia. . Some covered services or medications may need approval from Peach State Health Plan, and this is called a Prior Authorization. Sleep Studies. Federal And State Laws Governing the Release of Information 96. Peach State Health Plan | Georgia Department of Community Health A Family planning program for women who do not qualify for Medicaid, or who have lost Medicaid coverage. For your convenience, this section of our website was created to centralize information that may be particularly important to you as Medicaid and PeachCare for Kids providers. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. The Department of Community Health is the single State agency for Medicaid. Peach State Peach State. After creating an account within the Peach State Health Plan provider portal you can: Verify member eligibility Check & submit claims Submit & confirm authorizations Your Primary Care Provider will work with you to make sure you get the services you need. call center at 1-877-687-1180. You will need Adobe Reader to open PDFs on this site. MRI/MRA, PET scans. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. Find a Medicaid Provider | Georgia Medicaid | Peach State Health Plan Find a Doctor Find a Doctor Start your search for a doctor, dentist, specialist, hospital, clinic, or pharmacy in our network. Use the Find A Doctor Tool to search for in-network Medicare doctors, hospitals, pharmacies, and other providers. Georgia Medicaid unwinding causes 100,000 to lose health insurance Go Now Find a Medication View our Preferred Drug List to see what drugs are covered. Product lines include Medicaid, Medicare commercial, federal employees, and specialty services. This process will take approximately 14 months. Download the free version of Adobe Reader. The GAMMIS site is used for provider enrollment; client eligibility, including third party liability; benefit package maintenance; managed care enrollment; claims processing; prior authorizations; notices and information. Provider News - In this section, youll find the latest news about the mandated transition to ICD-10 Code Sets, the Hospital Provider Payment Program, the ACAs mandates on rate increases for certain primary care practitioners, Centralized Credentialing for new Medicaid Providers, Medicaid Enrollment for Ordering, Prescribing and Referring Providers and on-going audits and reviews being conducted by DCHs Office of the Inspector General. EMR Access 96. The email is not encrypted and is not transmitted in a secured format. *Accredited: NCQA has awarded an accreditation status of Accredited for service and clinical quality that meet the basic requirements of NCQAs rigorous standards for consumer protection and QI. Amerigroup is a wholly owned subsidiary of Anthem, Inc., founded in 2004 with the merger of Anthem and WellPoint Health Networks.