Notes from the Medicaid Fair 10/28/2021

Eligibility for Medicaid is updated daily, not weekly. What GAMMIS has for the member's eligibility is true. If the CMO states differently, need to report this to GAMMIS/Medicaid. If the CMO shows a primary insurance, go with what the CMO is stating.

*But the problem is, later in the meeting Medicaid stated that if the pt has a CMO, eligibility should be checked with the CMO first.

Provider rep contact info is listed on each CMOs website. Each CMO discussed that these links are listed under their contact us on their website for the state of GA

Amerigroup:

https://provider.amerigroup.com/georgia-provider/contact-us

https://provider.amerigroup.com/docs/gpp/GA_CAID_ProviderNetworkResources.pdf?v=202107271839

Caresource:

https://www.caresource.com/ga/providers/contact-us/medicaid/

click on contracting managers to get to this link:

https://www.caresource.com/documents/ga-p-0494-caresource-georgia-contracting-managers-pdf/

Peachstate:

https://www.pshpgeorgia.com/providers/resources.html

then click on Provider Relations Territory List

https://www.pshpgeorgia.com/providers/resources/territory-list.html

CMO provider reps are supposed to have a turnaround time of 48 business hours to respond to a question.

For credentialing with CMOs, after Medicaid is approved, new business need to request an application on their website. If it's a new provider being added to an existing business, roaster lists should be sent to provider rep of CMO.

Recordings for all the meetings this morning will be available on GAMMIS 11/15. Power points are already uploaded there now

GAMMIS: provider information tab, provider notices

There is no future cut off dates as of now for telehealth services. No changes are foreseen until after January, if any.