Provider Enrollment

Workgroup Mission

Increase Georgia’s Medicaid provider enrollment and retention by reducing barriers to an expedient and consistent user experience.

Current Projects

OAPI FY 2022 – 2024 Strategic Goal: Relieving burdens for our stakeholders, providers, and members.

CMO Notifications

  • Currently, the CMO systems automatically generate a welcome letter that is mailed.
  • Heard providers concerns of not being notified of provider effective dates or the letter going to the wrong office.
  • To relieve external factors, such as USPS hold ups or miscommunication, we streamline the notification by process by requiring all CMOs to upload the provider effective date letters to their portals.
  • Currently in the final stages of drafting communications to be released to providers.
  • Projected completion date: August 2023.

Dental Hospital Privileges

  • Removed a barrier for dental providers enrolling in Medicaid.
  • The Department of Community Health revised the policy to remove the requirement for dentists to have hospital admitting privileges as a condition to enrolling in the Medicaid/CHIP program.
  • Projected timeline:
    • This change is now in production on the GaMMIS portal.
    • A banner message has been released.
    • The change will be in the next release of the Part II Policies and Procedures for Dental Services.

Upcoming Projects

OAPI FY 2022 – 2024 Strategic Goal: Relieving burdens for our stakeholders, providers, and members.

7400 Items

  • Adding age ranges.
  • Requiring Provider Degrees. 
  • Group enrollment.
  • Enrollment on TIN/NPIs to reduce duplication.
  • Adding additional information for the CMO provider directory, such as area or population expertise.

CISS ACE

  • Creating FAQs, tutorials, and updated field representative contact information to assist the local educations agencies in their re-credentialing and revalidation process.

Engage provider groups and DCH Internal teams

  • We will be reaching out to provider groups to ensure that CPI is listening and responding to the concerns within our Medicaid provider network and the communities that they serve.
  • Working with additional departments within the Department of Community Health to identify areas of improvement, execute on, and facilitate completion of program improvement efforts.