Provider Enrollment

Workgroup Mission

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

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

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.

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.

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

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.

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

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.