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.