Georgia Horizons Update

DCH would like to provide an update on the Georgia Horizons system regarding Elderly Disabled Waiver Program (EDWP) prior authorizations (PAs) and billing.

A significant number of PAs were incorrectly entered into Georgia Medicaid Management Information System (GAMMIS). DCH is actively working with our partners and vendors to identify and resolve the technical issues as quickly as possible while reinforcing training and operational protocols to prevent future errors.

The majority of EDWP prior authorizations have been successfully processed and are available in GAMMIS. DCH continues to monitor authorization processing, validate data, and implement corrective actions to ensure remaining issues are prioritized and to minimize any disruption to member services and provider billing.

To support timely issue resolution, DCH recently conducted a targeted training for EDWP case management agencies, which identified the appropriate process for identifying and troubleshooting prior authorization issues before escalating them for technical review. Case management agencies have also been provided with the training materials and job aids to share with their staff.

If a provider is unable to bill for authorized services, the following process should be followed:

1. Contact your assigned Gainwell Provider Representative to verify the billing issue.
2. If the issue persists, contact the case management agency assigned to the member to review the prior authorization and determine whether corrections are needed.
3. Case management agencies have been instructed to complete initial troubleshooting before submitting a support ticket to DCH. This process helps ensure issues are accurately identified and resolved as efficiently as possible.

Providers should begin seeing August prior authorizations loaded into GAMMIS next week in accordance with the established schedule.

 The Georgia Horizons team remains committed to reviewing every reported issue and continues to work closely with Gainwell and GAMMIS team to improve system performance. We appreciate the community's continued partnership and patience as we strengthen these processes and work toward timely and accurate service authorization and billing.