Providers - Related Links
Providers
For Our Providers
The Georgia Department of Community Health (DCH) values all physician and health care provider contributions to the health and well-being of all Georgians. For your convenience, this section of our website was created to centralize information that may be particularly important to you as Medicaid and PeachCare for Kids® providers.
Georgia’s Medicaid Management Information System (GAMMIS) is an integration of computer systems that process Medicaid and PeachCare for Kids claims and other pertinent information related to the management of the Medicaid and PeachCare for Kids programs. The GAMMIS site is used for provider enrollment; client eligibility, including third party liability; benefit package maintenance; managed care enrollment; claims processing; prior authorizations; notices and information.
National Provider Identifier - The National Provider Identifier (NPI) has been adopted by the U.S. Department of Health and Human Services to meet the HIPAA health care provider identification mandate. More information can be found on this page.
Provider Types
Physicians - This section of our site focuses on matters of significance to Physicians enrolled in our Medicaid and PeachCare for Kids programs. Links are also included to the two medical boards attached to the Department.
Hospital Providers - For hospitals in our state, you’ll find links to DCH’s Division of Healthcare Facility Regulation and their Office of Health Planning as well as information about the Indigent Care Trust Fund, Diagnosis Related Groups, the Outpatient Settlement Repayment Policy, Out-of-State Services, Transplants and more.
Nursing Home Providers - Here you’ll find Cost Reports, Amended Cost Reports, Provider Fee Report forms for Medicaid and non-Medicaid nursing facilities, Fair Rental Value System information for net per diem reimbursements and more.
Pharmacy - Information about Preferred Drug Lists, Prior Authorization criteria and process, the Pharmacy Benefit Manager (Catamaran, formerly known as SXC) and more can be found here.
Home Health, Dental, CIS/CISS and Other Providers
- Home Health section includes rate setting, cost reports and more.
- Dental section - Coming soon.
- Children’s Intervention Services (CIS) and the Children’s Intervention School Services (CISS) - Coming soon.
- Other Providers - Coming soon. This section will include information of particular interest to health care providers of Durable Medical Equipment (DME), Podiatry, Vision, Psychiatric Residential Treatment Facilities (PRTF), Early Intervention, Community Mental Health, Ambulatory Surgical Centers, Birthing Centers, Emergency Ambulance, Advance Nurse Practitioner and Nurse Midwifery.
Rural Health Centers - The State Office of Rural Health (SORH) works to improve access to health care in rural and underserved areas and to reduce health status disparities.
Provider Support
Provider News - In this section, you’ll find the latest news about the mandated transition to ICD-10 Code Sets, the Hospital Provider Payment Program, the ACA’s mandates on rate increases for certain primary care practitioners, Centralized Credentialing for new Medicaid Providers, Medicaid Enrollment for Ordering, Prescribing and Referring Providers and on-going audits and reviews being conducted by DCH’s Office of the Inspector General.