Enrolled in Medicaid
Filing Instructions for nursing homes enrolled in Medicaid
NOTE: Due to the passcode saving problems being experienced with the Single Site report, a new template report is available (Version 11).
The files available below provide information about current reporting requirements and instructions for how provider fees should be paid.
Report Formats
NOTE: Clicking on the documents may open them in a new browser window. To download the files to your hard drive, right-click the file (Control-click on Macintosh) and choose "Save Target As...".
Quarterly
report for single site
-- Updated 04/02/24
Quarterly
report for single site (If partial period only)
-- Updated 04/02/24
Quarterly
report for multi-sites
-- Updated 04/02/24
Send the completed Excel data file as an e-mail attachment to the department at [email protected].
Report Instructions
Provider Fee Payments
Effective January 11, 2020, Georgia Department of Community Health has changed the system of receiving provider fee payment from Bank of America Velocity to JP Morgan Chase PAY CONNEXION. Please use the following resources for assistance https://dch.georgia.gov/provider-fee-payment-faqs or call 888-706-0081 or email [email protected].
If your facility has not received a Registration Email from [email protected], please submit the Sign-up Form below.
This file includes the forms needed to set up the electronic funds transfer for payment of provider fee payments. The forms may also be used to make changes to facility name, home office name, contact person, and bank information related to provider fee payments (only).
JPMorgan
Chase PAY CONNECT Sign-Up Sheet
- Updated 01/04/21
Contact Information
If you have any questions about the provider fee program or reporting requirements, please consult the below directory and contact the person designated for the subject of your questions.
Directory
of Contacts in Medicaid
- Updated 02/27/23