Georgia Medicaid Provider Phone Number

Date:

Georgia Medicaid Replacement Card Number

Star Plus – Medicare Medicaid

If your Medicaid card was lost, stolen, or destroyed, you can ask for a replacement by contacting the Georgia Department of Community Healths Medicaid Member Services. You can reach them by phone at 1-866-211-0950.

For a complete list of all the available contact phone numbers for Georgia Medicaid, keep reading below.

Who Are The Managed Care Organizations

Amerigroup Corporation

Credentialing Process

DCH is in the process of revising its credentialing process and will begin to announce these changes as they occur. Current plans are to utlize HP to work with an NCQA approved vendor to manage the credentialing process. for details.

Checking Medicaid CMO Eligibility

With the implementation of HB 1234 in 2008, there have been some changes to the way you verify member eligibility. Previously, you would go to the CMOs websites to determine eligibility by plan affiliation however, due to the bill the only acceptable verification of plan affiliation for a member is via the GHP web portal. You may notice that all the CMOs have a link to the GHP web port for plan affiliation verification. You may still utilize the CMO eligibility verification for PCP assignment.

Who is eligible for the Georgia Families Managed Care Program?

Individuals who are eligible to enroll in Georgia Families include low-income families, children, and pregnant women, women eligible for Medicaid due to cervical cancer and PeachCare for Kids to managed care. Aged, Blind and Disabled population are included in the managed care program at this time. Children in foster care must opt out in order to not be transfered to Amerigroups Georgia Family 360.

Transportation With Logisticare And Southeastrans

Georgia Medicaid provides non-emergency medical transportation through two vendors: Logisticare and Southeastrans. Logisticare services Central, Southwest, and East Georgia, while Southeastrans services northern Georgia and metro Atlanta. To request service, use this chart to find the number for your county. Then, call between the hours of 7 AM and 6 PM from Monday to Friday to schedule your medical transportation. This is NOT for ambulance services – this is for helping you get to your doctors appointments or pick up your prescriptions.

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Unitedhealthcare Senior Care Options Plan

UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

Number To Check Application Status

Georgia Medicaid

If you are not a current Medicaid member, but have a Medicaid application pending, please contact your assigned Medicaid Eligibility Specialist. Every Medicaid applicant is assigned a Specialist upon submitting their application.

If you do not have the contact information for your Medicaid specialist, please contact the DFCS by calling the DFCS Help Center phone number at 877-423-4746.

Georgia Medicaid Portal

You can also check the status of your Medicaid application by logging into the Georgia Medicaid portal. The Georgia Medicaid Portal, also known as Georgia Gateway provides access to Medicaid benefits 24 hours a day, 7 days a week.

The Georgia Gateway online portal can be used to:

  • Apply for Medicaid benefits
  • Report changes that may affect your benefits
  • Upload verification documents
  • View notices and alerts about benefits

For help on how to log into your Georgia Gateway account, follow the .

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List Of Contact Phone Numbers For Georgia Medicaid

We have listed all contact information for Georgia Medicaid by department/service below.

Georgia Medicaid Application Request Phone Number

877-423-4746

PeachCare for Kids Phone Number

877-427-3224

Georgia Medicaid Eligibility Phone Number

404-651-9982

Georgia Medicaid Member Services Phone Number

866-211-0950

Georgia Medicaid Provider Services Phone Number

800-766-4456

Georgia Medicaid Customer Service Phone Number

404-657-5468

Georgia Medicaid Claims Resolution Phone Number

404-657-5468

Georgia Medicaid Policy Phone Number

404-651-9606

Georgia Medicaid Hospital Services Phone Number

404-651-9606

Georgia Medicaid Long-Term Care Phone Number

404-232-1411

If you do not see the Georgia Medicaid contact information you are looking for listed above, you can also send an email to the Georgia Division of Family and Children Services . To email the DFCS with additional questions, visit the link here.

Unitedhealthcare Dual Complete Plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call TTY 711 for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

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Georgia Medicaid Customer Service

We hope this post on how to contact Georgia Medicaid was helpful. If we are missing a contact phone number for Georgia Medicaid, please contact us and we will add that information to our post.

If your question was not answered and are still having trouble contacting Georgia Medicaid regarding your benefits, please let us know in the comments section below.

Number To Report Changes To Benefits

Medicaid

If you are a current Georgia Medicaid member, you can also contact the Division of Family and Children Services for help with your benefits. If you would like to report changes to your benefits, please contact the DFCS Call Center at 877-423-4746.

You can also report changes online 24 hours a day, 7 days a week by logging into your Georgia Gateway account. Click here for .

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How To Reach The Office Of The Ombudsman:

  • Phone: 214-7580 / Toll Free: 1-877-683-8993
  • The email and phone line are checked regularly between 8:00 a.m. 5:00 p.m.

The Office of Ombudsman:

  • Is a neutral, independent support for you
  • Helps arrange services with local groups
  • Involves covered and non-covered services
  • Helps guide you through your health plan
  • Helps to solve unsettled issues

Complete And Submit An Application

Self-service application options:

Online: Log on to Georgia Gateway at to apply for benefits. Available 24/7.

Call the Customer Contact Center at to submit an application by telephone.

An application is considered filed when it has the name of the head of household, address, date and signature of the head of household or another household member and is received by DFCS.

Notice of Free Interpretation ServicesIf you have difficulty communicating with us because you do not speak English or have a disability, please notify a staff person. Free interpretation services, translated materials or other assistance is available upon request.

For additional support with requesting large print versions of DFCS applications, please visit .

DFCS Reasonable Modifications and Communication Assistance Request Form for Persons with Disabilities

Do you have a disability and need a reasonable modification or communication assistance to access DFCS services? to request a reasonable modification, communication assistance, extra help or to learn more about the rights of customers with disabilities.

Medicaid Benefit Renewal

All benefits recipients are required to undergo periodic review of continued program eligibility. A renewal form and any required accompanying verification can be submitted in Georgia Gateway or by using Form 508 the FOOD STAMP/MEDICAID/TANF Renewal Form.

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Doctors And The Provider Network

To find a doctor near you that accepts your GA Medicaid plan, visit the Georgia Department of Community Health website. Keep in mind that you have a secondary insurance plan or if you are dual eligible for Medicare and Medicaid and have benefits from both, your provider network may be different. If you have a Medicare Advantage plan, youll need to check with your plan details to find out what doctors and pharmacies are within your plan network.

Have Questions? Request Information On Local Options

Planning For Healthy Babies

Contact Number for Georgia Medicaid [List]

Planning for Health Babies Planning for Healthy Babies is a waiver program developed by the DCH with the goal of reducing the number of low birth weight and very low birth weight births in Georgia. This program provides Family Planning, Inter-Pregnancy Care and Recourse Mother services to members 18 through 44, who would otherwise not be eligible for Medicaid.

Services include:

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Georgia Department Of Community Health

Myers and Stauffer provides professional accounting, consulting, data management and analysis services to state and federal agencies managing government-sponsored health care programs. We have more than 30 years experience assisting Medicaid agencies with complex reimbursement issues for hospitals, long term care facilities, home health agencies, federally qualified health centers, rural health clinics, pharmacy providers, physicians and other practitioners. Our specialized experience in health care consulting and reimbursement gives our clients an added advantage another partner at the table to address the ongoing challenges associated with todays complex health care environment.

Important Contact Information

1349 W Peachtree Street, Suite 1600Atlanta, Georgia 30309

Medicaid Recovery Audit Contractor

The toll-free Georgia Medicaid RAC telephone number is 201-4570. This number is staffed by trained personnel who can answer questions about the Georgia Medicaid RAC program. We are available between 8:00AM and 4:30PM , Monday Friday. Messages left after hours will be returned as quickly as possible. You can also reach us via e-mail at .

To update your provider contact information please email with the following information: provider number, contact name, email address, current address, and new contact address.

Audit Procedures and Protocols

Update

The Georgia RAC Audit Agenda for the First Quarter of SFY 2023 has been posted.

Secure File Transfer Portal

Using The Georgia Medicaid Application

If you think youre eligible, you can use the Georgia Medicaid application online through Georgia Gateway. If you have not applied for Medicaid in the state of Georgia before, youll need to create an account. Once you have a Georgia Gateway account, you can check, renew, and apply for benefits all online.

If you prefer, you can complete the Georgia Medicaid application in person at your local County Division of Family and Children Services office or Social Security office, or call 1-877-423-4746 . Alternatively, you can . Once you complete it, either mail, fax, or bring in your application to your local DFCS office. You can also apply for food stamps with this application.

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How Can Your Patients Can Enroll In Georgia Families

Maximus, the enrollment broker for GA Families, works with Medicaid members who are eligible to participate in the GF program. Members are encouraged to do the following to enroll:

  • By calling 1-888-GA-ENROLL or for the on line enrollment process.
  • Attending an assisted enrollment session
  • Once a member has enrolled into a plan, they will have 90 calendar days to change their health plan or PCP. After the 90-day period, they will not be able to make any changes to their health plan affiliation without cause until the open enrollment period begins the following year.

    To assist you and your patient in the enrollment process, there are a few thing you should know:

    Maximus has also developed a brochure and CMO comparison sheet that you can download from their website for distribution to your patients in the office.

    Providers can tell their patients which plans they are participating with, but they cannot advise their patients which plan to choose. The patients need to chose a plan based on their own decision making process.

    Please be reminded that CMO Medicaid members have the option during their open enrollment period to change their CMO and PCP assignment. Open enrollment is continuous, based on the individual members enrollment date. Members will receive a letter from Georgia Families 30 days prior to their enrollment anniversary date. If the member does not make a choice during the 30-day window they will remain in their CMO.

    Unitedhealthcare Connected General Benefit Disclaimer

    Georgia Medicaid Spring Virtual Fair 2022 Provider Appeal Process

    This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.

    You can get this document for free in other formats, such as large print, braille, or audio. Call Member Services, 8 a.m. – 8 p.m., local time, Monday – Friday . The call is free.

    You can call Member Services and ask us to make a note in our system that you would like materials in Spanish, large print, braille, or audio now and in the future.

    Language Line is available for all in-network providers.

    Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al Servicios para los miembros, de 08:00 a. m. a 08:00 p. m., hora local, de lunes a viernes correo de voz disponible las 24 horas del día,/los 7 días de la semana). La llamada es gratuita.

    Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro.

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    Office Of The Ombudsman

    The NavigateCareSource Office of the Ombudsman is an independent, neutral unit. If you have a problem that you feel CareSource has not addressed or resolved, the Office of Ombudsman is here to help. This involves:

    • Making sure you get a fair answer to any issues.
    • Helping you find covered care in the CareSource network.
    • Finding doctors who can provide care not covered under your CareSource plan.

    Receive Information From Your Care Management Organization

    Your child/childrens coverage will begin on the first day of the month after your child/children are enrolled.

    Medicaid recipients will receive one ID card from your Care Management Organization with Kaiser Permanente information on it.

    PeachCare for Kids recipients will receive two ID cards one from your Care Management Organization, and one from PeachCare for Kids.

    Please continue to bring your child/childrens Georgia Medicaid card to their appointments even after you receive their CMO ID card.

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    How To Cancel Georgia Medicaid

    If you need assistance canceling your Georgia Medicaid benefits, there are three ways you can cancel your Medicaid coverage.

    The three available options for canceling your Georgia Medicaid coverage are:

    Option 1 Cancel by Phone

    You can call the Georgia Department of Community Healths Medicaid Member Services phone number to cancel your coverage. You can reach them by phone at 1-866-211-0950.

    Option 2 Cancel online through Georgia Gateway

    You can also login to your Gateway account to submit a request to cancel your coverage.

    Your coverage will end on the last day of the month you selected for ending coverage. For example, if you requested to cancel your Georgia Medicaid coverage on May 15, your coverage ends as of May 31.

    Option 3 Contact Your Caseworker

    The third option for canceling your Georgia Medicaid coverage is by contacting the caseworker that handled your application. Your caseworkers name and contact information are available on your Medicaid paperwork.

    It is important to make sure that the date you select as your cancellation date does not leave you with a gap in coverage.

    Regardless of which method you choose to cancel your Medicaid coverage, you will receive a notice of cancellation in the mail.

    Unitedhealthcare Connected For Mycare Ohio

    Georgia Medicaid Income Limits

    UnitedHealthcare Connected® for MyCare Ohio is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio information, please contact our Member Services at from 7 a.m. to 8 p.m. Monday through Friday for help at no cost to you.

    Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio , comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al de lunes a viernes de 7 a.m. a 8 p.m. .

    This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays, and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.

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    Caresource24 Nurse Advice Line

    Members can call CareSource24®, our Nurse Advice Line any time to talk with a caring, skilled nurse. This is a free call. You can call 24 hours a day, 7 days a week, 365 days a year. Our nurses can help you:

    • Learn about a health problem
    • Find out more about drugs or over-the-counter medications
    • Find out about health tests or surgery
    • Learn about healthy eating habits

    To reach the CareSource24® Nurse Advice Line, call .

    Choose A Kaiser Permanente Doctor As Your Primary Care Provider

    In order to choose a Kaiser Permanente doctor:

  • First, find the Kaiser Permanente facility that is most convenient for you. Make a note of the facilitys address.
  • Then, contact the Care Management Organization you are assigned to and tell them the address of your preferred facility. Your CMO can see which providers are accepting new patients.
  • Kaiser Permanente may or may not be open to new Medicaid patients depending on our contract with our plan partners, WellCare, Amerigroup, Peach State, and CareSource.

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