Why You Are Getting So Many Unwanted Calls
Most legitimate companies will not call you if your phone number is on the Do Not Call Registry. However, scammers do not adhereto this rule and will relentlessly call as many phone numbers as possible. Current technology also makes it easy for them to spoofor fake the caller ID.
The best practice is to simply Not Answer calls from numbers you do not recognize and let it go to voicemail. Although that may notbe practical for some, legitimate callers will usually leave a message and you can return those specific calls. You canread more here from the FTC.
Who Can Be In Star+plus
To get services through STAR+PLUS you must: be approved for Medicaid, be one or more of the following:
- Age 21 or older, getting Supplemental Security Income benefits, and able to get Medicaid due to low income.
- Not getting SSI and able to get STAR+PLUS Home and Community-Based Services.
- Age 21 or older, getting Medicaid through what are called “Social Security Exclusion programs” and meet program rules for income and asset levels.
- Age 21 or over residing in a nursing home and receiving Medicaid while in the nursing home.
- In the Medicaid for Breast and Cervical Cancer program.
The following people can’t be in the STAR+PLUS program:
- People over 21 who get Medicaid 1915 waiver services or who live in community homes for people with Intellectual Developmental Disabilities , and get Medicare.
- People who are not able to get full Medicaid benefits, such as Frail Elderly program members, Qualified Medicare Beneficiaries, Specified Low-Income Medicare Beneficiaries, Qualified Disabled Working Individuals and illegal immigrants.
- People who aren’t able to get Medicaid.
- Children in state foster care.
- Age 20 or younger and not in the Medicaid for Breast and Cervical Cancer program.
Important notes for those covered by Medicare:
How Do I Renew Chp+ Coverage
- Children enrolled in CHP+ must reapply every year. CHP+ will send you a packet about 3 months before your childs coverage ends. Complete this and return it to CHP+ as soon as possible. If you do not receive a renewal packet, call CHP+ Customer Service at 359-1991 to ask for one.
- Clients who have an active PEAK account will also have the ability to pay enrollment fees and update their information at any time.
- Pregnant women enrolled in the CHP+ Prenatal Care Program cannot renew coverage after their pregnancy ends. If you do become pregnant again, however, you can apply again.
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Who Are The Managed Care Organizations
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.
Number To Report Changes To Benefits
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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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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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.
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Unitedhealthcare Connected For Mycare Ohio
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. .
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Unitedhealthcare Connected General Benefit Disclaimer
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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Which Doctors Can I Visit
CHP+ works with Managed Care Organizations to provide health care to you or your child. Each MCO has their own network of doctors that you or your child can see on CHP+. The county you live in will determine which MCO you or your child enrolls with.
Your CHP+ MCO can help you find a doctor for you or your child.
Get Help Finding Information
Visit our Help Finding What You Are Looking For page where you’ll find contact information for some of our most requested services including:
- Help with your benefits or technical issues with the YourTexasBenefits.com website
- Information on how COVID-19 may affect your benefits
- Questions about your Lone Star Card
- Child care licensing questions
- Long-term care provider licensing information
- Help with downloading a form
- Technical issues with this website
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Are You Already Getting Insurance Through Your Employer
If you have health insurance coverage through your employer, you should keep that insurance and reach out to HRA. Medicaid may cover the cost of the premium for that insurance coverage.
The MBI-WPD program does not offer family coverage. Single people and married couples are both covered under this program if both individuals are working and have a disability. Spouses without a disability and children may be covered through other programs such as Medicaid through New York State of Health or Child Health Plus.
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
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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
The Georgia RAC Audit Agenda for the First Quarter of SFY 2023 has been posted.
Secure File Transfer Portal
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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/7 Access To Telemedicine With Teladoc*
Talk to a doctor any timefor a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.
*Telemedicine isnt a replacement for your Primary Care Provider . Your PCP should always be your first choice for care .
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What Does It Cost
CHP+ costs vary depending on your household size and income. CHP+ members may have to pay an annual enrollment fee. This fee is due within 30 days of your CHP+ approval. If the enrollment fee is not paid within the 30 days allowed then the family will be denied and will need to re-apply. Some CHP+ clients may also have to pay co-pays to their health care provider at the time of service. Prenatal women, American Indians and Alaskan Natives do not have to pay annual enrollment fees or co-pays.
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How Do I Get Dental Benefits
DentaQuest provides dental benefits to all eligible and enrolled CHP+ child members and to pregnant women. These benefits include preventive and diagnostic services, restorative services, endodontic, periodontic, prosthodontic, oral surgery, and limited orthodontic services. There will be a maximum allowable of $1000.00 per member per calendar year . As with all CHP+ benefits, higher income families may be required to pay a small fee or co-payment when they receive services. CHP+ Prenatal women will not be charged co-payments for dental services. If you have any questions about CHP+ dental benefits call DentaQuest at 1-888-307-6561, TTY 711.
Please visit the DentaQuest Member Access page. After registration, you will be able to search for a dentist, check your benefits, and download your member ID card.
Medical Standards Of Care And Clinical Practice Guidelines
If you want to research the clinical practice guidelines for a disease, condition, treatment or intervention or for health services administration, you can browse them online here. Your prescription in determining the standards of care and clinical guidelines applicable to your cases. Medical standards of care and clinical practice guidelines are established by a consensus of health care professionals as diagnostic and therapeutic actions or behaviors that are considered the most favorable in affecting the patients health outcome. The Internet offers a wide variety of expert consensus and evidence-based standards and guidelines, which provide insight, on a national level, to a broad scope of medical practice. Additionally, standards of care are established through, state and federal regulations, institutional policy & procedures, expert witnesses and literature. These links will lead directly to the pertinent sections on standards, guidelines, or position statements.
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What If I Need Immediate Care For My Pregnancy
If you are pregnant, you may qualify for a program called Presumptive Eligibility . PE is a way for pregnant women to receive prenatal care right away without having to wait to see if you are eligible. To apply, you must visit a PE Site and they will do a quick review. If found eligible you will get enrolled for up to 60 days while you wait to see if you qualify. Find a PE Site in your area.
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
PeachCare for Kids Phone Number
Georgia Medicaid Eligibility Phone Number
Georgia Medicaid Member Services Phone Number
Georgia Medicaid Provider Services Phone Number
Georgia Medicaid Customer Service Phone Number
Georgia Medicaid Claims Resolution Phone Number
Georgia Medicaid Policy Phone Number
Georgia Medicaid Hospital Services Phone Number
Georgia Medicaid Long-Term Care Phone Number
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.
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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:
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.
How Can You Apply
You or your authorized representative can apply by mailing in an application to the address below:
Initial Eligibility Unit HRA/Medical Assistance Program PO Box 24390 Brooklyn, NY 11202-9814
You can also fax your application to 917-639-0732. Your authorized representative can fax an application to 917-639-0731.
You or your authorized representative can also apply at any local Medicaid office within New York City. You can call 311 for the nearest Medicaid Office, or visit our Medicaid Office page for the complete list.
For help applying, please see this list of facilitated enrollers.
For more information, call the Medicaid Helpline at 1-888-692-6116 or visit the NYS website.
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How Long Does Chp+ Coverage Last
- For children, CHP+ coverage begins the date the application is received at the CHP+ office, an Application Assistance Site, or a county office. Coverage lasts at least 12 months.
- For pregnant women, CHP+ Prenatal Care Program coverage begins the date the application is received at the CHP+ office, an Application Assistance Site, or a county office. Coverage will last for at least 60 days after your pregnancy ends.
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 .
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