Newsletter: September, 2023
What you need to know
On August 15th, 2023 Georgia Department of Community Health (DCH) announced through a banner on their GAMMIS website that if providers do not complete revalidation by September 15th 2023, those providers would be dropped from Medicaid on 09/16/2023.
Subsequently, multiple communications have been released by the care management organizations (CMO’s) warning that if Medicaid contracts are suspended, they would also be dropped from those CMO contracts. As you can imagine, this has caused a lot of confusion and panic for practices who want to ensure that their providers do not get.
What does this mean, and what do I need to do?
The thought of losing Medicaid and CMO contracts is certainly concerning, but we wanted to explain what is happening so you and your practice can plan and react appropriately.
As a Medicaid provider, you are required to revalidate your information at least every five years. If you do not, Medicaid will drop you, and you will be required to reapply.
As part of the health declaration during Covid, DCH paused the practice of dropping providers who did not revalidate within their five-year time window. This current announcement relates to the providers who did not complete their revalidation within their windows and would have been dropped had not been for the pause during the pandemic time frame.
If providers were revalidated in compliance, this does not apply to you. This only applies to the providers who are out of compliance.
How do I know if providers are out of compliance?
For a list of out of compliance providers follow this link… Provider Revalidation Past Due by Provider Type
What to do?
If you have providers out of compliance, please complete the revalidation process by logging into GAMMIS for the corresponding provider. From there, go to Provider > Revalidation/Recredential and complete the application.
One of the benefits of working with The Glaeser Group is having a network of knowledge and experience to ensure you receive the maximum reimbursement possible. These monthly newsletters are to help spread the information we receive from insurance companies and vendors. We invite you to forward us information you think may be helpful to other members of our network to [email protected]