medicaid reimbursement for well child visits

MEDICAID REIMBURSEMENT FOR WELL CHILD VISITS FOR FREE
MEDICAID REIMBURSEMENT FOR WELL CHILD VISITS HOW TO
MEDICAID REIMBURSEMENT FOR WELL CHILD VISITS UPDATE

Practices are encouraged to check eligibility for their patients when scheduling appointments and retaining the eligibility screen confirming coverage on the day services were provided. Members who have aged out of PeachCare for Kids or are no longer eligible for Medicaid, will be referred to the Federally Facilitated Marketplace for alternative healthcare options.

MEDICAID REIMBURSEMENT FOR WELL CHILD VISITS HOW TO

Instructions on how to appeal a denial decision will be included in the notice. If a member disagrees with the denial decision, he/she has the right to appeal the decision.

If the member “failed to submit” their documents within their renewal period, they can still submit their documents within 90 days of their redetermination date. If a member is deemed ineligible and is denied coverage, they will be notified through mail or via email. Additional resources for physicians and families can be found at If a member is still eligible, notification will be sent confirming eligibility either through mail or via email that their coverage has been renewed for another year. If the individual is deaf, hard of hearing, deaf-blind, or have difficulty speaking, they can dial 711 for the Georgia Relay service.

MEDICAID REIMBURSEMENT FOR WELL CHILD VISITS FOR FREE

If a family needs assistance in reading and communicating with DFCS, they can also call 1-877-GA-DHS-GO (1-87) for free interpreters. In-person assistance can be scheduled at the various Division of Family & Children Services (DFCS) listed here. These English & Spanish flyers outline the process for families. This number can also be retrieved from the “Manage My Account” page of the Georgia Gateway.įamilies can choose if they want to be contacted about the renewal process by mail, phone, or email here. Families are encouraged to write it down their T Number for later use. Once families have successfully created a profile or updated their information on Gateway, they will receive a confirmation “T number” (tracking number).

MEDICAID REIMBURSEMENT FOR WELL CHILD VISITS UPDATE

Please encourage families to update their current account or create an account at so that they can stay informed about this process. The notice will explain that the member’s redetermination process has begun, and that they may have to submit documents such as pay stubs or other materials to complete their redetermination. Notices and/or emails will be sent to all members approximately 45 days before their coverage is scheduled to end. The redetermination process involves collecting and verifying information, including income and contact details, as well as other requested information or documents related to determining eligibility. A renewal date is the anniversary date of when an individual was enrolled in Medicaid or PeachCare for Kids® and can occur within the 14-month redetermination period from April 1, 2023, to May 31, 2024.

The purpose of the eligibility review is to determine if a member is still eligible for Medicaid or PeachCare for Kids® coverage. Beginning April 1, 2023, Georgia will begin the process of redetermining eligibility for all individuals enrolled in Medicaid or PeachCare for Kids® on their designated renewal date as per the 2023 Consolidated Appropriations Act.

Medicaid reimbursement for well child visits