December 2015

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DCH Prepares to Launch Credentialing for Fee-for-Service Only Providers

Effective January 7, 2016, Georgia's Department of Community Health's (DCH) Centralized Credentialing Verification Organization (CVO) will be responsible for credentialing and recredentialing Fee-for-Service Medicaid/PeachCare for Kids providers that are not affiliated with a Care Management Organization (CMO). This change will result in a uniform credentialing process for both Fee-for-Service and CMO providers (providers associated with Amerigroup, Peach State or WellCare).

The CVO's one-source application process will:
  • Save time;
  • Increase efficiency; and
  • Create one uniform credentialing process for both Fee-for-Service and CMO providers.
Click to read more...


The
ICD-10 Transition was October 1, 2015 - How Did Georgia Do?

October 1, 2015 was the go-live date for the transition to new ICD-10 code sets (CM - [diagnosis] and PCS [procedure] codes). With all the hard work that went into getting ready, providers probably have been wondering how the transition went.

"The transition has been smooth and successful," said Argartha Russell, DCH's Medicaid Director of Policy and Provider Services. "We had some challenges with providers learning and billing the new ICD-10 diagnosis codes, especially unspecified codes, but the vast majority of the providers are getting paid. These early challenges have been mostly resolved as well."

The success  of the ICD-10 project had to do with intense preparation, cooperation, and collaboration with dedicated staff resources assigned from DCH and Hewlett Packard Enterprise (HPE). Post-go live troubleshooting of any ICD-10 claim inquiries are being addressed by an ICD-10 Joint Triage Team (JTT) consisting of staff from HPE and DCH's policy specialists, clinicians, certified coders and ICD-10 consultants along with leadership's support from both DCH and HPE. The JTT will continue until the end of December.

GCHEXS Webinars and Information to Keep You Ahead of the Curve

Although the first Georgia Criminal History Check System (GCHEXS) was presented November 17, 2015, you can still learn all about the program.

You can learn about:
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  • Program participation requirements
  • The overview of the system
  • Mandatory vs. Voluntary background check requirements
  • DCH's training approach
  • The history of the National Background Check Program
  • The state grant
The PowerPoint Presentation and the webinar recording are posted on the DCH website for you to review at your convenience.Also,  the Office of Inspector General will repeat the November 17 and December 8 webinars on January 12, 2016.


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About DCH

 

2 Peachtree

 

Through effective planning, purchasing and oversight, the Department of Community Health (DCH)  provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and underserved populations.

 

 DCH is responsible for Medicaid and PeachCare for Kids, the State Health Benefit Plan, Healthcare Facility Regulation and Health Information Technology in Georgia.      

 

Clyde L. Reese III, Esq. is Commissioner of the Georgia Department of Community Health.  

 

We are dedicated to
A Healthy Georgia
.   

   

www.dch.georgia.gov 

 

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DCH-i

    

DCH Mission

 

We will provide Georgians with access to affordable quality health care through effective planning, purchasing and oversight.

We are dedicated to
A Healthy Georgia.


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About DCH-i

DCH-i is the bi-monthly newsletter from the Georgia Department of Community Health for all matters DCH. It provides timely and important information to you as physicians, dentists, hospitals, third-party payers, vendors and health care advocates.

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