Quick Reference Materials
CareSource wants to equip you to work with our health plan to provide the best service for our members. The following materials will help familiarize you with the CareSource Georgia Medicaid plan. You will find key information that will make it easier for you to do business with us and assist you in serving our members.
Quick Reference Guides
Below you will find quick reference guides and additional resources:
- View our CareSource Quick Reference Guide for information about contacting CareSource, submitting claims and prior authorization requests, and more.
- View our Dental Quick Reference Guide for information and instructions for dental providers to work with Scion Dental, our dental administrator.
- View the Georgia Families® Pharmacy Quick Reference Guide for information about the Choice Change Period, as well as pharmacy authorization, claim submission and contact information.
- View the Georgia Families® Provider Quick Reference Guide for information about the Choice Change Period, as well as authorization, claim submission and contact information.
Improving Quality Scores
The following resources will help improve your patients’ satisfaction and your quality scores:
- CAHPS Improvement Tips
- Pediatric CAHPS Tips
- Adult HEDIS Coding Guidelines
- Pediatric HEDIS Coding Guidelines
Clinical Practice Guidelines
CareSource adopts nationally recognized clinical practice and preventive health guidelines from federal agencies and medical professional specialty organizations. Access the links below and visit our Health Care Links page for more clinical practice and preventive health guidelines:
- CPG Medical Record Audit
- ADHD Clinical Practice Guidelines
- Depression Clinical Practice Guidelines
- Diabetes Clinical Practice Guidelines
- Hypertension Clinical Practice Guidelines
- Maternal Programs and Prenatal/Postpartum Guidelines
Frequently Asked Questions
Review the following answers to questions frequently asked by providers:
- Georgia Provider FAQs
- Georgia Families® Provider FAQs
- Georgia Families® Member, Provider and Assistance FAQs
Georgia Health Information Network
Providers are encouraged to participate in the Georgia Heath Information Network (GaHIN). This exchange of information can save time, improve care, reduce costs and enhance privacy for your patients.
The Georgia Health Information Network gives its members the ability to access a more complete view of their patient health information directly from their electronic health record (EHR) systems. At any time, a patient may choose to “opt-out” of having his or her electronic records shared through the network. He or she can simply complete an opt-out form from the doctor. If a patient does opt-out, no providers can share his or her health records through the network. If a patient does opt-out, but changes his or her mind, he or she can easily opt back into the system.
To start the registration process and learn more, visit the GaHIN website.
For more information about Georgia Families® and Planning for Healthy Babies®, visit the following links:
- GAMMIS web portal – Access communications, data exchange and self-service tools provided by the Georgia Medicaid Management Information System (GAMMIS).
- Georgia Department of Community Health – Find information important to Medicaid and PeachCare for Kids® providers.
- Georgia Families Enrollment Broker – Visit the Georgia Families® website to find enrollment information and links.
- Planning For Healthy Babies® – Obtain information about the Planning for Healthy Babies® program