As part of it’s Continuous Program Improvement Initiative, DCH is streamlining the process for submitting provider enrollment updates. DCH is eliminating the need for providers to submit enrollment updates through multiple platforms. This change will eliminate duplication, ensure program integrity, and reduce administrative burden.
Effective August 1, 2019, all provider enrollment updates (individual practitioners and facilities) must be submitted through the Georgia Medicaid Management Information System (GAMMIS). WellCare will no longer accept provider enrollment updates that are not processed through GAMMIS for those providers participating with our Medicaid Lines of Business. Thus, providers that are contracted with the WellCare are now required to submit all provider enrollment updates through GAMMIS. Providers are prohibited from submitting provider enrollment updates directly to WellCare. Failure to submit updates through GAMMIS may result in the delay of payment and/or denial of claims.
All enrollment updates must be completed via the online Change of Information form. In order to access the online Change of Information form, you must log into the Georgia Medicaid Management Information System (GAMMIS) web portal at www.MMIS.georgia.gov using your username and password. The online Change of Information form is located under the Provider link on the upper left-hand side of the GAMMIS web portal.
The online Change of Information form must be submitted when updating the following:
- Expired credentials (license, specialty certification, accreditation certification or business license);
- Drug Enforcement Agency (DEA) permit number;
- “Doing Business As” (DBA) provider name;
- National Provider Identifier Number (NPI);
- Provider or Business Name;
- Service Location Address;
- Sponsoring Physician;
- Social Security Number (individual practitioners);
- Attestation of Compliance for providers who have received $5 million or more during the Federal Fiscal year,
- Deactivation of provider identification number (for providers who have voluntarily terminated their participation in the Georgia Medicaid/PeachCare for Kids® program;
- Adding provider contracts;
- Reactivation of participation if your enrollment file has been suspended due to no claims activity in 12 months;
- Retroactive enrollment request;
- Electronic Funds Transfer (EFT) Account;
- Federal Employer Identification Number (FEIN);
- Payee Address;
- Payee Affiliation; and
- Payee Name.
Instances when the online Change of Information form may not be used:
- “Mail-to” address updates: Mail-to address updates are to be completed via the Demographic Maintenance panel on the GAMMIS web portal using your username and password. The Demographic Maintenance panel is located under the Provider link in the upper left-hand side of the GAMMIS web portal.
- Change of Ownership updates: A change of ownership includes, but is not limited to, a dissolution, incorporation, re-incorporation, reorganization, change of ownership of assets, merger, or joint venture whereby the provider either becomes a different legal entity or is replaced in the program by another provider. The new owner must submit an enrollment application via the GAMMIS web portal enrollment wizard. Failure to submit change of ownership updates through GAMMIS may result in delays in reimbursement.
- Owners and Managing Employee: Owners and Managing Employee updates are to be completed via the Demographic Maintenance panel via the GAMMIS web portal using your username and password. The Demographic Maintenance panel is located under the Provider link in the upper left-hand side of the GAMMIS web portal.
- Patient Demographic Information: Providers may use the Demographic Maintenance panel to update patient demographic information such as:
- Indicating that new patients are being accepted;
- Identifying correspondence medium; and
- Changes in office hours and accessibility.
Updates are to be completed via the Demographic Maintenance panel on the GAMMIS web portal using your username and password. The Demographic Maintenance panel is located under the Provider link in the upper left-hand side of the GAMMIS web portal.
If you require assistance or clarification on how to use to access the online Change of Information form or the Demographic Maintenance panel, please contact the DXC Provider Call Center at 1-800-766-4456.
For all other questions, please contact your WellCare Provider Relations Representative https://www.wellcare.com/en/Georgia
