Do you handle Georgia Medicaid and the Georgia Families CMOs?

Yes, and separately. State enrollment does not load a provider with each CMO, so both are tracked per provider.

Can you credential a new provider for us?

Yes, as a fixed-scope project per provider, including payer enrollment, CAQH maintenance and revalidation tracking.

We are a small rural practice. Is there a minimum size?

No. Percentage-of-collections pricing means a smaller practice is not paying a flat fee it cannot support, and the free A/R review is the same regardless of size.

How quickly can you start?

After the A/R review and a signed agreement and BAA, we usually run in parallel with your current process for two to four weeks before taking the full cycle.

Georgia

Medical billing for Georgia practices

Georgia practices split sharply between metro Atlanta, where commercial contracts and competition dominate, and rural counties where Medicaid and Medicare are most of the panel. The billing problems in each are not the same, and neither is the fix.

CMO enrollment is where claims get stuck

A provider active with Georgia Medicaid but not loaded with the care management organization a patient belongs to will have those claims denied as an unknown provider. It looks like a billing error and it is an enrollment gap. We check CMO participation per provider before a start date, and hold revalidation deadlines against a calendar.

Rural practices and payer concentration

Where Medicaid and Medicare make up most of the panel, a single denial pattern can move a month’s collections. Denials are grouped by reason code so a repeating cause is visible as a pattern rather than as a run of individual write-offs, and the upstream cause gets fixed instead of each claim being reworked forever.

Credentialing new providers

Georgia practices adding providers regularly find billing blocked by enrollment rather than by coding. Payer enrollment, CAQH upkeep and re-credentialing are tracked against deadlines, so a new provider’s claims are billable on the date they start seeing patients.

Georgia Medicaid

Most Georgia Medicaid members are enrolled with a care management organization, which owns the authorization rules and the claim. Enrollment with the state and enrollment with each CMO are separate pieces of work.

Program: Georgia Medicaid
Administered by: Georgia Department of Community Health
Managed care: Georgia Families care management organizations

Payers we work in Georgia

Anthem Blue Cross Blue Shield of Georgia
UnitedHealthcare
Aetna
Cigna
Humana
Georgia Families CMOs

Not an exhaustive list, and not a claim of network participation on your behalf — your contracts are yours. It is the payer mix we are set up to work in Georgia.

Services available to Georgia practices

Billing in Georgia — common questions

Do you handle Georgia Medicaid and the Georgia Families CMOs?: Yes, and separately. State enrollment does not load a provider with each CMO, so both are tracked per provider.
Can you credential a new provider for us?: Yes, as a fixed-scope project per provider, including payer enrollment, CAQH maintenance and revalidation tracking.
We are a small rural practice. Is there a minimum size?: No. Percentage-of-collections pricing means a smaller practice is not paying a flat fee it cannot support, and the free A/R review is the same regardless of size.
How quickly can you start?: After the A/R review and a signed agreement and BAA, we usually run in parallel with your current process for two to four weeks before taking the full cycle.

Everywhere else

All billing services

Next step

Start with the free A/R review.

Send an aging summary and a handful of denials. You get a written read on what is recoverable — no fee, no obligation to sign anything.

Book the A/R review See pricing