Quick Reference Materials

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 and instructions for submitting dental claims, authorization requests and accessing fee schedules, provider manuals and other documents via SkyGen USA, our dental vendor partner Provider Web Portal
• View the Georgia Families^® Provider Quick Reference Guide for information about the Choice Change Period, as well as authorization, claim submission and contact information.
• View the Behavioral Health is Critical to Overall Wellness flier to learn how provider care coordination ensures quality of care.
• Provider Attestation FAQs
• Clinical Practice Registry Guide
• Provider Portal Key Features Overview
• Depression Clinical Practice Guideline Flier
• Diabetes Clinical Practice Guideline Flier

The following resources will help improve your patients’ satisfaction and your quality scores:

• CPT II Coding Guide
• Patient Quality Experience Guide (CAHPS resource guide)
• 2024-2025 Adult HEDIS Coding Guide

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:

• Clinical Practice Guideline Medical Record Audit booklet
• ADHD Clinical Practice Guidelines
• Hypertension Clinical Practice Guidelines
• Maternal Programs and Prenatal/Postpartum Guidelines

CareSource has developed resources to help you with your telehealth practice. Access the resources below for telehealth-related guidance.

• Telehealth HEDIS Measure Quick Reference Guide
• Telehealth Tip Sheet

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 Pathways Provider FAQs

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.

GaHIN 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^®, and Georgia Pathways to Coverage, 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
• Pathways to Coverage – Obtain information about the Pathways to Coverage program