Peach State Health Plan: Personalized Approaches to Healthcare in Georgia.
The mission of the Peach State Health Plan is to improve the health of the community one person at a time by providing access to quality health care at an affordable price. Individual, overall health, and local participation are how we do this.
Focus on a single person: Treating people with compassion, respect, and dignity enables them to make healthy choices, leading to better families and a healthier community.
Whole-body health: In our practice, we believe in treating the whole person, not just their physical body.
Active local participation: Local relationships, in our opinion, are essential for ensuring that healthcare is practical and easily accessible.
A subsidiary of Centene Corporation, Peach State Health Plan offers health care services to Georgia Medicaid and PeachCare for Kids® beneficiaries via its provider network.
Improved access to high-quality doctors in all disciplines is one of Peach State’s priorities, as is better treatment for our members.
The Centene Corporation is a significant healthcare provider dedicated to improving the health of its patients and the communities in which it works.
Local brands and teams deliver integrated, high-quality, cost-effective services to government and commercial healthcare programs, emphasizing the under-insured and uninsured population.
About one-fifth of the people in the United States are covered by Centene’s affordable, high-quality health care products, including Medicaid and Medicare beneficiaries (including Medicare Prescription Drug Plans) and individuals and families served by the Health Insurance Marketplace and TRICARE.
In addition, the business offers a wide range of specialized services, all of which are geared toward holistic treatment.
Centene aims to create long-term value for its members, providers, local communities, and government partners by developing its people, systems, and skills.
Peach State Health Plan Provider Portal
You may register now if you’re a Peach State Health Plan contracted provider. After submitting your first claim, you will be allowed to join the program.
In the Peach State Health Plan provider portal, you may do the following things:
- Ensure that each member is eligible to participate.
- Take care of claims
- Ensure that the proper permissions are in place.
- View a list of patients
- Sign up for an account
Peach State Health Plan providers
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Peach State Health Plan benefits
Unlike Medicaid, the Peach State Health Plan offers additional benefits. You may discover more about Peach State Health Plan’s health benefits, pharmacy services, and other services in this area.
Have questions about these perks and services? At 1-800-704-1484 (TTY/TDD 1-800-255-0056), we’re here to help.
Further details about Peach State Health Plan may be found in our Member Handbook.
Services that aren’t medically required won’t be provided. Make sure you receive the care you need by working with your primary care provider.
To get these services, you must see your Primary Care Provider or a provider referred to you by your Primary Care Provider.
Some companies may offer:
- Limit the amount of coverage.
- The doctor’s permission is required.
- Prior permission is required.
There may be some Medicaid recipients who do not get all of the services mentioned here.
Peach State Health Plan’s health insurance policies, available across Georgia, cater to family and individual healthcare requirements.
Here are a few perks of the Peach State Health Plan’s coverage. You may also check out our Member Handbook for additional details.
WHO ARE THE GEORGIA COMMUNITY HEALTH DEPARTMENT?
Department of Community Health (DCH), Georgia’s Medicaid, PeachCare for Kids,® Planning for Healthy Babies, and Medicaid Waiver programs are all overseen by the DCH.
PLANNING FOR HEALTHY BABIES®: WHAT IS IT?
Visit the GAMMIS website to learn more about the P4HB initiative.
WHO ARE THE GEORGIA FAMILIES®?
Georgia Families® is a Medicaid and PeachCare for Kids® program that provides health care services to participants.
Private care management companies and the Department of Community Health (DCH) collaborate on the initiative (CMOS).
MEDICAID MANAGEMENT INFORMATION SYSTEM (GAMMIS): WHAT DOES IT MEAN?
What Is GAHIN?
Peach State Health Plan and the Department of Community Health will utilize the GaHIN in various ways (DCH).
HOW CAN I VERIFY MY ELIGIBILITY AS A GHP MEMBER?
You may verify a member’s eligibility by visiting GAMMIS.
HOW DO I JOIN THE GEORGIA REGISTRY OF IMMUNIZATION AS A PARTNER?
For additional information, go to the Georgia Immunization Registry website.
WHERE CAN I LEARN MORE ABOUT CME/CE PROGRAMS?
Make a choice here: CME/CE programs offered by Prime Inc. for physicians and clinicians to evaluate information about CME/CE programs.
HOW DO I APPLY FOR MY NPI IDENTIFICATION?
The NPPES website is where you may apply for your NPI.
HOW DO I GET INTO THE NETWORK?
Peach State Health Plan Provider Network or any other CMO network will require all Medicaid providers to be credentialed and credentialed by a centralized Verification Organization (CVO) established by the Georgia Department of Community Health (DCH) (CVO).
Before being accepted into our Provider Network, you must submit a credential application to the CVO. For more information, go here.
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