Georgia's Medicaid system has its own vocabulary. Before you start the enrollment process, these are the terms and systems you'll encounter most often — defined in plain language, with context for how each one affects your agency's setup.
Georgia has specific Medicaid enrollment requirements, waiver programs, and EVV rules that differ from other states. This page covers the Georgia-specific steps — GAPP enrollment, GAMMIS billing, DCH licensing, HHAeXchange EVV, and MCO contracting — so you build on the right foundation the first time.
Georgia's Medicaid system has its own vocabulary. Before you start the enrollment process, these are the terms and systems you'll encounter most often — defined in plain language, with context for how each one affects your agency's setup.
Department of Community Health. Georgia's state agency that oversees Medicaid, health facility licensing, and agency surveys. Your license comes from DCH. Your surveys are conducted by DCH.
Georgia Applications Processing Portal. Where you enroll as a Georgia Medicaid provider. Your provider enrollment, credentialing, and waiver program applications all go through GAPP.
Georgia Medicaid Management Information System. The portal for submitting fee-for-service Medicaid claims. MCO patients are billed through each MCO's portal, not GAMMIS directly.
Elder and Disability Waiver Program. The primary Medicaid waiver for elderly and physically disabled Georgians who qualify for home care. Most agencies serving elderly patients will work under EDWP.
New Options Waiver / Community Opportunities Waiver. Georgia Medicaid waivers for individuals with developmental disabilities. Separate enrollment and service definitions from EDWP.
Georgia's state EVV aggregator. All Georgia Medicaid EVV data must flow through HHAeXchange. Agencies use HHAeXchange directly or integrate their EVV system with it for data transmission.
Managed Care Organization. Most Georgia Medicaid members are enrolled in an MCO — Amerigroup, CareSource, Peach State, or WellCare. You must contract with each MCO separately.
National Provider Identifier. Your agency's unique identifier in the national provider registry. You need a Type 2 (organizational) NPI before you can enroll in Georgia Medicaid. Apply at NPPES.cms.gov.
Electronic Visit Verification. Federal requirement for all Georgia Medicaid personal care visits. Every visit must be electronically verified — caregiver identity, patient, location, time in and out.
These steps aren't sequential in a strict sense — some run in parallel — but each one is a gate. You cannot bill Georgia Medicaid without completing all of them. The agencies that get stuck during enrollment usually get stuck at Step 4 (MCO contracting) because they didn't start the MCO application process early enough.
Agencies providing personal care services in Georgia need a Personal Care Home license or a Home Health Agency license from DCH, depending on the services you'll provide. The application requires ownership and key personnel background checks, policy and procedure documentation, and an initial survey. DCH surveys can be scheduled or unannounced after licensing.
You need a Type 2 (organizational) NPI from NPPES before you can enroll in Georgia Medicaid. NPI registration is free and typically takes 5-10 business days. Once you have your NPI and DCH license, you can apply for Georgia Medicaid provider enrollment through GAPP. Base enrollment must be complete before you can apply for specific waiver programs like EDWP.
After base Medicaid enrollment, apply for the waiver programs relevant to your patient population. EDWP is the primary program for agencies serving elderly and physically disabled patients. Each waiver has its own service codes, billing requirements, and documentation standards. EDWP enrollment requires familiarity with the program's specific care planning and documentation requirements — including the EDWP intake form that Jackie mentions when she talks about CareBravo's intake management function.
Most Georgia Medicaid patients are enrolled in Amerigroup, CareSource, Peach State, or WellCare. State Medicaid enrollment does not automatically include MCO network participation — you must apply to each MCO separately and pass their credentialing process. MCO contracting is typically the longest step in Georgia Medicaid enrollment and should be started as soon as possible, ideally concurrent with GAPP enrollment.
Georgia requires all Medicaid personal care visits to be verified through HHAeXchange. You can use HHAeXchange's caregiver app directly or use another EVV system that integrates with HHAeXchange for data aggregation. EVV must be operational before your first visit — submitting claims without valid EVV data results in claim denials. CareBravo's EVV compliance function manages the HHAeXchange integration and exception resolution for Georgia agencies.
Scheduling, billing setup (GAMMIS credentials for fee-for-service, MCO portals for managed care), caregiver credentialing tracking, and authorization management should be in place before your first patient. This is where CareBravo comes in — nine operational functions built before your first visit, so you never develop the revenue-loss habits that cost established Georgia agencies thousands of dollars per month.
Jackie knows her HHAeXchange EVV system. She knows EDWP. She's three years into her agency in Stockbridge, Georgia. She's also losing approximately $4,100 every month in revenue she's already earned — authorization hours expiring before she schedules them, claims denied because the EVV exception wasn't resolved in time, and at least one caregiver credential somewhere that's closer to lapsed than she realizes.
The Georgia Medicaid system is well-documented. The operational gaps that cost Georgia agencies money aren't compliance ignorance — they're capacity limits. One person can't watch every authorization window, review every claim before submission, and track every HHAeXchange exception for 30+ patients simultaneously. That's what CareBravo is built to do.
Every Georgia agency owner who is now losing money on unworked GAMMIS denials, expired EDWP authorizations, and unresolved HHAeXchange exceptions built their operation on systems that weren't watching those things. They didn't build wrong because they were careless. They built with whatever was available at the time, under pressure, without a clear picture of what the operational gaps would cost at 30 patients.
You're choosing your systems before you have a patient. That's the best possible moment to see this — because the choice you make now determines which version of year three you get.
What starting on CareBravo looks like in Georgia:
HHAeXchange EVV integration built before your first visit. GAMMIS billing configuration for your service codes. EDWP authorization tracking from patient one. MCO-specific billing setup for Amerigroup, CareSource, Peach State, and WellCare. Caregiver credentialing tracked against Georgia DCH requirements. The operational layer in place before you need it — not assembled in the first year under pressure.
Base Georgia Medicaid enrollment through GAPP typically takes 45-90 days once the application is complete. DCH licensing adds 60-120 days depending on when your initial survey is scheduled. MCO contracting runs concurrently and takes 60-120 days per MCO — you should apply to all MCOs simultaneously rather than sequentially. From the time you begin the process, plan for 4-6 months to first billable visit in most cases, and as long as 9 months if survey scheduling or MCO contracting runs slow.
You don't have to enroll in all four, but most agencies serving a Georgia service area will want to be in-network with at least two or three to have access to a meaningful patient population. Which MCOs are most important depends on your service area — MCO market share varies by county in Georgia. For the Atlanta metro area where Jackie operates, all four MCOs have significant enrollment. Check which MCOs have the highest enrollment in your target service counties before prioritizing contracting applications.
Georgia fee-for-service Medicaid claims are submitted through GAMMIS — the Georgia Medicaid Management Information System. However, most Georgia Medicaid patients are enrolled in MCOs, and MCO claims are submitted through each MCO's own provider portal rather than GAMMIS. You'll need GAMMIS credentials for any fee-for-service patients and separate portal access for each MCO. CareBravo's billing function handles both GAMMIS and MCO claim submission for Georgia agencies.
EDWP (Elder and Disability Waiver Program) patient intake in Georgia involves receiving a referral from the patient's MCO case manager, completing the EDWP-specific intake forms, obtaining the patient's active authorization from the MCO, and completing the clinical assessment required for care plan development. EDWP case managers at the MCO control the authorization and referral process — building strong relationships with MCO case managers is the primary driver of EDWP referral volume for Georgia agencies. CareBravo's intake and referral management function tracks the full EDWP intake pipeline, including EDWP form submission and case manager contact management.
CareBravo's pricing is a percentage of your collections — not a flat fee that runs before you're collecting. During the pre-revenue period (before your first Medicaid payments arrive, which can be 60-90 days after your first visit given Georgia Medicaid payment cycles), your cost is structured around a startup floor rather than the full percentage rate. The specific pre-revenue cost for your agency is on the pricing page and in the first conversation with CareBravo. The pricing is designed to align with when you're collecting, not to run full-rate before your first check arrives.
The conversation starts with where you are in the Georgia enrollment process — what's complete, what's in progress, what still needs to happen. CareBravo configures your operational layer for Georgia's specific requirements: HHAeXchange EVV, GAMMIS and MCO billing, EDWP authorization tracking, Georgia DCH credentialing standards. You don't figure this out under pressure after your first visit. You build it before.