Tag Archives: Provider

To Permit Medicare Beneficiaries to Enroll with Qualified Provider- Sponsored Organizations Under Title XVIII of the Social Security ACT, and for Other Purposes. (Paperback) – Common

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To permit medicare beneficiaries to enroll with qualified provider- sponsored organizations under title XVIII of the Social Security Act, and for other purposes.

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How does Allied Health provider become a provider in Georgia Medicaid?

Question by fanya k: How does Allied Health provider become a provider in Georgia Medicaid?
I own a mammography facility in Georgia. Medicare enrolled me and it is an understatement to say how difficult that was. However, I am having trouble with Medicaid provider enrollment because they can’t find what category of service I fit into. I am not a physician, but a Radiologic Technologist. The Provider type does list Technologists/Technicians as a choice, but I cant seem to fit in their category of service because while we do provide Physician Services (Radiologist reads the film) , they don’t have a category that I am allowed to fall under. Anyone know anything about Mammography Provider Enrollment in particular?

Best answer:

Answer by Renee
Here is a link for some telephone number for various Georgia Medicaid departments, there is one listed for provider enrollment.


If you have no success there, call the Georgia Department of Community Health, let the operator know you need assistance with provider enrollment and she can forward you to someone who can help. (They were my last resort when I had provider enrollment issues, and they got my problems resolved quickly)

Good luck…getting those provider numbers is a chore!

Know better? Leave your own answer in the comments!

Health Care Exchange Cost Is More Important Than Provider Network

Health Care Exchange Cost Is More Important Than Provider NetworkHealth Care Exchange Cost Takes Priority

Based on the results of a recent consumer survey, more people who are eligible for federal premiums subsidies are worried about how much they are going to pay for health insurance than they are about whether or not a certain provider will included in the health exchange provider network. For this reason, health insurance companies are choosing to narrow their provider networks so they can keep their premiums as low as possible and reduce health care exchange cost.

37 percent of all respondents who are eligible to receive subsidies said that they consider health exchange cost most important when choosing health insurance. That percentage was higher than the 31 percentage of respondents who said benefits were the most important factor when choosing health insurance. The results of this survey led insurers to restrict their provider networks for the plans that will be sold on health insurance exchanges.

Benefits Most Important for People Not Eligible for Subsidies

Interestingly, for people who earn too much money to be eligible for federal subsidies do not look at the health care exchange cost as the primary factor when choosing health insurance. Neither do they believe that the provider network is most important. 37 percent of consumers who will not be receiving federal premium subsidies through the health insurance exchanges believe that benefits are the biggest determining factor for choosing health insurance.

This may be why only six percent of survey respondents will be shopping for health insurance on their state exchanges in 2014. All health insurance plans must cover the 10 essential health benefits to be considered qualified health plans under the Affordable Care Act, but if they aren’t receiving subsidies, they may be able to get a better deal outside of the exchange. They may also be able to find plans with richer benefits off exchange as well.

More Benefits at a Better Price

Regardless of whether or not people purchase health insurance through the exchanges, they will be getting more for their money. This is because all plans are required to cover those essential health benefits. So, even if they pay a little more, they are getting a whole lot more benefits. This is also true for people who will be shopping on the health insurance exchanges. While they may have to travel a little further to see a doctor that is participating in the health exchange provider network, they will still be getting more than they were on a pre-ACA policy.

The key to reaping the health care exchange cost savings is to finding a provider that is in network before receiving services. Even if a consumer has to drive for several miles, the savings are worth it, particularly for those who are receiving federal subsidies to help them pay for their premiums.

Some Physician Groups Wary of Low Reimbursements

One of the reasons the health exchange provider networks are restricted is because some physician groups are nervous about the low reimbursement rates from insurance companies operating through the exchanges. 59 percent of the respondents to a second survey of physician groups said the low reimbursement rates would pose a financial risk to their practice. As a result many physicians are taking a wait-and-see approach to the exchanges. While they might not be participating in 2014, it is possible more doctors will participate in subsequent years as they see how the system works.

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