Streamlining and Expediting Credentialing and Billing Processes

  1. Law
  2. Georgia Code
  3. Health
  4. Department of Community Health
  5. Streamlining and Expediting Credentialing and Billing Processes

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  1. As used in this Code section, the term "state medical plan" means the state health benefit plan under Article 1 of Chapter 18 of Title 45, the medical assistance program under Article 7 of Chapter 4 of Title 49, the PeachCare for Kids Program under Article 13 of Chapter 5 of Title 49, and any other health benefit plan or policy administered by or on behalf of the state.
  2. The department shall take all reasonable steps to streamline and expedite the credentialing and billing processes for state medical plans, including but not limited to examining the potential for a uniform billing platform or portal; examining the potential for the standardization of billing codes among providers; posting billing criteria and codes on the department's website; enabling a dual track process for credentialing and contract negotiation for new providers; allowing billing for telehealth delivered care and allowing payment for both the on-site provider and off-site provider; and maximizing billing for multiple specialists and multiple encounters with one provider at a single visit in safety net settings, critical access settings, federally qualified health centers, and general practitioner settings.
  3. This Code section shall not be construed to require the department to act in violation of any federal law, rule, or regulation.

(Code 1981, §31-2-15, enacted by Ga. L. 2018, p. 132, § 3B/HB 769.)

Editor's notes.

- Ga. L. 2011, p. 705, § 4-4/HB 214, effective July 1, 2011, redesignated former Code Section 31-2-15 as present Code Section 31-2-10.

Ga. L. 2018, p. 132, § 8(c)/HB 769, not codified by the General Assembly, provides: "(c)(1) Section 3A of this Act shall become effective on July 1, 2018, only if SB 357 or another Act creating the Health Coordination and Innovation Council is enacted by the General Assembly and becomes law in 2018, in which event Section 3B of this Act shall not become effective and shall stand repealed on July 1, 2018.

"(2) If SB 357 or another Act creating the Health Coordination and Innovation Council does not become law in 2018, then Section 3B of this Act shall become effective on July 1, 2018, and Section 3A of this Act shall not become effective and shall stand repealed on July 1, 2018." SB 357 was passed by the General Assembly but was vetoed by the Governor on May 8, 2018, and did not become law.


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