Ankota Help Center
Home | Contact Us

Contact Us

Georgia Workflow

Overview 

(As always, private pay is generally self-regulating within the confines of state law and regulatory processes. This article focuses on Medicaid billing in the state of Georgia.) 


In the state of Georgia, there are some unique billing processes. This is because select Medicaid visits must be completed using electronic visit verification (EVV), and these verified visits are required to be sent to the state's default EVV provider as their statuses change. For Ankota users, that means in addition to our regular EVV services which we provide, we also deliver your visit data to Netsmart/Conduent on a near-real-time basis to ensure your state's requirements are met. This article will help guide you through this process.


This article covers:

Set-up

Testing

Pre-Billing

Billing Management for Medicaid non-EVV Visits

Billing Management for Medicaid EVV Visits

Remittance Advice Management (835s)

Corrected Claims

Further Details


Critical Pathway

For a simple overview of key admin system maintenance, see this overview with linked steps: Georgia Critical Path PDF.pdf


Set-up

Ankota users in Georgia must register for Tellus/Netsmart EVV. (Ankota will deliver visit data to Tellus/Netsmart.) This registration will ensure Tellus will accept their data and give providers access to the Tellus log-in. After registering for Tellus, log in and make sure that Tellus has all of your clients, client addresses (including secondary locations), and authorizations.


Internally, Ankota users are automatically set up for delivery of EVV visit data to the state as part of implementation.


Please note the state of Georgia prefers mobile app over telephony for EVV. If you have clients who must use telephony, you must file the appropriate registration form and receive the state's approval to continue using telephony. Per confirmation 8/30/21, FOBs are not allowed (use the Lifeline Medicaid phone if needed). Also confirmed 8/30/21, as an alternative to mobile app usage on the caregiver's smartphone, clients with smartphones may download the Ankota Caregiver mobile and permit caregivers to clock in/out on that app if desired. To apply for client telephony registration, download this form and submit it to the state: Georgia EVV IVR Request Form - Provider Agency for Traditional Members.docx


Testing

No state testing processes are required. Organizations may begin billing Tellus/Netsmart and GAMMIS per the directions below once they have been configured to do so by their Ankota specialist. 


Pre-Billing


General Management

Successful billing starts at the beginning of the client's creation. The processes below will lead to successful billing. 


Billing Management for Medicaid non-EVV Visits (GAMMIS billing)

Non-EVV visits (all visits except T1019, T2025, and S9122) should be billed via the state portal. See here for further details.



Billing Management for Medicaid EVV Visits (TELLUS/Netsmart billing)

Currently, EVV visits are listed as T1019, T2025, and S9122 (pediatrics) visits. These are the only visits to be billed in Tellus/Netsmart. See here for further details on Tellus/Netsmart visits. If you have accidentally sent over the wrong visit types to Tellus/Netsmart, please note these visits can simply be archived in Tellus/Netsmart and billed through the GAMMIS portal as usual.


See here for a detailed overview of Tellus/Netsmart billing. (This overview includes a link to the critically important articles for reason codes and reading response files, as well as how to manage cancellations. Another helpful article is managing data exports, which clarifies other export options as well.)


Note: Tellus/Netsmart should receive all authorizations directly from the state, so if you see a client is missing an authorization in Tellus/Netsmart, reach out to Conduent right away. (For support regarding any claims issues in the state of Georgia, you must first reach out to Conduent for Tier 1 support at 833-701-0012, GAEVVSupport@Conduent.com, or www.GAEVV.com for chat.)


Remittance Advice Management (835s)

Remittance advice files, or 835s, are provided in response to filing Medicaid claims. Think of these like state receipts of payments. These files can be uploaded to Ankota for an automatic application of payments in the A/R records. GAMMIS can make this available. 



Corrected Claims

Generally, claims corrections are handled one of two ways:


For more information on errors and how to manage them, see Managing Data Corrections.


GAMMIS

For GAMMIS billing, you can correct the claims as needed by canceling the invoices and associated payrolls, correcting the data, and rebuilding the invoices as needed for upload. If you have partially paid claims which you don't wish to reverse, you will need to use the Corrected Claims process.


TELLUS

The key to understanding how data is managed between Ankota and Tellus/Netsmart is as follows:


Rejected visits in Ankota must have data corrected in Ankota first, then the data must be re-sent to Tellus/Netsmart by moving the invoice from Draft to Complete. (For information on what data to correct, check the response file.) If you see a rejection response, this is a great opportunity to fix an issue and still be able to send out the data. 


Completed AND accepted visits will move to the Work List and will be available to release for billing in Tellus/Netsmart. At this point, any errors in Work List claims must be corrected in Tellus/Netsmart, and Tellus/Netsmart will no longer accept further updates from Ankota. To resolve claims issues in Tellus/Netsmart, review the error messages and take action. For more information on Tellus training, go to Training Webinars - Mobilecaregiverplus.com

 

We generally recommend you use the Approval Assistant to simplify your Tellus visit corrections process. Please note you should ONLY use the Duration adjustments section if there are known, strict limitations on the allowed work duration for the selected visit type.


For support regarding any claims issues in the state of Georgia, you must first reach out to Conduent for Tier 1 support at 833-701-0012, GAEVVSupport@Conduent.com, or www.GAEVV.com (for chat). 


Further Details

For a more detailed walkthrough on the Tellus claims billing process, see the Tellus/Netsmart walkthrough.

For more information on rejection reasons, see Tellus/Netsmart Response Files.

For more information on reason codes, see Tellus/Netsmart Reason Codes.

For more information on multiple address management in Georgia, see Georgia Second Address Automatic Reason Coding.

For more information on rebilling claims already released from Netsmart but were never received by the Payer, see Rebilling(Claims were never received by Payer)