The Georgia Department of Community Health (DCH) implemented the centralized prior authorization (PA) feature which is the preferred method for submitting preauthorization requests. This feature allows participating Georgia Medicaid providers to submit PA requests to fee-for-service (FFS) and care management organizations (CMOs) through a centralized source: the Georgia Medicaid Management Information System (GAMMIS).
Alternatively, Amerigroup Community Care is available by phone or via the Interactive Care Reviewer (ICR) 24/7 days a week to accept preauthorization requests. You can access the ICR from the Availity Portal home page.
Providers and staff can call or fax Amerigroup for help with prior authorization via the following methods:
Pharmacy PA requests may be submitted in three ways:
The Medicaid-Approved Preferred Drug List (PDL) includes information such as mandatory generic requirements, prior authorization (PA), quantity limits, age limits or step therapy.
Pharmacy services billed with the following revenue codes always require prior authorization:
Behavioral health services billed with the following revenue codes ALWAYS require prior authorization:
Services billed with the following revenue codes ALWAYS require prior authorization: