Please check back here often, as the questions, answers and information shared via social media and other sources is in the process of being compiled for your reference.
Follow the link below to find the provider application:
To complete the application you’ll need to have your Tax Identification Number/Social Security Number, and an electronic copy of your completed W-9 form to upload, as well as your CAQH and National Provider Identifier (NPI) numbers (see below for more details).
If you work in a physician’s office or hospital, check with your billing department- they may want to apply for all lactation providers in your organization, or you will need to provide billing contact information.
Of special note: the answer to choose from the drop down menu on the “Specialty” field is “Birth Center” if you are not also licensed as another profession-there is no lactation specific specialty listed currently. While not overtly stated, CareSource typically contracts with licensed providers. So, if you are a private practice lactation consultant, and haven’t applied for your Georgia Lactation Consultant License, do it now! Find information here.
CAQH is an NCQA-certified Credentials Verification Organization (CVO) which provides a number used by insurance companies to streamline billing- if you don’t have a number yet, apply here.
A National Provider Identifier or NPI is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services(CMS). The NPI has replaced the unique physician identification number (UPIN) as the required identifier for Medicare services, and is used by other payers, including commercial healthcare insurers. The NPI number can be obtained online through the National Plan and Provider Enumeration System (NPPES). Turnaround time for obtaining a number is reported to be 1 to 20 days.
Another special note concerns billing: For clients who are within the 60 day postpartum period, consider billing for both Mother and Baby, as appropriate. Medicaid doesn’t pay for services for Mom after 60 days postpartum, so after that time the reimbursement will be for the infant only.
If you have any questions, you may contact CareSource at GAProviderRelations@CareSource.com.
IMPORTANT: SELCA is NOT offering legal, financial, tax, insurance or billing advice. Information compiled here is for your reference and resource only, and should not be relied upon as expert advice. SELCA will not be accountable for any consequence of relying on information found on this website.