Application Processing

An application must be registered within 24 hours of receipt by the agency.

Eligibility for Medical Assistance must be determined under all COAs before an application is denied. Refer to Section 2052 - Continuing Medicaid Determination (CMD) .

Eligibility for Medicaid coverage for the three months prior to the month of application must be considered for every Medical Assistance application filed.

Completion of the application process is defined as notification to the applicant of the approval or denial of Medical Assistance benefits.

An individual may withdraw an application for Medical Assistance at any time during the application process. A withdrawn application must be registered and denied. The applicant must be notified of the disposition of the withdrawn application.

Refer to Section 2011 - Health Information Portability and Accountability Act for information regarding privacy of health information.

If an individual receives Medical Assistance, and it is determined that documents are inconsistent with pre-existing information, are counterfeit or altered, the Division of Family and Children Services shall investigate for potential fraud and abuse and refer to Georgia Department of Community Health, Office of Inspector General:

By phone: in Metro Atlanta (404)463-7590, and statewide at (1-800-533-0686);

By email: medicaid.oig@dch.ga.gov ;

By mail: Department of Community Health, OIG PI Section, 2 Martin Luther King Jr Drive SE, 19 th Floor, East Tower, Atlanta, GA 30334; or

By internet: dch.georgia.gov/report-medicaidpeachcare-kids-fraud .

Refer to Section 2060 - ABD Medicaid Application Processing and Section 2065 - Family Medical Assistance Application Processing .