Candace .body@amerigroup.comCandace.b >
Transcription
Candace .body@amerigroup.comCandace.b >
t. Lany Brown, Team Lead for the Care Coordination Teams Email: larr-y.brown@amerigroup.com<mailto:larry.brown(g)amerigroup.com> Office: (678) 587-4859 2. Alison Barreiro-Jones is the mgr for the northern part of the state, Regions 1 & 2. Email : Allison.ban'eiro-j ones@ameri group. com <mailto:Allison.b Office: (678)583-5061 Cell: (470) 362-1209 3. candace Body is the mgr for the metro area east and west, Regions 3,5, 14 & 15 Candace .body@amerigroup.com<mailto:Candace.b > Office: (678) 587-4811 Cell: ((404) 242-6735 4. Tonia Richardson is the mgr for the southern part of the state, Regio ns 4, 6, 7 , g, 11, 12, 13 Tonia.richardson@amerigroup.com<mailto:Tonia.ric Office: (678) 587-0531 CeIl: (470) 362-1541 > g , 10, Georgia Families 360" Care Coordination Teams Team 1 DeKalb & Fulton Counties Last Name First Position Phone Contact Tatum Trina RN 470-336-0980 Email Contact Trina.Tatum @amerigrou p.com Linen Marcus CM 470 554-4549 Marcus.Linen @amerigrou p.com Toney Monica CM 470-554-2520 M o n i ca.To neu@ Cream Ashleigh CM 404-242-51.80 Ashleigh.Cream@a merigroup.com Robi nson Louquitta CM 470-723-4547 Louq Joh nson Tiffany CM 470-328-3942 Tiffanv.Johnson @amerigroup.com McLean Tiffany CM Pending u a ryr g_Ji gro u p. com itta. Robinson @a merigrou p.com McCollumMcKLean.TiffanV@amerigroup.com Team 2 Floyd, Bartow, Cherokee, Polk, Paulding, Cobb, Haralson, and Douglas Last Name First Position RN Phone Contact 470-336-0373 Ciaudia.GaVle@a merigrou p.com CM 470-385-s583 La Patrice cc 470-328-4123 Patrice.mcclinton @amerigrou p.com Thomas April CM 470-723-4166 April.Thmoas@amerigrouo.com Smith Angela cc 470-328-1286 Angela.Srnith @amerigroup.com Hammontree Amber CM 470-554-6094 Amber. Hammontree@amerigroup.com Gayle Claudia Wilcox La McClinton keisha Email Contact kesha.Wilcox@amerigrou p.com Georgia Families 360" Care Coordination Teams Team 3 Gwinnett, Barrow, Clarke, Elbert, Greene, Jackson, Jasper, Madison, Morgan, Newton, Oconee, Oglethorpe, and Walton last Name Gerard Agnew First Position Jennifer Crysta Phone Number 470- 554-7894 Jennifer.Gerard@amerigroup.com 470-362-8591 Crvsta l.Agnew@ 470-362-9488 Mega n.Todd @amerigrou p.com 470-38s-5752 Cody. iean@amerigroup.com 470-362-8881 Antoinettte.McClellan CM a merigroup.com CM I Todd Megan CM Jea n Cody CM McClellan Antoinette CM 470-554-4499 Muhammad Email Contact Timeka @a merigroup.com Timeka.Muham mad @amerigroup.com CM Team 4 Dade, Catoosa, Walker, Gordon, Gilmer, Fannin, Murray, Whitfield, Pickens, Union, Dawson, [umpkin, White, Habersham, Towns, Rabun, Stephens, Franklin, Hart, Banks, Hall, Forsyth, Jackson, Barrow, Oconee, Clark, Madison, Elbert, Oglethorpe Last Name First Position Phone Contact Email Contact Rea LeAnn CM 706-340-4271 LeAnn.Rea@amerigroup.com Brown rikki CM 770-912-6347 Tikki.Brown @amerigroup.com Higgs MallerV CC 678-524-4033 Mallery.Higgs@amerigroup.com Johnson Ayaana cc 404-578-3600 Avaana..Johnson@amerigroup.com Doe Karla CM Pending Karla.doe@amerigrou p.com Georgia Families 360" Care Coordination Teams Team 5 Clayton, Henry, Rockdale, Baldwin, Bibb, Crawford, Houston, Jones, Monroe, peach, putnam, Twiggs, Wilkinson, Butts, Carroll, Coweta, Fayette, Heard, Lamar, Meriwether, Pike, Spaldin g,Troup, Upson last Name Garrett First Position Phone Contact Email Contact Veronica CM RN 470-336-0762 Veronica.Ga rrett@a me rigroup.com Burns Shundra CM 470-554-5443 Sh Meyers Nadine CM Burns- Jackson Wanda CM 478-221,-0827 wa nda. burnsiackson @a merigroup.com nifer CM 470-328-3530 Jennifer. Benton @amerigroup.com CM 470-767-1,410 TracV. Krista lakis@amerigroup.com Benton Kristila kis Jen Tracy 678-519-7523 und ra. Bu rnes(da merigroup.com Nadine. Mvers@amerigroup.com Team 5 Burke, Columbia, Glascock, Hancock, Jefferson, Jenkins, Lincoln, McDuffie, Richmond, Screven, Taliaferro, Warren, Washington, Wilkes, Bryan, Bulloch, Camden, Chatham, Effingham, Glynn, Liberty, Long, Mclntosh, Appling, Bleckley, Candler, Dodge, Emanuel, Evans, Jeff Davis, Johnson, Laurens, Montgomery, pulaski, Tattnall, Telfair, Toombs, Treutlen, Wayne, Wheeler, Wilcox Last Name First Wynn LaVonne Norfleet Aungelia Position Phone Contact Email Contact CM 470-328-4812 Lavo n ne.Wvnn @a merigroup.co m 404-484-5053 Au ngel is. N orfleet (da me rigro u p. co m RN CM Georgia Families 360" Care Coordination Teams Dean-El Vontija CM 470-554-6273 Spivey Angela CM 912-271.-3863 An ge la. Spivv @ Reese Glen CM 470-554-4338 Glen. Reese@amerigroup.com Brown Brea n na CM Pending Vontiia. Dean-El@arnerigroup.com B a rn e rig ro u p. co rn rea n na. b rown @a m e rigroup. co m Chattahoochee, Clay, Crisp, Dooly, Harris, Macon, Marion, Muscogee, euitman, Randolph, schley, Stewart, Sumter, Talbot, Taylor, webster, Baker, Calhoun, Colquitt, Decatur, Dougherty, Early, Grady, Lee, Miller, Mitchell, Seminole, Terrell, Thomas, Worth, Atkinson, Bacon, Ben Hill, Berrien, Brantley, Brooks, Charlton, Clinch, Coffee, Cook, Echols, lrwin, Lanier, Lowndes, pierce, Tift, Turner, Ware Fre nch- H ines S. Michelle 229-338-606s 470-554-4652 Williams 229-221"-1,452 I Maria.sumner@amerisroup.com Mollv.Williams@amerigroup.com Tonva.sweeting@amerigroup.com 404-851,-7991 Belinda. mosbv@a merigroup.com tl { o o UJ O (/.) (JJ UJ N) N) N) N) N) N) NJ NJ N) NJ N) { oo o\ d o CD F 5 o\ o\ o\ o\ (^ UJ NJ \o I (/) o CD (,It u NJ J-.t a (^ 5 (J) B E 4 o o o o '/\ d ,f a o o o t0 o o \o N) r-t r- oo { o\ FD TD TD E E F-.1 +i o H (D () 5 u.) 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E (D (t a q (A Llr u) N) :i c) X + CD d (D (.n r'. j. @ (t - o a o o o o t-t F-t - (D i+) H ts-t J TA s Lar H @ tD U) o tst a E JJ ts1 CD ts Ia o o .D o o o ts t, \) u) o\ F-t Iq (D U) '-t CD et/ (t a a -J CD B B (D { H 7? 7 o o o o B H { (D r- UJ U) U) t, (Jl oo (D F-t o 4 o 5 ;J Ia H @ -l - -l -l a *l + H IA o Iq B 5 s 5 5 |+.) t/) \o oo A (/) NJ q o o 0q 5 5 5 A oo ! o\ d o .D (^ \o \o (rr )a (, .+ t} Ir] c z -l s (/J N.) -l -j -l -l -l a o H o ts * t0' CD (J) N) Lrl \o sD lD 2 a o c4 c U) oo C u JJ o (! + CD' t0 t4 B r-t -l I z Amerigroup GA Families 360" DFC$ Referral Form submit this form to AGP, DCH and Rev Max for any Georgia Families 360" action indicated by checkboxes below. complete each section of this form prior to submitting. submit completed form by sending email to all 3 email addresses listed: FClntake@arnerigrouB.eom FCFTAOJi*Memheir'Serviees@dei, r,!=cJs_JL,,.sa.6us .ga.gov;, ftssr?i6AL,y!u Revfliiaxe MOTransition@di.rr.state.ga.us ! rdfrst!.t{rr}€treilf.sE;l{e.ga.{J5 Fax torm form {: ; to Amerigroup to A at ggg_375_5064 if not emailed. * sheck sme tr Ghild Enters CareiGustody trGhange in Placement trGhild leaving DFGS Gustody trUpdate ncM Ghange seetlean ffi,eascm fon ffio*gffrce€Esffi €* s"smerggtrs&*p Current Date: Name of Person Completing Form: Section 2: lnformation about the child: This section must be Child's Name: Medicaid lD #: Section 3; lnformation about the child's case worker: This section must be DFCS Case Manager Name: Case Manager Contact Number/email Date Entered Custody: Joint Custody: Y/N address: County Office Address: Section 4: lnformation about the child's current placement: This seciion ;ust b" .o*pteted Placement Provider Name : Placement Provider Address : Placement Provider Telephone Number (if available): Placement Provider Email (if available): lnformation about the child's future placement: Complete this section if the child has a change in placement New Placement Provide Name : Date the Child Will Move to New placement: DFCS New Placement Provider Address: New Placement Provider Telephone Number (if available): Placement Provider Email (if available): Section6:lnformationaboutachildleavingDFcscu5tody:Completeitttrecr'@ Date child will leave foster care: Reason for Leaving Foster care (aging out, custody to someone, guardianship to someone): Section7:lnformationaboutthechild,smedicalneeds:Completeiftnectr Emergency Care Needed? yes No Emergency Medications Needed? yes lf yes, explain (include name of facillty and No lf yes, specify drug and pharmacy: treatment needed): 5ection8lListallreferralsthathavebeenmadesincechildtakenintelcustoo any other healthcare services etcl: Reason for Referral (BCW, CCF Date of Referral aldiagnosislconditions,i'e.nouoJnXietyciscrdeieic $e*c*, 3€:''rill*di*gti*is Medication Name tti:sr rU fi€dicart€lis *"t tne Arlr,f is How often is this taken Usethisformfor:intakeorentryintoFc;placementchange;.h"nJ-inorcscasetvtan"g"'( Version: v03-17 Reason for Medication Families:nn: Georgia Families 360" Resource lnformation Questions from Adoption Assistance parents or members about enrollment, opting inf out, primary care providers, primary dental providers, scheduling appointments, provider network: Amerig rou p I nta ke Li ne : 855.66L.2021 (phone)-- DcH may 'warm transfer' calls to the lntake Line 888.375.s06a (fax) FClntake@amerigroup.com xfor member documents only* (email) Questions from Foster Care parents or members about enrollment, primary care providers, primary dental providers, scheduling appointments, provider network: Ame rig rou p Inta ke Li n e : 855.661.2021 (phone) -- DcH may 'warm transfer' calls to the lntake Line 888.375.s064 (fax) FClntake@amerigroup.com *for member documents only* (email) Questions from Juvenile Justice parents or members about enroltment, primary care providers, primary dental providers, scheduling appointments, provider network: Amerig rou p I ntoke Li ne : 855.661.2021 (phone) -- DcH may 'warm transfer' calls to the lntake Line 888.375.s064 (fax) FClntake@amerigroup.com *for member documents only* (email) Questions or concerns from members about health care related issues or program services: Ombudsmon Program: Amerigroup: 1-855-558-1436 (phone) helpOM 3(damerigroup.com (email) 1-888-375-5067 (fax) DCH: GeorgiaFamilies36C Ombudsman@dch.ga.gov Amerigroup $Wmm$S$ru]uffiffijxj i"^^1+l^-..-*^ i i Udl Li !L d,r- e Amerigroup ID card S *"*0"' ==- to For starters, to view, print or change a doctor, you,ll need the member,s: s Medicaid lD number .fr Last name fl: Date of birth $l ZIP code once you've received this information, visit wu/w.myamerigroup.com and click on Register Here to create a username and password to view the member's information. View and print ID card it Log in to view andlor print the lD card Click on lD card Click on View and Print To request an lD card by phone, please call the Georgia Families 360",, Member lntake Line at 1.-855-661,-202L Change primary care provider (pCp) i,rl Log in to change the PCp Click on My Account Click on Your Primary Care provider to make changes Choose a PCP from the search page Click on Change to your pCp To change a PCP by phone, please call the Georgia Families 350",, Member lntake Line at 1-855-66 L-Z0ZL (TTY 1-800-855 -zgS0). Ceorgi Families 360:- Amerigroup ffimmKffimlmtfmmm .iieal.thcare Tarjeta de identificacion de Amerigroup Para principiantes, para ver, imprimir o cambiar un doctor, necesita16 la siguiente informaci6n del miembro: & NUmero de identificaci6n de Medicaid i,i Apellido &u Fecha de nacimiento lu C6digo postal Una vez usted haya recibido esta informaci6n, visite www.myamerigroup.com y haga clic en Register Here (Registrese aqui) para crear un nombre de usuario y contrasefia para ver informaci6n del miembro. la Ver e imprimir la tarjeta de identificacion s* lnicie sesi6n para ver y/o imprimir la tarjeta de identificaci6n Haga clic en lD card (Tarjeta de identificaci6n) Haga clic en View and Print (Ver e imprimir) Para solicitar una tarjeta de identificaci6n por tel6fono, llame a Georgia Families 360",, Member lntake Line al I-855-661-2021,. Cambiar el proveedor de cuidado primario (pCp) W ',] fr 1{ *.fwr'o" / ,u - hffi$' iW MT\i .. lnicie sesi6n para cambiar su PCp Haga clic en My Account {Mi cuenta) Haga clic en Your Primary Care provider (Su proveedor de cuidado primario) para hacer cambios Elija un PCP de la p6gina de b0squeda Haga clic en Change to Your pCp (Cambiar su PCP) Para cambiar un PCP por tel6fono, llame a la Georgia Families 350",. Member lntake Line al 1-8ss-661-2021 (TTy 1-800-8ss-2884). eorSr Families 360:. Youth Enters DFCS Custody and Enrolls in Amerigroup Activities that occur during the first 72 hours of the youth entering DFCS custody L' Child is removed from home, taken into DFCS custody and assigned a Social Services Case Manager (SSCM). The SSCM completes the following: a. During the removal of the child and following the removal, gathers as much medical history (through VHR, family, etc.) and enters the information into SHINES b. Completes and sends the E Form to the Amerigroup intake unit and DCH (within 24 hours of the youth entering care) 2. c. Submits Medicaid application via SHINES to the DFCS Rev Max unit At the Preliminary Protective Custody hearing, a judge determines if the youth will remain in DFCS custody. lf the judge determines the youth will remain in DFCS custody, the social services case worker selects a CCFA provider within 24hours of the Preliminary Protective Custody hearing; if the judge allows the child to return home, the enrollment process stops a. The CCFA provider confirms receipt of the referral and acceptance of the referral 3. Amerigroup receives the E Form (see step 1b) from DFCS and accesses the member's VHR (if available) to begin care coordination planning and developing the member's individualized care planning team; if the CCFA provider is not known at the time of form submission, the E Form will resubmitted with including the CCFA provider referral and noting that the E Form is an update within 24 hours of the Preliminary Protective Custody hearing 4. Upon receiving the CCFA provider information (see step 2) from DFCS, Amerigroup will begin coordinating medical assessments and development of individualized member care plan Activities that occur during the first 96 hours ofthe youth entering DFCS custody The SSCM completes the following: 5. Updates all court orders and placement information in SHINES and sends to Rev Max Specialist 6. Sends written notification to the Amerigroup intake unit and DCH within 24 calendar hours of the Preliminary Protective Custody hearing to notify Amerigroup Note - to finalize the use of the E form/notifications following Preliminary Protective Custody Hearing. The Rev Max Unit will complete the following; 7. Determines Medicaid eligibility, changes living arrangement code and removes member from existing active/pending SUCCESS cases (within L business day of receipt of application)1. Amerigroup will complete the following: 8. Assigns the member to a care coordination team Activities thot occur during the first r44 hours of the youth entering DFCS custody 9. DCH receives the SUCCESS file from DFCS (see Step 7), loads the file into GAMMIS. The file then automatically sent to Amerigroup through the daily eligibility file within 4g hours of it is loading into GAMMIS Once Amerigroup receives the eligibility file from DCH, Amerigroup enrolls the member Activities that occur within lPossible lr days of the member entering DFcs custody Categories of Assistance s: F22 or F11; Living Arrangement Code: FC; Aid Categories: 133, 131 Version 02281,4 10. will be assigned within 2 business days and the dental home will be assigned within 5 business days of receipt of the enrollment file 11. Amerigroup will provide lD Card to members via a secure portal on the Amerigroup website within 5 business days of receipt of eligibility file from DCH. Members may request, via phone, that lD cards be sent via mail. lnformation packets will be provided at county DFCS offices PCP Version O228L4 Use Case Workflow Acronyms ACS : Assessment and Classification Specialist AGP: Amerigroup CCFA: Comprehensive Child and Family Assessment CCT: Care Coordination Team CPS lnvestigator : Child Protective Services lnvestigator DJJ: Department of Juvenile Justice FFS: Fee for Service ICAMA: lnterstate Compact on Adoptions and Medical Assistance ICPC: lnterstate Compact on the Placement of Children IFSP: lndividual Family Service plan JPPS: Juvenile Probation Parole Specialist MCH Assessment: Maternal and Child Health Assessment JPPS : Juvenile Probation/Parole Specialist RevMax: Revenue Maximization RPS: Residential Placement Specialist SSCM: SocialServices Case Manger