• IMPORTANT BENEFIT UPDATE: INSECT SPRAY COVERAGE

    Peach State Health Plan is committed to ensuring our members have the best products available to manage their health. As of July 15, 2016 Peach State Health Plan will be offering two formulations of insect repellant to help prevent the spread of mosquito borne diseases, like Zika.   One of the top prevention recommendations by the…

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  • Advanced Life Support Ground Ambulance Payment Policy

    Peach State Health Plan will provide reimbursement for Advanced Life Support (ALS) ground ambulance services when the services are medically necessary, meet the destination limits of closest appropriate facilities, and services are provided by a licensed ambulance provider. The use of emergency transport must be justified based on the condition of the patient. Reimbursement will be provided…

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  • Attention Medicare & Ambetter Providers – Clinical Coverage and Payment Policy Changes Effective 8-15-16

    Peach State Health Plan is publishing its Payment and Clinical Policies to inform providers about acceptable billing practices and reimbursement methodologies for certain procedures and services. We will apply these policies as medical claims reimbursement edits within our claims adjudication system. This is in addition to all other reimbursement processes that Peach State Health Plan…

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