NEMT Medicaid Billing in Georgia

Here is the part that trips up Georgia fleets: the trip and the claim run through the broker, not straight into the state. Under the Department of Community Health regional broker model, Georgia is split into five regions, and as of April 1, 2026, Verida (formerly Southeastrans) is the sole statewide broker for all of them. NEMT is carved out of the Georgia Families CMOs, so fee-for-service members and CMO members book through the same broker. You submit your trip claim through the Verida provider portal, the broker adjudicates it against the authorization, the broker bills Georgia Medicaid through GAMMIS, and the member pays $0. Getting assigned the trips is one job; getting paid for them is another. The difference between a fleet that gets paid on time and one that bleeds revenue is almost never the trips - it is the claims work behind them. This page walks the full cycle across all five regions: how a Verida authorization becomes a clean portal claim, what makes it clean, why claims deny, and how the money gets reconciled so nothing quietly goes unpaid.

A clean claim is one the broker cannot bounce, and the center of it is matching the Verida authorization to the claim: the authorization reference matches, the level of service and mileage reconcile with the authorized trip, the signature or electronic proof of the completed trip is attached where required, and the trip falls inside the filing window. Georgia adds an enrollment-level catch that shows up as a billing problem - each rendering NPI must link to a centralized billing-group NPI, with enforcement running to July 1, 2026. If a rendering NPI is not rolled up to your billing group in GAMMIS, claims tied to it can fail. Most denials trace back to the claim drifting from the authorization or a broken NPI linkage, so we build both checks in before the claim goes, and the first submission is the one that pays instead of the one that gets kicked back.

The last mile is proving you were paid for every Verida-authorized trip you ran across all five regions. Reconciliation runs against the broker remittance: each payment has to be matched to its trip, and the trips that were run but not paid - short-pays, missing claims, silent denials - have to surface instead of disappearing. Recurring dialysis standing orders are where this bites hardest, because a single missed line repeated across weeks quietly adds up. This is the step fleets skip when they are busy, and it is where the money leaks. We reconcile every remittance against your trip records and the Verida roster, post payments, and chase the gaps, so your revenue matches your operation instead of trailing it.