![]() ![]() The member's compliance with attending therapy sessions.Consultation with different actively practicing physiatrists and therapists regarding appropriate case level assignments.Medical guidelines promulgated by CMS, WellCare and Millman guidelines. ![]() Diagnosis code(s) as determined by the referring physician.Q7: How does the network develop a case rate?Ī number of factors were taken into consideration as part of the methodology for determining the case rate level and pricing for each therapy case. Yes, TNGA will be processing provider claims for the therapy services under its agreement with WellCare of Georgia. For additional information, please visit Q6: Will TNGA be processing claims for WellCare of Georgia? Medicaid: 95% of clean electronic claims are processed in 15 business days and 95% of clean paper claims are paid within 30 calendar days of receipt. TNGA's claims payment turnaround standards are as follows: Medicare - 95% of clean electronic claims are paid within 15 calendar days from the date of receipt and 95% of clean paper claims are paid within 30 calendar days of receipt. TNGA will be administering therapy benefits for all WellCare of Georgia's Medicaid, PeachCare for Kids®, and Medicare members. Q5: Will TNGA be arranging PT/OT/ST services to only a select group of WellCare members? The holidays that TNGA observes are: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, the day after Thanksgiving and Christmas Day. After regular business hours, a TNGA representative is available for urgent cases that need immediate attention by calling 1-85, Option #1. TNGA maintains regular business hours of 8 a.m. Q3: What are TNGA's hours and days of operation? for over six years, providing medical management for Wellcare of Florida lines of business. The company has been in partnership with WellCare Health Plans, Inc. TNGA is contracted with WellCare of Georgia to coordinate the provision of outpatient therapy (PT/OT/ST) services to WellCare members through a network of therapy providers contracted with TNGA. Q2: What is the relationship between WellCare of Georgia and TNGA? For more than seven years, TNGA and its affiliated companies have contracted with nine different health plans to provide therapy network management services. Its owners are also the founders and operators of the company. ![]() markets and cover all lines of business (Medicaid, SCHIP, Medicare, Commercial HMO, Commercial PPO). TNGA and its affiliated companies operate in four different U.S. TNGA and its affiliated companies provide rehabilitation services to over 1.2 million health plan members through its 1,100+ contracted provider locations. TNGA is a provider network company focused on contracting with independent therapy providers (PT/OT/ST) in order to arrange for outpatient rehabilitative services on behalf of health plans and their assigned members. Frequently Asked Questions Q1: Who is Therapy Network of Georgia? ![]()
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