Primary care provider
Choosing Dare2Care as your child’s primary care provider
Georgia Medicaid plans and many HMO plans only pay for care that goes through the primary care provider (PCP) on file. Naming Dare2Care Pediatrics as your child’s PCP takes a few minutes and keeps visits, referrals and claims running smoothly.
Why it matters
What the PCP on file controls
A primary care provider is the doctor or practice your plan recognizes as your child’s home base. For Georgia Medicaid, PeachCare for Kids and HMO plans, the plan pays for well visits and sick visits at the PCP on file, and specialist referrals, therapy authorizations and some tests must start there.
When the PCP on file is a practice you no longer use, three things go wrong: our claim may be denied and the visit billed to you, a referral we write may be rejected because the plan does not see us as your PCP, and the plan keeps sending reminders and care-coordination calls to the wrong office.
PPO and most EPO plans do not require a PCP, so this page mostly matters for Medicaid, PeachCare for Kids, HMO and POS products. Not sure which you have? The card usually says HMO, POS or PPO, and Medicaid cards show the plan name: Amerigroup, CareSource or Peach State Health Plan.
By plan type
Which plans need a PCP on file
| Plan type | PCP selection | Referrals to specialists | What to do |
|---|---|---|---|
| Georgia Medicaid and PeachCare for Kids (Amerigroup, CareSource, Peach State Health Plan) | Required; the plan assigns one if you do not choose | From the PCP; the plan authorizes | Choose Dare2Care Pediatrics in the plan’s app or by calling member services, then tell us |
| Georgia Medicaid fee-for-service (including Katie Beckett) | Not required | Not required for most specialists | Bring the Medicaid card; we bill Medicaid directly |
| HMO | Required | Required from the PCP | Select Dare2Care Pediatrics with your insurer at enrollment or in the member portal |
| POS | Usually required for in-network benefits | Required for the in-network level of benefits | Select Dare2Care Pediatrics as PCP; out-of-network care costs more |
| PPO or EPO | Not required | Not required | Nothing to do; confirm we are in-network for your product |
| Tricare Prime | Required (PCM) | Required from the PCM | Ask Tricare to list Dare2Care Pediatrics as the primary care manager |
Georgia Medicaid and PeachCare for Kids
Set Dare2Care Pediatrics as PCP with your Georgia Families plan
Step 1: Find the plan on the card
Look for Amerigroup, CareSource or Peach State Health Plan. New members choose a plan through Georgia Families (1-888-GA-ENROLL) and can pick a PCP at the same time.
Step 2: Change the PCP
Open the plan’s app or member portal, or call member services at the number on the card, and ask for Dare2Care Pediatrics, 5460 McGinnis Village Pl, Suite 103, Alpharetta 30005. You can name Dr. Madhuri Viswanadham as the PCP.
Step 3: Tell us the effective date
Changes usually start on the first day of the next month; new members are often effective immediately. Call or text us with the date and your child’s member ID and we verify it before the first visit.
HMO and POS plans
Set Dare2Care Pediatrics as PCP with a commercial plan
Step 1: Check the product
HMO and POS cards need a PCP; PPO and EPO cards do not. If the card lists a PCP that is not us, the plan may deny our claim.
Step 2: Select us with the insurer
In the member portal or by phone, choose Dare2Care Pediatrics for each child. Our group NPI is 1972958197 if the insurer asks for it.
Step 3: Newborns: add the baby within 30 days
A newborn is covered under the mother’s plan for the first 30 days, but the baby must be added to the policy in that window and given a PCP. We see newborns within days of discharge either way.
Questions
PCP questions we hear most
What happens if the wrong PCP is on file when we visit?
We will still see your child. For Medicaid and HMO plans the claim may be denied, so we ask you to update the PCP that day and we resubmit; most plans allow a change with a same-month effective date for new members.
How long does a PCP change take?
Most Georgia Families plans make the change effective the first of the next month, sometimes immediately for a newly enrolled child. Commercial HMOs are similar. Ask the plan for the effective date and tell us.
Can I change PCP in the middle of the year?
Yes. Medicaid and PeachCare for Kids members can change PCP at any time; commercial HMO members usually can too, subject to the plan’s rules.
Does a PPO need a PCP?
No. PPO and most EPO plans let you see any in-network pediatrician without a referral. Just confirm Dare2Care Pediatrics is in-network for your specific product.
My child is in foster care. Who sets the PCP?
Children in foster care are covered by Georgia Families 360° through Amerigroup Community Care. The caseworker or foster parent chooses the PCP with the plan; we are glad to be that PCP and to coordinate with DFCS.
Need a hand with the change?
Call or text (770) 615-7000 with the plan name and member ID. Our front desk walks families through the PCP change every week.