Georgia Medicaid plans for centralized credentialing for Medicaid CMO’s

The Department of Community Health (DCH) has announced its plan for implementing centralized credentialing for Medicaid and all three CMO’s.  Centralized credentialing is targeted to be in effect during the first half of 2013.

The centralized credentialing initiative will streamline provider enrollment by implementing a single source application. Provider enrollment will consist of one application to enroll as a Medicaid provider and submit their application to become credentialed as a network provider with each of our three CMOs – Amerigroup, Peach State Health Plan and WellCare of Georgia.

Phase I of the process will begin with new Medicaid program applicants (i.e., facilities, professional and ancillary providers) who also wish to participate in the CMO network.

It is important to note that centralized credentialing will not take the place of contracting with each CMO. Providers will still need to contact each CMO to initiate the contracting process.  However, this new process will eliminate the need for going through an application and credentialing porcess 4 different times to become providers with Medicaid and the three CMO’s.

Recredentialing will be part of Phase II and is expected to be initiated late in 2013.  This transition will allow providers to re-credential with Medicaid and all three CMO’s with just one recredentialing application.

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Contact nCred to discuss our Medicaid provider enrollment services.  Call us at (423) 443-4525 or visit our information request page to request more information.