Government Payer

Medicaid Credentialing & Provider Enrollment

Comprehensive Medicaid provider enrollment services across all 50 states. Get approved by state Medicaid programs and managed care organizations to serve millions of beneficiaries.

2000+ Medicaid Providers

50 States Covered

60-90 Days Average

Start Medicaid Enrollment Free Medicaid Consultation

All 50 States

Complete Medicaid Enrollment

State Medicaid programs and managed care organization credentialing

Our Process

Medicaid Enrollment Made Simple

Our comprehensive 3-step process navigates complex state Medicaid requirements efficiently.

State Requirements Analysis

We analyze specific Medicaid requirements for your state and collect all required documentation for enrollment.

Application Submission

We prepare and submit complete enrollment applications through state Medicaid portals and managed care organizations.

Follow-Up & Approval

We track applications, respond to state requests, and ensure successful enrollment and provider number assignment.

Medicaid Programs We Cover

All Medicaid Program Types

We credential providers for all state Medicaid programs and managed care plans.

State Medicaid Fee-for-Service

Traditional state Medicaid programs

Medicaid Managed Care

MCO plans including Aetna Better Health, UHC Community Plan

CHIP Programs

Children's Health Insurance Program

Long-Term Services & Supports

LTSS and home and community-based services

Dual Eligible (Medicare-Medicaid)

D-SNP and MMP plans

Medicaid Dental

State dental program enrollment

Medicaid Vision

Vision care provider enrollment

NEMT Services

Non-Emergency Medical Transportation

State Expertise

50-State Medicaid Coverage

We navigate the unique requirements of each state's Medicaid program.

California Medi-Cal

CA Medicaid and managed care plans

Texas STAR/STAR+PLUS

TX Medicaid managed care programs

Florida Medicaid

Statewide Medicaid Managed Care

New York Medicaid

NY Medicaid and managed care plans

Illinois Medicaid

HealthChoice Illinois managed care

Pennsylvania Medicaid

HealthChoices and Community HealthChoices

Ohio Medicaid

Ohio Medicaid managed care plans

Michigan Medicaid

Healthy Michigan and Medicaid HMOs

Core Requirements

Medicaid Enrollment Essentials

We ensure all Medicaid provider enrollment requirements are met with precision.

State Medical License

Active, unrestricted license in practicing state

NPI Number

National Provider Identifier registration

Medicaid Provider Agreement

State-specific provider enrollment agreements

Malpractice Insurance

Coverage meeting state Medicaid requirements

Background Screening

Fingerprinting and criminal background checks

OIG/SAM Exclusion Check

Federal and state exclusion list screening

Site Visit Preparation

Pre-enrollment and post-enrollment site visit readiness

W-9 Form

Current IRS W-9 for tax identification

Why Choose Us

Medicaid Enrollment Excellence

We understand the complexities of state Medicaid programs and managed care credentialing.

50-State Expertise

Deep knowledge of Medicaid enrollment requirements across all states and territories.

MCO Credentialing

Experience with all major Medicaid managed care organizations nationwide.

Error-Free Applications

Complete and accurate applications that minimize processing delays and rejections.

Revalidation Support

Ongoing monitoring and management of Medicaid revalidation cycles (typically every 3-5 years).

FAQ

Medicaid Credentialing Questions Answered

Clear answers to common questions about Medicaid provider enrollment.

How long does Medicaid enrollment take?

Medicaid enrollment typically takes 60-120 days depending on the state. Some states offer expedited processing. We track state-specific timelines.

Do I need separate enrollment for each state?

Yes, each state operates its own Medicaid program and requires separate enrollment. We manage multi-state applications efficiently.

What is the difference between Medicaid fee-for-service and managed care?

Fee-for-service is traditional state-run Medicaid. Managed care involves private MCOs that contract with states. Most states require enrollment in both.

Do I need an NPI for Medicaid?

Yes, all Medicaid providers must have an active NPI number. We assist with NPI registration and maintenance.

What is Medicaid revalidation?

Medicaid requires providers to revalidate enrollment periodically (every 3-5 years). We track deadlines and manage complete revalidation.

Does Medicaid require site visits?

Yes, many states require pre-enrollment or post-enrollment site visits. We help prepare for all required inspections.

What is the OIG exclusion list?

The OIG exclusion list identifies providers barred from federal programs. We screen all providers against OIG, SAM, and state exclusion lists.

Can non-physician providers enroll in Medicaid?

Yes, NPs, PAs, therapists, and other providers can enroll. Requirements vary by state and provider type.

What is CHIP?

CHIP (Children's Health Insurance Program) provides coverage for children in families that don't qualify for Medicaid. Enrollment is often separate.

How do I bill for out-of-state Medicaid patients?

Generally, providers must be enrolled in the patient's state Medicaid program. We can help with multi-state enrollment strategies.

Ready to Enroll with Medicaid?

Let our Medicaid enrollment experts navigate state requirements and get you approved to serve millions of beneficiaries.

Start Medicaid Enrollment Free Medicaid Consultation