Medical Credentialing Services in Georgia

One CVO for all three Georgia Families plans

Georgia Medicaid is run by the Georgia Department of Community Health, the DCH, and provider enrollment happens through GAMMIS, the Georgia Medicaid Management Information System. That is your front door for enrolling, billing and managing your Medicaid record.

Here is the part that actually helps you. Managed care in Georgia runs through the Georgia Families program, and its three Care Management Organizations are Wellpoint (formerly Amerigroup), CareSource and Peach State Health Plan. DCH runs a centralized credentials verification organization, a CVO, that credentials providers for all three of those plans. So you are not running the same credentialing paperwork three separate times, once per plan. You credential through the DCH process and the CMOs work from it. Georgia also runs Georgia Pathways to Coverage, its limited expansion program, which widens who you can see and bill. Medicare is a separate track, filed through PECOS and the CMS 855 forms, so when you bill both we sequence the two so neither stalls the other.

What we handle for Georgia providers

Georgia centralizes credentialing for all three Georgia Families managed care plans through a single CVO, and licenses MDs, DOs and PAs through one composite board. That consolidation can speed things up when the file is right the first time, which is exactly what we build:

Not sure which pieces you need? Tell us your specialty and market and we will scope it, or go straight to provider credentialing and payer enrollment.

Your Georgia license: one board for MDs, DOs and PAs

The Georgia Composite Medical Board licenses MDs, DOs and physician assistants together, which keeps the physician side of your file simpler than in many states. Nurse practitioners and other APRNs go through the Georgia Board of Nursing instead. Every payer wants your active Georgia license confirmed at the source, so we pull and document licensure correctly for each provider, then watch the renewal dates so nothing slips past you in the middle of an enrollment.

Georgia payers we enroll you with

Metro Atlanta is one of the Southeast's biggest healthcare markets, and the payer mix shows it. We enroll and contract you with:

That Kaiser point matters. Kaiser Permanente has a real Georgia region, one of its few markets outside the West and Mid Atlantic, and it mostly cares for members inside its own integrated system. Joining as an outside provider works differently from a standard commercial panel, so we tell you up front whether that route fits before you spend time on it.

How long credentialing takes in Georgia

Honest answer: it depends on the payer. Industry typical commercial credentialing runs about 90 to 120 days from a complete, clean file. On the Medicaid side, the DCH centralized CVO and the Georgia Families CMOs each move at their own pace. The single biggest lever, every time, is an application with no gaps in it.

Frequently asked questions