Get Credentialed

   

Credentialing 

Georgia’s Department of Community Health (DCH), through its fiscal agent, has implemented a Credentialing Verification Organization (CVO) which performs credentialing and recredentialing functions for providers enrolled or seeking to enroll in the Georgia Families® network.

CareSource® will include in our network only those providers who:

  • Have been appropriately credentialed by the CVO;
  • Maintain a current license; and
  • Have appropriate locations to provide covered services to our members.

To begin credentialing, submit an application and check application status, providers must enroll with Medicaid and/or Georgia Families® by submitting an application and supporting documentation to the CVO online via the provider credentialing portal.

If you have any questions, you may email the CVO or call them at 1-800-766-4456.

CareSource will not conduct its own credentialing processes and shall accept the CVOs credentialing and recredentialing determinations. CareSource cannot appeal the CVOs credentialing decision. CareSource cannot require providers to submit supplemental or additional information for purposes of conducting a second credentialing process.

CareSource will not pay for claims for dates of service prior to the credentialing approval date.

Contracting

Upon a provider’s interest in contracting with CareSource, the process below is followed:

  1. CareSource will review the provider’s request and begin building the provider’s contract.
  2. CareSource will coordinate with the CVO to confirm the status of providers who request to enroll with us and to confirm their credentialing or recredentialing status.
  3. CareSource will refer new providers who are not Medicaid providers to the CVOs website to complete the credentialing process.
  4. Upon receipt of notice that the CVO has completing the credentialing process, CareSource will electronically send the contract to the provider.