Managed Care Organization

How to Get Credentialed with Amerigroup (Anthem) in Maryland

Network: Open
30-60 Days CAQH Required

Quick Overview

Timeline

30 - 60 days

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

Maryland-Specific Requirements

Amerigroup Maryland participates in the HealthChoice Medicaid managed care program. Providers must first enroll with Maryland Medicaid through the CRISP enrollment portal, then apply to Amerigroup via CAQH ProView. Active Maryland medical license and NPI are required. Service areas cover select jurisdictions across the state. Maryland requires providers to meet specific access standards and timely appointment availability for HealthChoice participation.

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Maryland.

2

Complete Your CAQH ProView Profile

Amerigroup (Anthem) requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.

3

Submit Your Application

Submit your completed enrollment package to Amerigroup (Anthem).

4

Track & Follow Up

Credentialing typically takes 30-60 days. Monitor your application status and respond promptly to requests for additional information.

Free Consultation

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Our specialists handle the entire Amerigroup (Anthem) enrollment process: applications, follow-ups, and approvals in Maryland.

Required Documents Checklist

Board Certification

Conditional

Required if board certified; highly recommended

CV/Resume

DEA License

Conditional

Required if prescribing controlled substances

Malpractice Insurance

Medical Degree

Medical License

NPI Certificate

Professional Reference

Key Credentialing Terms

Capitation
A payment model where a payer pays a provider a fixed amount per member per month regardless of whether the member recei...
CAQH
The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
Credentialing
The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
Effective Date
The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
Managed Care
A healthcare delivery system organized to manage cost, utilization, and quality through techniques such as provider netw...
Network Adequacy
The requirement that a health plan's provider network has enough providers in each specialty and geographic area to give...
NPI
The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
Primary Source Verification
The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...

Credentialing Checklist

Make sure you have everything ready before applying to Amerigroup (Anthem).

View Physician Credentialing Checklist →

Contact Information

Provider Credentialing

National

1-800-454-3730

Mon-Fri 8am-5pm

Provider Services

National

1-800-454-3730

Claims & Billing

National

1-800-454-3730

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Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.

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