Managed Care Organization

How to Get Credentialed with AmeriHealth Caritas in Georgia

Network: Open
30-90 Days CAQH Required Delegated Credentialing

Quick Overview

Timeline

30 - 90 days

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

Yes

Georgia-Specific Requirements

AmeriHealth Caritas Georgia participates in the Georgia Families Medicaid managed care program. Providers must first enroll with Georgia Medicaid through GAMMIS, then apply to AmeriHealth Caritas via CAQH ProView. Active Georgia medical license and NPI are required. Service areas cover select counties across the state. The plan also participates in PeachCare for Kids (CHIP) and Georgia Families 360 programs.

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 Georgia.

2

Complete Your CAQH ProView Profile

AmeriHealth Caritas 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 AmeriHealth Caritas. You can start the process at their enrollment portal.

4

Track & Follow Up

Credentialing typically takes 30-90 days. Monitor your application status and respond promptly to requests for additional information.

Free Consultation

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Our specialists handle the entire AmeriHealth Caritas enrollment process: applications, follow-ups, and approvals in Georgia.

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 AmeriHealth Caritas.

View Physician Credentialing Checklist →

Contact Information

Credentialing

National

1-800-617-4608

Network Enrollment

National

1-800-617-4608

Claims (TX)

National

1-800-600-4441

Provider Relations

National

1-800-617-4608

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