Managed Care Organization

How to Get Credentialed with Anthem HealthKeepers / Hoosier Healthwise in Virginia

Network: Open
CAQH Required

Quick Overview

Timeline

Varies

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

Virginia-Specific Requirements

Anthem HealthKeepers Plus participates in the Medallion 4.0 Medicaid managed care program in Virginia. Providers must first enroll with Virginia Medicaid through DMAS, then apply to Anthem via CAQH ProView. Active Virginia medical license and NPI are required. Service areas cover multiple DMAS managed care regions across the Commonwealth. Medallion 4.0 integrates physical health, behavioral health, and pharmacy services under one managed care contract.

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 Virginia.

2

Complete Your CAQH ProView Profile

Anthem HealthKeepers / Hoosier Healthwise 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 Anthem HealthKeepers / Hoosier Healthwise.

4

Track & Follow Up

Credentialing typically takes 60-90 days. Monitor your application status and respond promptly to requests for additional information.

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

Contact Information

Credentialing

National

Network Enrollment

National

Quick Links

Need Help?

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Anthem HealthKeepers / Hoosier Healthwise in Other States

Georgia Indiana Kentucky Wisconsin

Other Payers in Virginia

Aetna UnitedHealthcare Cigna Healthcare Anthem / Elevance Health Humana Centene Corporation Molina Healthcare Kaiser Permanente CareFirst BlueCross BlueShield Anthem Blue Cross and Blue Shield of Virginia
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