How to Get Credentialed with CareSource in Georgia
Quick Overview
Timeline
30 - 51 days
CAQH
Required
Re-credentialing
Every 3 year(s)
Delegated
No
How CareSource Credentialing Actually Works
Verified July 2026Apply Through
Timeline
The credentialing phase typically runs 60 to 75 business days
Recredentialing
At least every three years; you are considered recredentialed unless notified otherwise
Four gates in order: the Health Partner Contract Form, contract execution, credentialing, then enrollment into claims and directory systems. A CAQH number is required in most cases, with CareSource authorized as a viewing plan.
The stall to avoid: Contracted is not enrolled: providers are not payable until the final enrollment step loads them into claims systems. For Medicaid products an active state Medicaid ID comes first.
From PayerReady's payer enrollment research, built from the payer's own provider manuals and enrollment pages. Payer processes change; when a fact is not published by the payer, we say so rather than guess.
Georgia-Specific Requirements
Step-by-Step Enrollment Process
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Georgia.
Complete Your CAQH ProView Profile
CareSource requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.
Submit Your Application
Submit your completed enrollment package to CareSource.
Track & Follow Up
Credentialing typically takes 30-51 days. Monitor your application status and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with CareSource?
Our specialists handle the entire CareSource enrollment process: applications, follow-ups, and approvals in Georgia.
Required Documents Checklist
Board Certification
ConditionalRequired if board certified; highly recommended
CV/Resume
DEA License
ConditionalRequired if prescribing controlled substances
Malpractice Insurance
Medical Degree
Medical License
NPI Certificate
Professional Reference
Free Tools for Your CareSource Enrollment
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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 CareSource.
View Physician Credentialing Checklist →Contact Information
Provider Credentialing
National1-800-488-0134
Mon-Fri 8am-5pm
Provider Services
National1-800-488-0134
Claims & Billing
National1-800-488-0134
Quick Links
Reviewed by the PayerReady Credentialing Team
Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.