Managed Care Organization

How to Get Credentialed with CareSource in West Virginia

Network: Open
CAQH Required

Quick Overview

Timeline

Varies

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

West Virginia-Specific Requirements

CareSource West Virginia participates in the Mountain Health Trust Medicaid managed care program. Providers must first enroll with West Virginia Medicaid through BMS, then apply to CareSource via CAQH ProView. Active West Virginia medical license and NPI are required. Service areas cover all 55 West Virginia counties. The plan serves traditional Medicaid and Medicaid expansion populations under the Mountain Health Trust program.

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 West Virginia.

2

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.

3

Submit Your Application

Submit your completed enrollment package to CareSource.

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

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