PAYER READY CREDENTIALING & COMPLIANCE
Managed Care Organization

How to Get Credentialed with MedStar Family Choice in Maryland

Network: Unknown
CAQH Required

Quick Overview

Timeline

Varies

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

Maryland-Specific Requirements

MedStar Family Choice participates in the Maryland HealthChoice Medicaid managed care program. Providers must first enroll with Maryland Medicaid, then credential with the plan via CAQH ProView. An active Maryland license and NPI are required.

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

MedStar Family Choice 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 MedStar Family Choice.

4

Track & Follow Up

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

Free Consultation

Need help enrolling with MedStar Family Choice?

Our specialists handle the entire MedStar Family Choice enrollment process: applications, follow-ups, and approvals in Maryland.

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 MedStar Family Choice.

View Physician Credentialing Checklist →

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.

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