Medicaid

How to Get Credentialed with Delaware Medicaid in Delaware

Network: Open
30-60 Days

Quick Overview

Timeline

30 - 60 days

CAQH

Not Required

Re-credentialing

Every 5 year(s)

Delegated

No

Delaware-Specific Requirements

Delaware Medicaid (Diamond State Health Plan) enrollment steps: (1) Obtain NPI via NPPES. (2) Register through the Delaware DHSS Medicaid provider enrollment portal. (3) Submit application with DE state license, proof of malpractice insurance, and required documentation. (4) Background check including state and federal criminal history is required for all providers. Delaware operates managed care through MCOs under the Diamond State Health Plan. Behavioral health providers accepted include LPCMH (Licensed Professional Counselor of Mental Health), LCSW, and Licensed Psychologist with active Delaware licensure. Revalidation is required every 5 years.

Medicaid Information — Delaware

Agency: Delaware DHSS, Division of Medicaid and Medical Assistance

Program: Diamond State Health Plan

Portal: https://dhss.delaware.gov/dhss/dmma/

Phone: 1-800-372-2022

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 Delaware.

2

Prepare Your Application

Complete Delaware Medicaid's provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to Delaware Medicaid.

4

Track & Follow Up

Credentialing typically takes 30-60 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

Background Check

Federal/state background check required for Medicaid enrollment

CV/Resume

Work history required

Malpractice Insurance

Conditional

Required in most states; some state programs waive for government employees

Medical License

NPI Certificate

Enrollment Forms

Delaware Medicaid Provider Enrollment

Required
Online Open →

Contact Information

Provider Enrollment

National

1-800-372-2022

General Provider Inquiries

National

1-800-372-2022

Quick Links

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