Medicaid

How to Get Credentialed with Rhode Island Medicaid in Rhode Island

Network: Open
30-60 Days

Quick Overview

Timeline

30 - 60 days

CAQH

Not Required

Re-credentialing

Every 5 year(s)

Delegated

No

Rhode Island-Specific Requirements

Rhode Island Medicaid (Rite Care) enrollment steps: (1) Obtain NPI via NPPES. (2) Register through the EOHHS (Executive Office of Health and Human Services) Medicaid provider enrollment portal. (3) Submit application with RI state license, proof of malpractice insurance, and required documentation. (4) Background check including state BCI and federal criminal history is required for all providers. Rhode Island operates managed care through Rite Care with 3 MCOs covering the majority of Medicaid beneficiaries. Behavioral health providers accepted include LMHC and LICSW with active Rhode Island licensure. Revalidation is required every 5 years.

Medicaid Information — Rhode Island

Agency: Rhode Island EOHHS

Program: RIte Care / RIte Share

Portal: https://eohhs.ri.gov/providers

Phone: 1-401-462-5300

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 Rhode Island.

2

Prepare Your Application

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

3

Submit Your Application

Submit your completed enrollment package to Rhode Island 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

Rhode Island Medicaid Provider Enrollment

Required
Online Open →

Contact Information

Provider Enrollment

National

1-401-462-5300

General Provider Inquiries

National

1-401-462-5300

Quick Links

Provider Portal

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Other Payers in Rhode Island

Aetna UnitedHealthcare Cigna Healthcare Anthem / Elevance Health Humana Centene Corporation Molina Healthcare Blue Cross & Blue Shield of Rhode Island UnitedHealthcare Community Plan TRICARE
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