Credentialing in Delaware

Delaware Medicaid (DHSS Division of Medicaid & Medical Assistance, DMMA) runs provider enrollment through the Delaware Medical Assistance Portal (DMAP) at medicaid.dhss.delaware.gov, operated by Gainwell Technologies. Because the Diamond State Health Plan is mandatory managed care, state screening/enrollment is only step one, a billable Delaware practice then needs separate credentialing/contracting with each of the three MCOs.

Delaware Medical Assistance Portal (DMAP) · checked Jul 2026

"In Delaware, Medicaid benefits are provided mainly through a managed care organization, or MCO, under contract with the state… Delaware's Medicaid Program is called Diamond State Health Plan (DSHP)." The lineup, verbatim: "Delaware contracts with three managed care plans", namely AmeriHealth Caritas, Delaware First Health and Highmark Health Options (Delaware First Health = Centene, joined 2023. Older two-plan lists are stale). Members choose a plan within ~90 days or the Health Benefit Manager auto-assigns, and "Prescription and non-emergency medical transportation services are covered directly by Medicaid, not through the MCO."

DE DHSS/DMMA, Diamond State Health Plan · checked Jul 2026

None found. Delaware's managed-care law, 18 Del. C. ch. 64, Regulation of Managed Care Organizations (§§ 6401-6420), contains no credentialing-deadline section; the full text was checked with zero "credential" occurrences, and Delaware is also absent from cross-state prompt-credentialing tables.

18 Del. C. ch. 64 (delcode.delaware.gov, verified negative) · checked Jul 2026

The individual-credentialing door is shut for associate-tier clinicians (LACMH, LMSW) at AmeriHealth Caritas DE, which limits individual BH credentialing to "Independently Practicing Licensed Behavioral Health Clinicians (LPC, LMFT, LCISW, and LMFT)" [sic, the manual's own label string]; its fraud-waste-abuse examples include "Submitting a claim for provider services on behalf of an individual that is unlicensed." Whether associate-rendered work pays under a supervisor or facility claim remains unresolved, ACDE does credential Community Mental Health Centers as facilities, so an agency lane can't be ruled out.

AmeriHealth Caritas DE Provider Manual · checked Jul 2026

Under the Division of Professional Regulation: the Board of Mental Health and Chemical Dependency Professionals (LPCMH/LACMH plus LMFT/LAMFT. There is no separate MFT board in Delaware), the Board of Social Work Examiners (LBSW/LMSW/LCSW), and the Board of Examiners of Psychologists.

DE Division of Professional Regulation, boards list · checked Jul 2026

Delaware IS a Counseling Compact member (on the counselingcompact.gov jurisdictions list) but not issuing privileges as of July 2026 (issuers: AZ, MN, OH, LA, GA, IN).

Counseling Compact, Compact Jurisdictions list · checked Jul 2026

Delaware First Health (2025 Provider Manual v11.2) credentials BH practitioners at clinical level only, "Doctoral or Master's-Level Psychologists… Master's-Level Clinical Social Workers", plus an unexpanded "Other behavioral healthcare specialists" catch-all, and requires DMAP enrollment first. No associate tier appears on the list.

Delaware First Health, 2025 Provider Manual v11.2 · checked Jul 2026

Medicare-eligible members, nursing-facility/ICF-IID residents, and HCBS-waiver members are not in regular MCO enrollment. The LTSS population instead runs through DSHP-Plus, Delaware's managed long-term-care arm integrating nursing-facility and HCBS services (same MCOs).

DE DHSS, DSHP-Plus program page · checked Jul 2026