How to Get Credentialed with The Health Plan Medicaid in West Virginia
Quick Overview
Timeline
Varies
CAQH
Not Required
Re-credentialing
Every 3 year(s)
Delegated
No
Who Runs West Virginia Medicaid Provider Enrollment
50-state researchEnrollment Portal
West Virginia Medicaid provider portal
Operated By
Gainwell Technologies
Platform
State MMIS
From PayerReady's 50-state Medicaid enrollment platform research, verified July 2026. Portal contracts change; where an operator is in transition or not publicly confirmed, we say so rather than guess.
West Virginia-Specific Requirements
Step-by-Step Enrollment Process
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.
Prepare Your Application
Complete The Health Plan Medicaid's provider enrollment application with all required information and supporting documentation.
Submit Your Application
Submit your completed enrollment package to The Health Plan Medicaid.
Track & Follow Up
Credentialing typically takes 60-90 days. Monitor your application status and respond promptly to requests for additional information.
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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 The Health Plan Medicaid.
View Physician Credentialing Checklist →Quick Links
Need Help?
Let PayerReady handle your The Health Plan Medicaid enrollment in West Virginia.
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Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.