By state
Credentialing services by state
Credentialing is bought state by state. Each page below covers that state's Medicaid program, managed-care plans, licensing boards, and the timelines we actually see.
Markets
States we publish detail for
Every state runs its own Medicaid program, its own managed-care contracting, and its own licensing boards. The notes below are the differences that actually change your timeline.
Credentialing services in New York
New York State Medicaid · 8 managed-care plans
New York State Medicaid enrolls through eMedNY, and the downstate managed-care plans — Fidelis, Healthfirst, MetroPlusHealth, EmblemHealth — each load rosters separately afterward. Behavior analysts need an NYSED LBA license before ABA panels will close. This is our home market; our office is in Brooklyn.
View NY detailsCredentialing services in New Jersey
NJ FamilyCare (New Jersey Medicaid) · 5 managed-care plans
NJ FamilyCare enrollment runs through NJMMIS, then five managed-care plans contract and load rosters on their own schedules. Horizon BCBS dominates commercial volume and runs an intake process separate from CAQH-only payers, so we file both tracks in parallel.
View NJ detailsCredentialing services in Florida
Florida Medicaid (AHCA) · 6 managed-care plans
Florida runs nearly all Medicaid through Statewide Medicaid Managed Care, so AHCA enrollment is only step one. Level 2 background screening through the AHCA clearinghouse and behavior analyst licensure through the Department of Health both gate ABA billing.
View FL detailsCredentialing services in Texas
Texas Medicaid · 7 managed-care plans
Texas Medicaid enrollment goes through TMHP's PEMS system, and almost every member sits in a STAR or STAR Kids plan that loads providers individually. BCBS of Texas leads commercial volume, and behavior analysts need an LBA through the Behavioral Health Executive Council.
View TX detailsCredentialing services in California
Medi-Cal · 7 managed-care plans
Medi-Cal enrollment through PAVE is the longest state process we work in, commonly 90–180 days. Much of California's commercial volume then sits behind delegated IPAs and medical groups with their own credentialing committee calendars, which is where most out-of-state groups stall.
View CA detailsCredentialing services in Virginia
Cardinal Care (Virginia Medicaid) · 6 managed-care plans
Virginia consolidated Medicaid under Cardinal Care, so providers enroll with DMAS first and contract with the managed-care organizations after. Northern Virginia groups usually need DC and Maryland enrollment alongside Virginia, and we plan the DMV as one project.
View VA detailsCredentialing services in Tennessee
TennCare (Tennessee Medicaid) · 4 managed-care plans
TennCare is delivered entirely through managed-care organizations, so state registration and MCO contracting must be sequenced correctly. BlueCross BlueShield of Tennessee carries a large share of the commercial market, so we prioritize that panel first.
View TN detailsCredentialing services in Pennsylvania
Pennsylvania Medical Assistance · 6 managed-care plans
Providers enroll through PROMISe for Medical Assistance before joining HealthChoices plans in their zone. Pennsylvania is effectively two commercial markets — Highmark in the west, Independence Blue Cross in the southeast — plus UPMC and Geisinger's own networks.
View PA detailsCredentialing services in New Mexico
Turquoise Care (New Mexico Medicaid) · 4 managed-care plans
New Mexico Medicaid operates as Turquoise Care with a small set of managed-care organizations. Presbyterian Health Plan and BCBSNM carry most volume, so a single stalled contract is a larger share of revenue here than in most states.
View NM detailsStates we cover outside these pages
We credential providers and enroll groups in all 50 states and the District of Columbia. The pages above are the markets we file in most often and where we publish the program-level detail, but the absence of a page does not mean the absence of coverage — we file Medicare Part B through PECOS nationwide, every state Medicaid program and its managed-care organizations, and the national commercial carriers (Aetna, Cigna, UnitedHealthcare, Humana, and the regional Blues) wherever your locations are.
For multi-state organizations, the work is less about any single application and more about sequencing: which entity and TIN files where, which licenses gate which payers, which Medicaid programs require managed-care contracting on top of state enrollment, and which effective dates support retroactive billing. That mapping is what we build first, before a single form goes out.
If you are entering several states at once, start with multi-state expansion support or multi-state payer contracting and enrollment. Larger organizations with delegated agreements should look at delegated credentialing and health system credentialing.
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Tell us which states you're expanding into
We'll map the Medicaid program, MCOs, licensing, and realistic timeline for each one.