By payer
Payer credentialing by plan
Every payer has its own prerequisites, portals, roster cycles, and denial patterns. These pages cover what each major Medicaid MCO and Medicare Advantage plan actually requires — and where files usually stall.
Medicaid MCOs
Medicaid managed care organizations
Managed Medicaid is two layers: the state Medicaid ID first, then the MCO roster load. These pages cover both.
Molina Healthcare credentialing
Molina Healthcare Medicaid MCO credentialing and enrollment — requirements, state Medicaid prerequisites, roster loads, common denials, and realistic timelines.
View requirementsCentene / Ambetter credentialing
Centene and Ambetter credentialing — Medicaid MCO, Marketplace, and Wellcare Medicare products, enrollment requirements, denial patterns, and timelines.
View requirementsAnthem / Elevance Medicaid credentialing
Anthem (Elevance) Medicaid MCO credentialing — Blue-branded plan structure, Availity submissions, behavioral carve-outs, denial patterns, and timelines.
View requirementsUnitedHealthcare Community Plan credentialing
UnitedHealthcare Community Plan Medicaid credentialing — state prerequisites, Optum behavioral carve-out, roster loads, denial patterns, and timelines.
View requirementsAetna Better Health credentialing
Aetna Better Health Medicaid MCO credentialing — state plan structure, CVS/Aetna requirements, common denials, roster loads, and realistic timelines.
View requirementsCareSource credentialing
CareSource Medicaid MCO credentialing — Ohio, Indiana, Georgia, Kentucky and beyond. Requirements, common failure points, roster loads, and timelines.
View requirementsMedicare Advantage
Medicare Advantage plans
Every Medicare Advantage contract rests on a clean PECOS enrollment. These pages cover the prerequisite, the application, and the roster load.
Humana Medicare Advantage credentialing
Humana Medicare Advantage credentialing and enrollment — PECOS prerequisites, application requirements, common failure points, FAQs, and timelines.
View requirementsUnitedHealthcare Medicare Advantage credentialing
UnitedHealthcare Medicare Advantage credentialing — AARP plans, PECOS prerequisites, Optum behavioral carve-out, failure points, FAQs, and timelines.
View requirementsAetna Medicare Advantage credentialing
Aetna Medicare Advantage credentialing — CVS Health network requirements, PECOS prerequisites, common denials, FAQs, and realistic timelines.
View requirementsWellcare Medicare Advantage credentialing
Wellcare (Centene) Medicare Advantage credentialing — PECOS prerequisites, entity confusion with Ambetter and Medicaid plans, failure points, and timelines.
View requirementsGet started
Not sure which plans to file first?
Send your payer list and we'll sequence it — prerequisites, retro windows, and realistic effective dates.