For healthcare providers, being properly enrolled with Georgia Medicaid isn’t just about access — it’s a compliance requirement that affects billing accuracy, reimbursement timelines, and patient trust. Yet with evolving state regulations, CAQH verification, and multiple insurance credentialing requirements, even experienced administrators can make costly mistakes during enrollment.

In this comprehensive guide we’ll break down the Georgia Medicaid provider enrollment process step by step — from verifying your National Provider Identifier (NPI) to completing your state application and maintaining your credentials post-approval. Whether you’re handling enrollment for the first time or preparing for revalidation, this article will help you avoid compliance pitfalls and streamline your credentialing workflow.

Step 1: Verify Eligibility and Gather Required Documentation

Before you begin your Georgia Medicaid provider enrollment, confirm that you and your organization meet the eligibility criteria set by the Georgia Department of Community Health (DCH). You’ll need:

  • A valid and active National Provider Identifier (NPI)
  • Proof of professional licensure in the state of Georgia
  • Completed W-9 form
  • Professional liability insurance documentation
  • Tax Identification Number (TIN)
  • Ownership or controlling interest disclosures

Having these documents ready prevents administrative delays later in the process. For physicians and group practices, this is also a good time to review your physician credentialing checklist to make sure no documents are expired or incomplete.

Step 2: Update and Verify Your CAQH Profile

Most payers — including Georgia Medicaid and private insurers like Cigna Healthcare — rely on the Council for Affordable Quality Healthcare (CAQH) to verify your credentials. If you haven’t already, create or update your CAQH ProView profile.

During this stage:

  • Make sure your CAQH number is active and accurate.
  • Complete your CAQH attestation, confirming all information is correct and up to date.
  • Upload all required documents (licenses, DEA certificates, malpractice insurance, etc.).

This step is critical, as incomplete or outdated CAQH profiles are one of the most common causes of provider enrollment delays.

Step 3: Create an Account in GAMMIS (Georgia Medicaid Management Information System)

Georgia Medicaid enrollment is handled through the GAMMIS portal. You’ll need to:

  1. Visit the GAMMIS website and select “Provider Enrollment.”
  2. Create an account or log in if you already have one.
  3. Select your provider type (individual, group, facility, etc.).
  4. Enter your NPI and taxonomy code.
  5. Begin your online enrollment application.

At this point, accuracy is everything. Double-check your address, practice location, and contact information — small inconsistencies can cause the state to reject your application.

Step 4: Complete and Submit the Medicaid Provider Enrollment Application

Once logged into GAMMIS, complete your online application. You’ll be asked for detailed business, credentialing, and ownership information. Here’s what to pay special attention to:

  • Licensing information: Make sure the license name, number, and expiration date exactly match state records.
  • Practice affiliations: If you belong to a group or hospital, provide complete organizational details.
  • Disclosure of ownership/control: Required for compliance with federal Medicaid regulations.
  • Supporting documents: Attach your W-9, CAQH attestation confirmation, and liability insurance.

After submitting, you’ll receive a confirmation number — save it for your records.

Step 5: Application Review and Screening Process

After submission, your application enters the screening phase, which may include background checks, site visits (for certain provider types), and verification of credentials.

During this time:

  • Monitor your GAMMIS account for updates or requests for additional documentation.
  • Respond promptly to any correspondence from the DCH or fiscal intermediary.
  • Ensure your insurance credentialing information (like Cigna or other private payers) is consistent with your Medicaid application.

This step can take several weeks depending on provider type and state workload.

Step 6: Enrollment Approval and Provider Number Assignment

Once approved, you’ll receive a Medicaid Provider Number (MPN) and official notification via the GAMMIS portal. This allows you to:

  • Bill for Medicaid-covered services in Georgia
  • Check claim status and eligibility in GAMMIS
  • Update and maintain provider data

At this stage, you are officially recognized as a Georgia Medicaid provider — but the work doesn’t stop here.

Step 7: Maintain and Revalidate Your Enrollment

Georgia Medicaid requires all providers to revalidate their enrollment periodically (usually every 3–5 years). Failing to revalidate can result in deactivation of your Medicaid number.

To stay compliant:

  • Regularly update your CAQH profile and re-attest every 120 days.
  • Keep your licenses, insurance, and contact information current.
  • Review your physician credentialing checklist quarterly.
  • Reconfirm enrollment data across other payers (Cigna, Aetna, Blue Cross, etc.) for consistency.

Proper maintenance not only keeps your Medicaid participation active but also supports smooth insurance credentialing across all networks.

Why Work with Contracting Providers

At Contracting Providers, we specialize in simplifying complex credentialing and payer enrollment processes for healthcare professionals across Georgia. Our team handles:

  • Medicaid, Medicare, and commercial payer enrollment
  • CAQH attestation management and verification
  • Full-service insurance credentialing with major payers like Cigna Healthcare
  • Provider revalidation and ongoing compliance support

We act as your credentialing partner — ensuring accuracy, faster turnaround times, and fewer administrative headaches so you can focus on patient care.

Enroll with Confidence

The Georgia Medicaid provider enrollment process can be time-consuming, technical, and high-stakes — but with the right steps and expert guidance, it doesn’t have to be overwhelming. By following this structured approach, you’ll minimize errors, reduce approval delays, and maintain compliance across all payer networks.

If you want to speed this process up, or need help managing your CAQH, Cigna, or Medicaid credentialing, get in touch with Contracting Providers today. Our credentialing specialists are ready to handle the details — so you can get enrolled, get approved, and get back to care.