Whether you just received your license or are already a licensed provider, you will want to obtain a Medicaid number and be accepted on to the MCO and available commercial insurance panels. This is a detailed and lengthy process.
- If you have not yet done so, send a copy of your professional license to Jpolley@transforamtionsllc.net
- Review your BamboooHR profile for accuracy
- Complete Medicaid application and follow all instructions. The forms must be signed by you in blue ink and the original submitted to the Transformations office. The completed forms are submitted to an MCO and forwarded to Medicaid. The application time may take up to six weeks or more.
- While you are waiting on the Medicaid number, you will be asked to obtain a CAQH number and complete your CAQH profile. Click here for instructions.
- Once your CAQH profile is complete and your Medicaid number obtained, you will be sent several Medicaid MCO applications through the BambooHR system. The BambooHR system populates mos of the forms with your information but there will still be info for you ro add and questions to answer. Please read the details to prevent error.
- Your MCO applications will be monitored by our agency and the MCOs will be held accountable to follow through. At present Transformations is advocating with Medicaid through Children;s Alliance to improve the MCO credentialing process. The MCOs are required to complete the credentialing within 90 business days of the application. This requirement is often not met by the MCO and this is why we are addressing out concerns with Medicaid.
- Transformations will also seek paneling with several commercial plans including Anthem, Human, and United Behavioral Health. These plans report that credentialing takes 120 business days and some times longer. Transformations will also submit these applications in your behalf.