Centralized CVO

Georgia’s Department of Community Health (DCH) will implement a NCQA certified Centralized Credentialing Verification Process utilizing a Credentialing Verification Organization (CVO). This functionality is located on the Georgia Medicaid Management Information System (GAMMIS) website (www.MMIS.georgia.gov) and streamlines the time frame that it takes for a provider to be fully credentialed.

Credentialing and recredentialing services are provided for Medicaid providers enrolled in Georgia Families and/or the Georgia Families 360° program.   

This streamlined process results in administrative simplification thereby preventing inconsistencies, as well as the need for a provider to be credentialed or recredentialed multiple times.

The CVO’s one-source application process:

• Saves time
• Increases efficiency
• Eliminates duplication of data needed for multiple CMOs
• Shortens the time period for providers to receive credentialing and recredentialing decisions

The CVO performs primary source verification, checks federal and state databases, obtains information from Medicare's Provider Enrollment Chain Ownership System (PECOS), checks required medical malpractice insurance, confirms Drug Enforcement Agency (DEA) numbers, etc. A Credentialing Committee renders a decision regarding the provider's credentialing status.  Applications that contain all required credentialing and recredentialing materials at the time of submission will receive a decision within 45 calendar days. Incomplete applications that do not contain all required credentialing documents will be returned to the provider with a request to supplement all missing materials. Incomplete applications may result in a delayed credentialing or recredentialing decision. The credentialing decision will be provided to the CMOs.

HP provider reps provide training and assistance as needed. Providers may contact HP for assistance with credentialing and recredentialing by dialing 1-800-766-4456. 

The CMOs are responsible for the delegated credentialing and recredentialing for Independent Practice Associations (IPA) and Provider Hospital Organizations (PHO).

If you have additional questions, please review the Frequently Asked Questions (FAQs) posted on the DCH website here . 

You can also email questions to Georgia Medicaid at [email protected], contact your local HP Provider Relations representative at 1-800-766-4456 or go to https://www.mmis.georgia.gov/portal/.

Questions regarding contracting should be addressed directly to the CMO at the following: