Provider Credentialing

NC Medicaid established a Credentialing Committee to meet weekly and review practitioner files that contain flagged items for disposition of their enrollment, reenrollment and recredentialing applications, plus ongoing monitoring for all NC Medicaid, Division of Mental Health, Developmental Disabilities and Substance Use Services (DMH/DD/SUS), Division of Public Health (DPH), Office of Rural Health (ORH) and NC Medicaid Managed Care health plans.

The Credentialing Committee is comprised of voting and non-voting members, including one Medical Director, two NC Medicaid representatives and one representative from the above payers and plans. The launch date for the Credentialing Committee is Sept. 28, 2025, with the first Committee meeting slated for Oct. 8, 2025. Visit the Credentialing Committee webpage for more information.

NC Medicaid is pausing the implementation of Delegated Enrollment/Credentialing until further notice. This initiative would allow NC Medicaid to delegate individual provider credentialing to major hospitals and large health care systems to perform enrollment credentialing activities for their health care practitioners.

Due to limited administrative funding, the Department must pause the implementation of delegated enrollment and credentialing at this time. For more information about provider enrollment, visit NC Medicaid’s Provider Enrollment webpage.