Medicaid Enrollment, Revalidations, & CHOW Applications

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Individual providers may need Medicaid enrollment before they can render services, join a group, participate with managed care plans, or support billing under an organization.

We assist individual providers such as:

• Behavioral health providers 
• Licensed mental health counselors 
• Licensed clinical social workers 
• Marriage and family therapists 
• Psychologists 
• Occupational therapists 
• Physical therapists 
• Speech-language pathologists 
• ABA providers and clinicians, when applicable 
• Physicians and advanced practice providers 
• Other eligible Medicaid provider types

Many practices and healthcare organizations need Medicaid enrollment under a group, facility, agency, or organizational structure.

We assist organizations such as:

• ABA agencies 
• Behavioral health groups 
• OT, PT, and speech therapy practices 
• Pediatric therapy providers 
• Multidisciplinary therapy practices 
• Home health agencies 
• Health care clinics 
• Provider groups 
• Other eligible healthcare organizations

Medicaid enrollment must be maintained. Providers are required to renew or revalidate their enrollment by the applicable deadline to remain active and eligible for payment.

Florida Medicaid policy states that institutional, DME, Medicare crossover-only, ordering/referring, and out-of-state providers renew every three years, while non-institutional providers renew every five years. The policy also states that providers who fail to renew by the expiration date are ineligible for payment from both Medicaid Fee-for-Service and Medicaid managed care plans. 

A Medicaid change of ownership, often called a CHOW, can be one of the most sensitive provider enrollment events. A CHOW may involve ownership changes, tax ID changes, entity restructuring, Medicaid ID review, new enrollment requirements, provider agreement updates, managed care updates, and coordination with other licensing or payer systems.

Florida Medicaid Provider Enrollment performs CHOW reviews that include ownership disclosure verification, pending enforcement review, and review of money owed by the seller or buyer.  Florida Medicaid policy also states that changes of ownership must be reported in writing at least 60 days in advance, with limited exceptions.