Marlien / Payer guides
What each payer asks for, in plain language.
Nine Georgia and Texas payers, written down: where you file, what they ask for, how long they publish, and what we could not verify. Every line here was checked against the payer's own pages on 2026-11-04.
Core provider file (assembled once, reused across payers)
CAQH/DataSpring holds most of this. Confirm every element is present and current BEFORE starting any payer file — a stale element fails every payer at once.
Every payer asks for these
Also shared, where it applies
The payer guides
Each guide covers one payer: where you file, the things that must be true before you file, what they ask for, the timings they publish, and what we could not confirm.
- Anthem GAGA · 4 lines of business · files through Availity Digital Provider EnrollmentRead the guide
- BCBSTXTX · 3 lines of business · files through CAQH Provider Data Portal — mandatory for CAQH-approved provider typesRead the guide
- UHCGA and TX · 5 lines of business · files through UHC provider onboarding portalRead the guide
- MolinaGA and TX · 5 lines of business · files through Availity Essentials + Molina Provider Network Management portalRead the guide
- CareSourceGA · 3 lines of business · files through GAMMIS (Medicaid, via the DCH Centralized CVO) + CareSource New Health Partner Contract FormRead the guide
- AmerigroupGA · 1 line of business · files through GAMMIS (Medicaid, via the DCH Centralized CVO) + Amerigroup digital provider enrollment in AvailityRead the guide
- Peach StateGA · 2 lines of business · files through GAMMIS (Medicaid, via the DCH Centralized CVO) + the Peach State Provider Contract Request Form; Ambetter uses its own Network Participation RequestRead the guide
- DBHDDGA · 1 line of business · files through The Georgia Collaborative (Carelon) ASO on behalf of DBHDD — this is a state track, not a payer portalRead the guide
- AetnaGA and TX · 2 lines of business · files through Aetna's own participation request, processed by 3Won / ProVaultRead the guide
Six bundles of filings
These are the groupings Marlien prices and works in. A bundle is a set of filings that share the same core file, the same authorisations and the same chain of steps.
Commercial file4 filings
Employer plans. The lightest touch and the natural first sale.
Anthem GA — CommercialBCBSTX — CommercialUHC — CommercialMolina — Commercial
Georgia Medicaid file6 filings
One state enrolment, ONE CVO credentialing, then a contract with every CMO the provider wants — and Georgia is mid-transition, so which CMOs is a decision, not a given.
CareSource — Georgia Medicaid (Georgia Families / 360)Amerigroup — Georgia Medicaid (Georgia Families / 360)Peach State — Georgia Medicaid (Georgia Families / 360)Molina — GA Medicaid (Georgia Families / 360)UHC — Medicaid / CHIP — GeorgiaDBHDD — Georgia Medicaid behavioural health — Tier 2 (Community Medicaid Provider)
Texas Medicaid / STAR file3 filings
TMHP enrolment, the CVO layer, then STAR contracts with Molina and BCBSTX.
Molina — TX Medicaid (STAR / STAR+PLUS / CHIP)BCBSTX — Medicaid — STAR / STAR Kids / CHIPUHC — Medicaid / CHIP — Texas
Medicare Advantage file5 filings
The only bundle where you can claim 30 days back. The one to lead with.
Anthem GA — Medicare Advantage (MA)BCBSTX — Medicare Advantage (MA)UHC — Medicare Advantage (MA)Molina — Medicare Advantage (MA)CareSource — Medicare Advantage (MA)
Marketplace file4 filings
ACA exchange. Seasonal — the window is what matters, not the paperwork.
Anthem GA — Marketplace (Anthem only)Molina — MarketplaceCareSource — MarketplacePeach State — Marketplace (Ambetter from Peach State)
Behavioral health file1 filing
A different company, a different portal, a different form and a different queue.
UHC — Behavioral health — Optum BH
What this is, and what it is not
These guides describe what each payer publishes. They are not a promise about how fast a payer will decide, and they do not replace a decision by the payer.
Checked against the payer's own pages on 2026-11-04. We check again on 2027-02-02 and whenever a payer tells us something changed.
Where a payer publishes nothing, the guide says so instead of guessing. Some payers do not publish a review time, a committee calendar, or a re-credentialing cycle. We would rather say "not published" than quote a number we cannot stand behind.
Payers decide approval, participation, timing and effective dates. Marlien does not guarantee them.