Behavioral health credentialing simplified
Free to focus on your priorities.
Your patients are your top priority. You can’t support them unless your behavioral health organization is running at its best, and contracting and credentialing is a part of maintaining a healthy business.
At SimiTree Behavioral Health, our contracting and credentialing services not only simplify these time-consuming tasks but also free up your vital resources, allowing you to prioritize what matters most: caring for your patients.
Expert contracting and credentialing services.
Trust in our team for accuracy and transparency.
Our contracting and credentialing experts understand the complexities of the ever-evolving behavioral health industry. We keep the lines of communication open, answering questions and addressing concerns every step of the way.
You’re putting your trust in us to handle sensitive information. Know that we take your privacy seriously.
We take special measures to ensure that your documents and information are handled with care, accuracy, and total transparency. Our goal? Provide you with a smooth, positive experience.
Behavioral Health Credentialing & Contracting Services:
Account setup includes:
- Step-by-step instructions on what is needed for a successful credentialing process
- Review of your CAQH profile prior to applications being submitted
- Live and real-time assistance throughout the onboarding process
Our credentialing staff can:
- Complete new and re-credentialing applications
- Maintain your CAQH profile
- Conduct file and document maintenance
- Update demographics with your contracted payers
- Set up direct deposit so that your payers make payments to you via ACH
- Enroll in Medicare Part B and Medicare Advantage Part C plans for both groups and individuals
- Enroll in state Medicaid and Medicaid MCO plans both for groups and individuals
- Provide status updates on applications throughout the credentialing process
- Obtain or convert to new EIN
- Obtain NPIs both for groups and individuals
- Negotiate rates with contracted payers
Frequently Asked Questions
The Council for Affordable Quality Healthcare (CAQH) is a nonprofit alliance that allows insurance companies to use a single, uniform application for credentialing. Insurance companies also use CAQH profiles to verify information. Almost all health plans require practitioners to complete and attest their CAQH profile before submitting an application.
Every 90 days, you will receive a request from CAQH to attest that all information in your profile is accurate and up to date.
On average, credentialing typically takes 90-120 days.
Every provider must carry professional liability insurance with a minimum limit of $1,000,000-$3,000,000.
You must have a Medicaid number to become a contracted provider with the Medicaid managed plans. Licensed marriage and family therapists (LMFTs) and licensed mental health counselors (LMHCs) were previously precluded from becoming contacted providers, but from January 1, 2024, they can become credentialed with Medicaid. These professionals will require a Medicaid number in order to enroll in Medicaid Managed Care plans.
This is a letter that you will receive from the IRS once you have completed an application for an Employer Identification Number (EIN). EINs, which are also known as Federal Tax Identification Numbers, are used to identify business entities. The EIN is utilized in place of a provider’s Social Security Number (SSN) when contracting with insurance plans and submitting claims. EINs can be assigned to a sole proprietor or a group practice.
EFT (Electronic Funds Transfer) is the preferred method of payment for health plans. Similar to how direct deposit works for employee paychecks, EFT enrollments allow health plans to send payments directly to a provider’s financial institution.
An out-of-network profile ensures that your billing and practice information is on file with health plans that you are not contracted with. If you do not have an out-of-network profile, this can lead to a delay in the payment of claims.
An Electronic Transmitter Identification Number (ETIN) is the billing code that is required to electronically submit Medicaid claims. The ETIN enrollment form must be notarized, and the original copies must be sent to Medicaid. Please note that ETINs need to be recertified annually.
Keep your CAQH updated and attested during the credentialing process. Any changes, small or large, could potentially lead to delays in the timeline. Additionally, any changes to your demographics (e.g., address) should wait until after you are an approved, in-network provider.
Our team takes a dedicated approach to credentialing that involves being proactive and communicative. We regularly reach out to insurance payers to check on status and provide updates to you whenever we receive them.
When you work with SimiTree Behavioral Health, you don’t have to work individually with multiple insurers. Instead, you work with an experienced team with proven results that will get you approved as an in-network provider.
Let's work together to improve the health of your organization. At SimiTree, we balance financial expertise and clinical excellence to help our clients grow. How can we help you? Call us at 866.839.5471 or complete the form below.