Behavioral health professionals and organizations may need to satisfy provider-specific credentialing and insurance payer enrollment requirements before participating with applicable health plans and healthcare programs.
Intelix Credentialing provides administrative support for behavioral health credentialing and payer enrollment. We help organize provider and practice information, prepare applicable enrollment materials, coordinate supporting documentation, and manage payer follow-up.
Requirements vary by payer, provider type, license, organization, state, and program.
Intelix Credentialing supports credentialing and applicable payer enrollment requirements across a range of behavioral health provider and organizational types.
Behavioral health networks can have provider-type and payer-specific credentialing and enrollment requirements.
Depending on the applicable provider and payer, Intelix Credentialing can support information and document collection, application preparation, commercial payer enrollment, CAQH support, Medicare enrollment when applicable, Medicaid enrollment when applicable, demographic updates, payer follow-up, and recredentialing support.
Medicare enrollment eligibility depends on the applicable provider or supplier category and current CMS requirements. Eligible categories may include physicians, nurse practitioners, clinical psychologists, clinical social workers, marriage and family therapists, and mental health counselors who meet applicable requirements, among others.
Because eligibility varies by provider type and program requirements, Medicare enrollment support is provided when applicable. Eligibility should not be assumed for every behavioral health provider, counselor type, BCBA, program, or facility.
Intelix Credentialing can support applicable credentialing and payer enrollment requirements for behavioral health organizations and programs, including Intensive Outpatient Program (IOP) and Partial Hospitalization Program (PHP) credentialing needs where applicable. Requirements may vary based on the organization, program structure, state, payer, and applicable participation standards.
Intelix Credentialing can provide administrative support for applicable IOP credentialing and payer enrollment requirements based on the program structure, state, payer, and applicable participation standards.
Intelix Credentialing can provide administrative support for applicable PHP credentialing and payer enrollment requirements based on the program structure, state, payer, and applicable participation standards.
We review available provider or organizational information, requested payer participation, and existing documentation.
Applicable information, profiles, and supporting documentation are organized according to payer requirements.
Credentialing or enrollment materials are submitted through the applicable payer-designated process based on the agreed service scope.
We monitor available status information and coordinate outstanding payer requests.
Credentialing requirements for an independently practicing behavioral health professional may differ from requirements that apply to a group, clinic, program, or facility.
Intelix Credentialing approaches each request based on the applicable provider or organizational structure rather than assuming that one enrollment process applies to all behavioral health clients.
Whether you are an individual behavioral health professional, group practice, program, or facility, Intelix Credentialing can help coordinate applicable credentialing and payer enrollment requirements.
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