Are You Sure Every Provider Is Credentialed With Every Payer You Bill?
Credentialing gaps are invisible until they cost you. A provider who thinks they are in-network with Optum, but is not credentialed with Optum's behavioral health network, is billing out-of-network on every session. We handle the full process, including the carve-out payers most billing companies cannot navigate.
Why Behavioral Health Credentialing Is Different from Medical Credentialing
Behavioral health adds a layer most medical billers have never met: the managed behavioral health organization (MBHO). Credential with the wrong entity and your claims never reach the one that adjudicates them.
Two Separate Credentialing Tracks
Carve-out plans require credentialing with two organizations: the commercial payer for medical, the MBHO for behavioral health. Being in-network with United Healthcare does not make you in-network with Optum Behavioral Health. Separate applications, separate timelines, separate status.
Network Closures
Optum, Carelon and other MBHOs routinely close panels where they consider a network full. Getting in means letters of need, documented patient demand, and knowing each MBHO's process. We manage that and advocate for you.
Scope of Practice Variation by State and Payer
Requirements vary by license type, state and payer. Some credential LPCs and LMHCs independently; others want supervision documentation. LMFTs face payer-specific rules on couples and family codes. We structure each application to the payer's actual criteria.
Group Practice Multi-Provider Credentialing
Participation follows the individual provider's NPI and license, not the group's, so every clinician needs their own cycle with every payer. We start a new provider's credentialing the day you decide to hire, to shorten the gap between start date and billable date.
Complete Credentialing Management for Every Mental Health Provider
CareVixis tracks every application, every follow-up, every expiration, and every re-credentialing cycle across your entire payer panel. You see exactly where every application stands at any moment.
CAQH Profile Setup and Maintenance
We build and maintain CAQH ProView profiles, including the quarterly attestations that keep them active. Most commercial applications pull from CAQH, so one stale profile delays every payer at once.
Commercial Payer Enrollment
Initial and renewal credentialing with Cigna, Aetna, United Healthcare, Humana and BCBS state plans. We submit, follow up on a schedule, answer requests for information, and confirm your effective date in writing.
Behavioral Health Carve-Out Enrollment
Enrollment with Optum Behavioral Health (United Behavioral Health / OptumHealth Behavioral Solutions), Carelon Behavioral Health (formerly Beacon Health Options), Magellan Healthcare and ComPsych. This is the layer general billing companies skip or get wrong.
Medicare and Medicaid Enrollment
Medicare enrollment through PECOS, and Medicaid in every state you practise. State rules differ on which license types enrol independently versus under a group or supervising physician.
Recredentialing and Expiration Tracking
Most payers recredential every two to three years, and licenses, DEA registrations and malpractice cover all expire on their own schedules. We track every date and renew early. A lapse means denied claims and possible removal from the panel.
Complimentary Credentialing Assessment
Every practice partner gets a complimentary credentialing assessment: we audit your payer panel, find payers your patients use that you are not credentialed with, and flag gaps causing out-of-network billing.
Behavioral Health Payers CareVixis Credentials With
Each of these organizations has its own application process, its own credentialing criteria for mental health providers, and its own timeline. CareVixis has worked with all of them and knows the specific requirements for each license type.
Optum Behavioral Health
Includes United Behavioral Health (UBH) and OptumHealth Behavioral Solutions. Administers behavioral health benefits for United Healthcare commercial plans and many employer-sponsored plans. Separate credentialing process from United Healthcare medical network.
Carelon Behavioral Health
Formerly Beacon Health Options and ValueOptions. One of the largest MBHOs in the US. Administers behavioral health benefits for Anthem plans and many other commercial and government contracts. Separate credentialing application and provider portal from Anthem medical.
Magellan Healthcare
Manages behavioral health benefits for several commercial payers and government programs. Magellan has its own credentialing standards and network management policies that differ from commercial medical payer credentialing processes.
ComPsych
The world's largest EAP provider, also managing behavioral health benefits for some commercial plans. ComPsych has specific credentialing requirements and a separate panel application process. EAP credentialing is a revenue opportunity many mental health practices overlook.
Aetna Behavioral Health
Aetna manages its own behavioral health network separately from CVS Health's other managed care products. Credentialing requirements for mental health providers with Aetna's behavioral health network have specific documentation requirements for each license type.
TRICARE and VA Programs
Mental health providers who work with military families and veterans need TRICARE credentialing and may benefit from VA Community Care Network enrollment. CareVixis manages both, including the specific documentation requirements for behavioral health providers in these government programs.
How CareVixis Manages Your Credentialing
Credentialing is a slow process by design, payers move at their own pace. What CareVixis controls is ensuring that no delays on your end, no missing documents, and no unreturned payer requests add any avoidable time to the process.
Credentialing Assessment and Payer Target List
We audit your payer panel against your patients' actual payer mix, and identify the gaps where you believe you are in-network but are not. The output is a target list ordered by revenue impact.
Document Collection and CAQH Setup
We collect the documents once (licenses, malpractice, DEA, NPI, training records, references) and build or update your CAQH profile, then maintain it so later cycles need almost nothing from you.
Application Submission and Proactive Follow-Up
Applications go out in parallel where possible. We follow up on a defined schedule rather than when someone remembers, log every payer interaction, and escalate stalled files. You get status without asking.
Approval Confirmation and Ongoing Maintenance
On approval we confirm the effective date in writing, update your billing system, and calendar the recredentialing and expiration dates so the next cycle runs without your attention.
Mental Health Credentialing Questions
Answers to the most common questions about behavioral health credentialing and payer enrollment.
Commercial payer credentialing typically takes 60 to 120 days depending on the payer. Medicare enrollment through PECOS takes 30 to 90 days for most providers. Medicaid enrollment timelines vary by state and can range from 30 to 180 days. Behavioral health carve-out payer enrollment (Optum, Carelon, Magellan) frequently takes 90 to 150 days because these organizations have their own separate credentialing queues. CareVixis tracks every application and follows up proactively to minimize avoidable delays, though we cannot control payer processing times.
CAQH ProView is the universal credentialing database used by most commercial payers to collect and store provider information. Rather than submitting duplicate documentation to each payer separately, most commercial payer applications reference the provider's CAQH profile. CareVixis sets up and maintains CAQH profiles for all providers, including the quarterly attestation updates required to keep the profile active. An outdated CAQH profile, even by one day past the attestation deadline, can pause every payer credentialing application simultaneously.
Yes. CareVixis handles credentialing and enrollment with Optum's behavioral health network, including United Behavioral Health (UBH) and OptumHealth Behavioral Solutions. Optum's behavioral health credentialing process is entirely separate from United Healthcare's medical credentialing process. A provider who is credentialed with United Healthcare for medical services is not automatically in-network with Optum Behavioral Health. Many practices discover this gap only after patient complaints or claim denials. CareVixis identifies and closes this gap during the credentialing assessment.
Carelon Behavioral Health (formerly Beacon Health Options and ValueOptions) is one of the largest managed behavioral health organizations in the US. Carelon administers behavioral health benefits for Anthem plans and several other commercial payers and government programs. CareVixis handles credentialing and enrollment with Carelon separately from Anthem medical credentialing. We track each provider's participation status within the Carelon network and manage recredentialing cycles on schedule.
Credentialing is an optional add-on service. A complimentary credentialing assessment is included for all practice partners at no cost. This assessment identifies your current credentialing status, gaps, and opportunities. The ongoing credentialing management service (applications, follow-up, CAQH maintenance, recredentialing) is an add-on to the core platform. The assessment itself often reveals credentialing gaps that, once corrected, generate revenue many times greater than the cost of the service.
Yes. Adding a new provider to a group practice requires submitting new credentialing applications with every payer the practice participates with, under the new provider's individual NPI. CareVixis initiates this process as soon as a hiring decision is made and tracks the new provider's credentialing status across all payers. Until credentialing is complete, the new provider cannot bill in-network. We minimize this gap by starting the process early and following up aggressively throughout.
What Credentialing Costs
Credentialing is optional. Many practices are already credentialed and only need their enrollment kept current.
Credentialing assessment
Every partner gets one: your enrollment status with each payer, carve-out enrollment (Optum, Carelon, Magellan, ComPsych), gaps, re-credentialing deadlines, CAQH, and license and DEA dates.
Per payer, per provider
For practices on CareVixis revenue cycle management, half the $225 standalone rate. Ongoing credentialing management is included.
Complex enrollments
Priced on the actual work, and we tell you during the free practice assessment, not after.
More Mental Health Practice Solutions
Mental Health Billing
Once you are credentialed, your billing needs to be just as precise. CareVixis handles end-to-end revenue cycle management for behavioral health practices.
Billing details →Credentialing Guide
Read our comprehensive article on the medical credentialing process, timelines, and how to avoid the most common delays.
Read the guide →How Long Credentialing Takes
Realistic timelines for provider enrollment with commercial payers, Medicare, Medicaid, and behavioral health carve-out organizations.
Read the article →Approved, but Claims Still Deny
Approval and payability are separate states. The effective date, the identifiers, the reassignment of benefits and revalidation: what to check, in order.
Read the guide →Mental Health Hub
Return to the full mental health practice solutions hub to see everything CareVixis offers for behavioral health providers.
Mental health solutions →Find Out Where Your Credentialing Gaps Are
Every practice partner receives a complimentary credentialing assessment. We will audit your current payer panel, identify gaps, and show you the revenue lost to incomplete enrollment. No cost. No obligation.
No credit card. No obligation.
Mental Health Workflows, Connected
VixisMH™ is the mental-health specialty experience within the CareVixis ecosystem. It supports the clinical workflow while CareVixis connects the revenue cycle, credentialing, communications, operations and growth around it. Prefer your current EHR? Keep it. Working with CareVixis does not require a migration.