Who we help
Credentialing for behavioral health, where the rules are different.
For therapy practices, psychiatry groups, and virtual-first behavioral health companies, where carve-outs, associate licensure lanes, and multi-state rosters make enrollment genuinely harder.
Sample file, shown for illustration.
Behavioral Health & Telehealth Groups: the numbers that shape it
major payers route behavioral health through separate networks or units
states with their own associate-licensure and supervision rules
every new state multiplies licensure, Medicaid, and payer questions
Behavioral health credentialing is genuinely different, not just harder. The biggest payers split behavioral networks away from medical ones: UnitedHealthcare through Optum, Cigna through Evernorth, while Humana runs behavioral through its own in-house unit. An application aimed at the wrong network is not slow, it is void, and the routing map changes often enough that yesterday's knowledge quietly expires.
Under that sits the licensure lane problem. Whether an associate-level or pre-licensed clinician can enroll, bill under supervision, or bill at all is a per-state, per-payer fact, and staffing plans built on the wrong assumption fail months later at the remittance line. We keep those lanes mapped per state because our own enrollment work depends on them daily.
Your version of the problem
What this looks like from your seat
The carve-out maze is real
UnitedHealthcare routes behavioral health through Optum. Cigna routes it through Evernorth. Humana keeps it in-house. Applying to the medical network when the behavioral network is separate wastes months, and which is which changes.
Associate-level licensure is a per-state, per-payer question
Whether a pre-licensed or associate-level clinician can enroll, bill under supervision, or bill at all differs by state Medicaid and by commercial payer. Staffing models built on a wrong assumption here fail at the remittance.
Multi-state telehealth multiplies everything
Every state added is a licensure question times a Medicaid question times each payer's telehealth policy. Rosters of dozens of clinicians across a dozen states are where spreadsheets go to die.
What actually happens
Your first ninety days, honestly
Week 1
The routing map and the lane check
Your payer targets mapped to the entities that actually credential behavioral health, and every associate or pre-licensed clinician on the roster checked against the state and payer lanes before anything files. This week is where wrong-door months get prevented.
Weeks 2 and 3
Profiles built, files out the door
CAQH profiles built or repaired for behavioral panels, supervision documentation assembled where a lane requires it, and applications filed to the correct network per payer, with proof of submission kept per file.
Months 1 to 3
Every queue chased on its own clock
Behavioral carve outs run their own review queues, and each one gets follow-up on its own cadence. You watch each panel move in the portal, and anything sitting past a stated window gets escalated rather than waited on.
Around day 90
Panels open, rails on, the roster keeps moving
First commercial panels typically land in this window when files went out clean. Effective dates get confirmed in writing, payment rails go live, and new hires enter the same pipeline the first group proved out.
How we work for you
Built for your shape of the work
Carve-out-correct routing
Applications go to the network that actually credentials behavioral health for that payer, first time, from playbooks that track the carve-out structure per payer.
Licensure-lane mapping
For associate and pre-licensed clinicians, we map who can be enrolled and who bills under supervision, per state and per payer, before hiring plans depend on the answer.
State expansion as a production line
New states run as a sequenced build: licensing, Medicaid, then commercial panels, with the roster tracked per state so growth does not outrun enrollment.
In your client portal
Every panel, every clinician, one board
A behavioral roster in flight is a grid: clinicians down one side, panels across the top, and a status in every cell. That grid is exactly what your portal shows: which panels are open, which applications sit in which carve out queue, which clinician is waiting on a supervision document, and what got chased this week.
The full process, step by stepSample data, for illustration.
Where the work lives
The services that carry your weight
Provider enrollment
Where the carve out routing lives: applications filed to Optum, Evernorth, and Carelon instead of the medical networks that sit on them.
See the serviceProvider licensing
Multi-state telehealth growth runs licensure first, and counseling and psychology boards differ more than physician boards do.
See the serviceCompliance monitoring
Supervision arrangements, attestations, and renewals across a roster that turns over faster than most specialties.
See the serviceEDI, ERA and EFT
Behavioral panels pay through the same rails as medical ones, and the setup is separate per carve out entity.
See the serviceThe research that matters to you
The EAP networks playbook
The employee assistance panels behavioral groups add once commercial panels are live.
Read itThe Carelon playbook
The behavioral carve out entity whose separate track surprises most practices.
Read itThe Wait Times Index
Every payer's stated window, the honest math under your launch plan.
Read itAsked constantly
Straight answers
Can our pre-licensed clinicians be credentialed?
It depends on the state and the payer, and the honest answer is a map rather than a yes or no. Some state Medicaid programs enroll associate-level clinicians directly, some allow billing under a supervisor with specific modifiers, and some exclude them from outpatient billing entirely. Commercial payers layer their own rules on top. We map your roster against those lanes before the staffing plan depends on guesses.
Why did our UnitedHealthcare application go nowhere for months?
Very often because it went to the medical network instead of Optum, whose behavioral process runs separately through its own portal. Behavioral applications aimed at the wrong network do not get redirected; they evaporate. Routing to the correct network first time is exactly the kind of fact our payer playbooks exist to hold.
We want to add three states this quarter. Realistic?
Usually, if the sequencing is right: compact or endorsement licensure first where available, Medicaid next where it matters to your payer mix, commercial panels behind each license as it lands. What makes it unrealistic is starting all three states' slowest steps last. We build the state-by-state schedule before anyone promises launch dates.
Expanding a behavioral health roster? Check the lanes before you hire.
Tell us your roster and where things stand today. You get a straight answer on timeline and price, whatever you decide to do with it.