Credentialing Criteria
MBHP credentialing criteria
details requirements that must be met for providers to become
contracted with MBHP. Our credentialing criteria are organized
according to five major classifications of practitioners, as follows:
Individual
practitioners whose licensure levels qualify them to practice either
privately, in group practices, or in organizational providers (clinics,
agencies, and/or hospitals)
Group practices (a group practice is defined as a team of individual practitioners contracted as one entity)
Individual practitioners who may practice only in organizational providers (clinics, agencies, and/or hospitals)
Organizational providers (clinics, agencies, and/or hospitals)
Specialty programs
The
general eligibility criteria for individual practitioners, individual
practitioners in a group, and organizational providers to receive a
contract includes the following:
- Complying with all
applicable state and federal laws and regulations, licensing and
accreditation requirements, and federal and state affirmative action
requirements
- Conforming to all applicable licensing,
certification, or other professional standards as set forth in
applicable state and federal laws and regulations
- Demonstrating
that any suit, claim, proceeding, or disciplinary action that occurred
in the previous five years involving mental health or substance use
disorder services has either been resolved without adverse findings or
has been addressed so that MBHP is assured services will be of
acceptable quality
- Licensing by the appropriate state agency
for the specific service type and accreditation by The Joint Commission
or other appropriate national accreditation body
- Operating without restriction to sex, race, creed, physical disability, sexual orientation, or national origin
- Meeting
the requirements of the MBHP site-review process including, but not
limited to, being able to demonstrate age- and population-appropriate
activities, privileges, and restrictions for all defined specialty
population units/programs
Download the MBHP Credentialing CriteriaFor more information on the MBHP credentialing criteria and process, contact the National Provider Service Line at 800-397-1630.