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Behavioral Health Facility and Ancillary Credentialing Application 2026
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- Click ‘Get Form’ to open the Behavioral Health Facility and Ancillary Credentialing Application in our editor.
- Begin by filling out the 'Type of Application' section, selecting whether this is for initial credentialing, adding a new site/service, or recredentialing.
- Provide your legal name, parent company name (if applicable), and the facility type from the dropdown options available.
- In the 'Identify Levels of Care Offered by Facility' section, check all applicable levels of care your facility provides.
- Complete the 'Facility Locations' section by entering addresses, phone numbers, NPI numbers, and other relevant details for each location.
- Fill in the 'Facility Information' with mailing and billing addresses, contact information, and federal tax ID numbers.
- Attach required documents such as accreditation letters and insurance policies using our platform's upload feature.
- Review all entries for accuracy before submitting via email or mail as indicated at the end of the application.
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What are the key components of the behavioral health management field?
Components of behavioral health management Early engagement and assessment of the patients functioning level are crucial in effective mental health care management. Psychiatric providers collaborate with other healthcare professionals to develop treatment plans tailored to each patients needs.
What are some of the key components of behavioral health referral forms?
Key Components of a Mental Health Referral Form Patient Information: Name, age, gender, contact details. Referring Provider Details: Name, practice name, contact information. Reason for Referral: Brief description of the concerns leading to referral.
What are the three types of referrals for mental health?
Types of Referrals Passive Referral. A passive referral is the most basic type of referral. Facilitated Referral. A facilitated referral is a step up from a passive referral. Active Referral. An active referral is the most involved type of referral.
What are the three major components of behavioral health?
Overview. Behavioral health1 refers to a state of mental, emotional, and social well-being or behaviors and actions that affect wellness. Behavioral health is a key component of overall health.
What are the sources of referral for mental health?
These services may come from your GP surgery, a large local health centre, a specialist mental health clinic or a hospital. Your GP can also refer you to a psychological therapy service or a specialist mental health service for further advice or treatment.
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The individual must possess experience working in a managed care setting with specific background in network development, provider recruitment, provider
Apr 30, 2025 The application should be sent directly to the health benefit plan or workers compensation network for which you want to become a participating health careRead more