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Optum individual therapist credentialing form

Optum individual therapist credentialing form 2025

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The document is a guide for completing the Individual Therapist Credentialing Form, which is required for credentialing therapists at clinic locations. It outlines the necessary information to be provided, including therapist details and malpractice documentation, and emphasizes the importance of prompt responses to information requests. The form must be submitted to OptumHealth for processing, and additional contact information is provided for inquiries.

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Click ‘Get Form’ to open the optum individual therapist credentialing form in the editor.
Begin by filling out the Clinic Information section. Enter details such as Group Name, Clinic Address, Phone Number, and Credentialing Contact Email. Ensure all fields are accurately completed for a smooth credentialing process.
In the Therapist Information section, list each licensed therapist at your clinic. For each therapist, provide their First Name, Last Name, Date of Birth, Social Security Number, Individual NPI, and CAQH ID. If applicable, include any Former Last Names.
Make sure to check the box if the clinic phone number or fax number is the same for any therapists listed. This will streamline your submission.
Once all information is filled out correctly, review the form for accuracy before saving or exporting it from our platform.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How long does it take to get credentialed with Optum?

This will take 3-6 months depending on the facility(s), health plans, and State of practice involved. Many OptumCare business entities utilize CAQH as their repository.

What is credentialing for therapists?

Mental health credentialing means going through the process of becoming a member of an insurance panel. The ultimate goal is to be listed as an in-network therapist by a specific insurance company. Unfortunately, you cant apply to one place and be credentialed with every insurance company simultaneously.

What is the phone number for Optum physical health credentialing?

Please review the Credentialing FAQs to see if we have an answer to your question. If not, please contact Provider Services at: (800) 873-4575. If you have other questions about doing business with OptumHealth Physical Health, please contact Provider Services at: (800) 873-4575 or send us an email.

How to become an Optum EAP provider?

Who can provide EAP services? All Optum contracted therapists may provide, and are encouraged to provide, EAP services to members who have the EAP benefit. Optum does not have a separate EAP network, so there is no additional credentialing or contracting required to provide EAP services.

How do I join Optum as a provider?

How do I join the OptumHealth Care Solutions - Physical Health Network? You must first sign a Participating Provider Agreement (PPA) that describes the legal and regulatory requirements of joining the network. Once you agree to the contractual terms in the PPA, you must complete and submit a credentialing application.

optum behavioral health credentialing application

Optum credentialing application Optum Credentialing phone number Optum Provider Express Credentialing with Optum Behavioral Health Optum Physical Health Provider Portal Optum Health Provider Portal Optum physical health provider phone number Optum Physical Health portal

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What is Optum pay for providers?

Optum Pay, formerly known as Electronic Payments Statements (EPS). With Optum Pay, claim* payments are deposited directly into your bank account as soon as possible. That shortens your revenue cycle, which can make running a successful business a whole lot easier.

How do I become a UHC provider?

What to have ready One Healthcare ID. Licensing and certification details. National Provider Identifier (NPI) number. W-9. Work and education histories. Proof of insurance liability face sheet. Current Council for Affordable Quality Healthcare (CAQH) ID, if applicable*

Optum individual therapist credentialing form 2025

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How to use or fill out optum individual therapist credentialing form with our platform

See more optum individual therapist credentialing form versions

Complete this form in 5 minutes or less

Got questions?

How long does it take to get credentialed with Optum?

What is credentialing for therapists?

What is the phone number for Optum physical health credentialing?

How to become an Optum EAP provider?

How do I join Optum as a provider?

Complete this form in 5 minutes or less

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What is Optum pay for providers?

How do I become a UHC provider?

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