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  • Credentialing & Insurance | BHealthy For Life

    Credentialing & Insurance The credentialing process for mental health professionals seeking to work with insurance providers involves a series of steps to ensure that the practitioner meets the necessary qualifications and standards. This process is crucial for establishing a provider's eligibility to deliver services and receive reimbursement from insurance companies. Our Partner Phone: (281) 994- 7020 Credentialing: enrollment@rcmexperths.com Billing: support@rcmexperths.com Website: www.rcmexperths.com BHealthy In Network Insurance Overview: Ohio BHFL Accepts All License Types Aetna Allied All Savers UHC Allstate Anthem Buckeye Health Plan Buckeye Ohio Medicaid Caresource Caresource OH Medicaid​​​​​​ Cigna Cigna Behavioral Health Humana Humana Choicecare Medical Mutual Meritain Molina Healthcare of Ohio Ohio Healthy ​ Ohio Medicaid ​ Ohio Rise Aetna Better Health Ohio State University Optum Optum VA Oscar Oxford Health Plans Tricare VA United Behavioral Health United Healthcare Patient Out Of Network fee ~ is $120. / hr. *It is the clients responsibility to ensure insurance coverage and eligibility benefits prior to scheduling. Call your provider line on the back of your insurance card before you schedule. Pre-authorization for services requires a code. EAP requires a form Please find out deductible Please find out copay (Insurance Provider info is listed below) Ohio Provider Directory & Provider Portal Links: Availity : (800) 282-4548 Change : (866) 371-9066 Aetna Commercial : (800) 353-1232 #3 Eligibility | Verification of benefits Aetna Medicaid : (833) 711-0773 Aetna Medicare : (800) 624-0756 Allied : (888) 781-0585 Amerihealth : (833) 644-6001 Anthem Commercial : (833) 639-1634 Eligibility | Verification of benefits Anthem Medicaid (OH): (220) 212-8851 Anthem Medicare : (800)676-2583 Buckeye Health plan : (866) 296-8731 Caresource : (800) 488-0134 #6 Cigna : (800) 997-1654, 1 800.853.2713 Eligibility | Verification of benefits Humana Medicaid: (877) 856-5707 Humana Medicare : (844) 291-2162 ​ Medical Mutual : (800) 625-2583 Eligibility | Verification of benefits Molina : (855) 322-4079 Mutual of Omaha : (800) 228-7104 Ohio Healthy: 800) 455-4460, #4 Ohio Medicaid : (800) 686-1516 Optum VA : (844) 839-6108 Eligibility | Verification of benefits Oscar : (800) 235-3149 Eligibility | Verification of benefits Oxford : (800) 666-1353 Eligibility | Verification of benefits Paramount Advantage : Tricare : (866) 773-0404 Eligibility | Verification of benefits United Healthcare : (877) 614-0484 Eligibility | Verification of benefits United Behavioral Health : (877) 842-3210 Eligibility | Verification of benefits United Healthcare Optum : (877) 842-3210 Eligibility | Verification of benefits Ohio Medicaid Pre-Auth Links MH PA Form SUD PA Form Aetna MyCare 1-855-364-0974 Determine if PA required by code (link) PA Not Required for: 90837 , 90832, 90834, 90839, 90840, 90853 ​ Aetna OhioRISE Availity : 1-800-282-4548 ​ Amerihealth Caritas Ohio Inc. ​Link to Navinet ​ Anthem Blue Cross and Blue Shield PA Lookup tool Provider Manual Not Required for: 90837, 90832, 90834, 90839, 90840, 90853 Fax PA: 866-577-2183 ​ Buckeye Health Plan: 866.296.8731 For eligibility Access (800) 224-1991 Ext: 57148 Retrospective Review Fax: 866-529-0290 Pre-Auth Check Tool : Ambetter Medicaid Medicare MyCare Ohio ​ ​ ​ ​ Caresource : 1-833-230-2100 FAX: 937-396-3901 PA Look up PA Not Required for : 90837 , 90832, 90834, 90839, 90840, 90853 ​ Humana healthy Horizons 800-523-0023 PA via Availity Search Tool PA Not Required for : 90837 , 90832, 90834, 90839, 90840, 90853 ​ Molina Healthcare (855) 322-4079 PA Form ​Fax Medicaid: (844) 251-1451 Fax Medicare: (844) 251-1450 ​ United Healthcare Community Plan ​Provider Portal PA Not Required for : 90837 , 90832, 90834, 90839, 90840, 90853 ​ ​ Credentialing Process Overview Educational and Professional Qualifications: Mental health professionals must meet specific educational and professional requirements. This often includes holding a relevant degree (such as a master's or doctoral degree in psychology, counseling, social work, or a related field) from an accredited institution. State Licensure: Mental health providers must be licensed to practice in the state where they plan to offer services. State licensure ensures that the practitioner has met the required standards for education, training, and professional competence. Clinical Experience: Insurance companies typically require mental health professionals to have a certain amount of supervised clinical experience. This may involve completing a specified number of supervised clinical hours and, in some cases, demonstrating expertise in specific areas of mental health. National Provider Identifier (NPI): Mental health professionals need to obtain a National Provider Identifier (NPI), a unique identification number assigned to healthcare providers. This number is used for billing and identification purposes in electronic transactions. Professional Liability Insurance: Many insurance companies require mental health professionals to carry professional liability insurance. This insurance protects both the practitioner and the client in the event of a malpractice claim. Application Submission: Mental health professionals interested in becoming credentialed providers with an insurance company must submit a comprehensive application. This application typically includes details about the provider's education, licensure, certifications, experience, and other relevant information. Verification of Credentials: The insurance company will verify the credentials provided by the mental health professional. This process may involve contacting educational institutions, licensing boards, and other entities to confirm the accuracy of the information provided. Panel Approval: Once the verification process is complete and the mental health professional is deemed eligible, they may be added to the insurance company's panel of approved providers. Being on the panel means the provider is officially recognized and can offer services to clients covered by the insurance plan. Contract Negotiation: After approval, the provider may need to negotiate a contract with the insurance company, outlining terms such as reimbursement rates, covered services, and other relevant details. Regular Re-Credentialing: Credentialing is not a one-time process. Mental health professionals are typically required to undergo periodic re-credentialing to ensure they continue to meet the insurance company's standards. This may involve submitting updated information on education, licensure, and other relevant factors. It's important for mental health professionals to be proactive in the credentialing process to ensure timely approval and the ability to work with a diverse client base covered by various insurance plans. The specific requirements and procedures may vary among insurance companies and states. The Credentialing Process Made Simple Contact Credentialing RCM Credentialing Submission Form First name* Last name* Birthday* Month Phone* Fax Email* Position* Practice Specialty Company name Service Address Billing Address Provider NPI Practice NPI Provider Tax ID Practice Tax ID CAQH ID PECOS NPPES Medicaid # Medicare # Highest Degree Upload File License Upload File License 2 Upload File State ID/ Driver License Upload File Payers to be Credentialed Aetna Aetna Betterhealth Allied Allstate Anthem Buckeye Health Caresource Cigna Humana Medicaid Medicare Medical Mutual Meritain Molina Ohio Health Ohio State Optum Optum VA Oscar Oxford Tricare United Behavioral Health United Healthcare Other Submit Insurance Credentialing 101 Step by Step Credentialing Credentialing & Contracting Credentialing for Therapists Setting up CAQH Medicare Provider Number, PTAN Medicare/ Pecos Enrollment Applying for an NPI Billing for Beginners Billing 101 Minute Billing Revenue Cycle Management (RCM) Electronic Health Record Options TherapyNotes: First Clinician:$59/month Additional Clinicians:$30/month Schedulers/Billers:Free Clearinghouse Services Real Time Eligibility Requests: $0.14 each Electronic Claims: $0.14 each Remittance Advice (ERAs): $0.14 per claim Mailed Paper Claims: $0.49 each Email Reminders: Free SMS (Text Message) Reminders:$0.14 each Automated Phone Reminders:$0.14 each Telehealth: Free TherapyNotes ePrescribe: Each Prescriber:$65/month Simple Practice Stater Plan : $29/mo. Unlimited clients Paperless intakes Client portal Progress notes Diagnosis and treatment plans Automated invoicing and billing Credit card processing Live customer support Mobile app Telehealth Add for $15/mo Essential Plan: $69 Everything in Starter, plus: Customizable notes and assessments Appointment reminders Online appointment requests Secure client messaging Monarch directory (practitioner directory) Professional website Analytics dashboard Insurance claim filing (starting at $.25/claim): 10 claims included/mo Wiley Treatment Planner: Add for $15/mo Telehealth Included ​ Essential Plus Plan: $99/mo. Calendar sync Appointment request widget Advanced calendar filters Add team members Add practice managers ($39/mo per person) Add clinicians ($59/mo per person) Insurance claim filin g (starting at $.25/claim) 35 claims included/mo Wiley Treatment Planner Included Telehealth Included Wiley Practice Planners Build effective, well documented treatment plans with Wiley PracticePlanners®. Access the treatment plans, progress notes, and homework assignments that are already seamlessly integrated into your EHR system. Wiley PracticePlanners® offer comprehensive treatment approaches that can be customized for individual needs. ​ Therabill $149 per month / per provider + $199 one-time setup cost Your membership includes: Unlimited non-provider logins Unlimited email support Unlimited claims, scheduling, and documentation 2 GB of attachment storage Online training and onboarding No per-claim or clearinghouse costs ​ My Clients Plus Monthly Plan $29/month per provider Unlimited clients Multi-user access to your account. Multiple office location support. Unlimited email reminders In-depth reports to keep track of revenue, number of sessions, type of session and other metrics important to your practice. Credit card processing. Generate invoices and superbills with ease. Client portal access included for first provider $5/monthly claim subscription • Includes 10 claims, additional claims are 25¢ each Enrollments $5 per payer enrollment for annual plan subscribers $10 per payer enrollment for monthly plan subscribers Add Ons Wiley Practice Planners: $25 per month, per provider Telehealth: $15 per month, per provider Appointment Reminders: Price Varies for SMS Text and Voice Reminders. Email Reminders Free. ​ Annual Plan $319/year per provider Unlimited clients Multi-user access to your account. Multiple office location support. Unlimited email reminders In-depth reports to keep track of revenue, number of sessions, type of session and other metrics important to your practice. Credit card processing. Generate invoices and superbills with ease. Client portal access included for first provider Claims Processing: $5/ monthly claim subscription, Includes 10 claims, additional claims are 25¢ each Enrollments $5 per payer enrollment for annual plan subscribers $10 per payer enrollment for monthly plan subscribers ​ TheraNest Cost: 30 Active Clients: $39 40 Activ e Clients: $50 50 Activ e Clients: $60 80 Activ e Clients: $91 100+ Active Clients: 205-537-9167 Add Ons: Wiley: $25/ per user Client Portal: $6 per therapist Telehealth: $12 per therapist Features: Unlimited staff members World class customer support, including live phone support Full-featured calendar that keeps you organized Automatic email, phone, and text appointment reminders* Client Portal with client self-scheduling Customizable Intake Forms Integrated credit card processing that allows you to store and charge cards Batch Payments feature for easy payment collection Robust reporting features with over 25 reports available Eligibility Checks for TheraNest Pro and TheraNest Enterprise (Apex Customers Only) Unlimited note templates with Custom Forms Seamless client and insurance billing Electronic claims filing* Integrated ERA/ EOB Comprehensive knowledge base with articles, videos, and on-demand training HIPAA compliant secure messaging Unlimited document storage for clients and staff members Customizable superbills and client statements Practice chat for secure internal communication iPhone and Android mobile apps available ​ Ka reo Comprehensive Dashboard: Enjoy intuitive dashboard, task lists, and customizable multi-resource calendar. Simple Charting: See how simple and fast it can be to create patient encounter notes. E-Prescribe: Save time and eliminate phone calls for you and your staff with electronic prescribing. Convenient eLabs: Automate inefficient paper based processes Electronic Superbills: Complete and submit an accurate superbill in just a few clicks. Integrated Patient Portal: Share medical records and billing information and communicate with patients securely at any time. Secure Messaging: Conveniently message anyone in your practice, your biller or billing team, even your patients. Meaningful Use Stage 2 Certified: Meet the highest standards for maintaining data confidentiality and secure sharing of information. ICD-10 Ready: Trust Kareo to guide you and your practice through a successful ICD-10 transition. Maximize productivity:Support your staff's entire practice workflow including managing patients, uploading documents and sending secure messages. Flexible Calendar: Save time and customize your schedule so your front office can easily manage important patient communications. Agenda Overview: Get complete visibility at a glance by showing you outstanding items that need your attention for the day. Integrated Prescription Discounts:Search and compare prices at the point of prescribing. Increase likelihood of patients filling their prescriptions by providing them with discounts to save money. Flowsheets: Easily review and make necessary adjustments to individual lab and vital trends on one screen while getting a holistic view of your patient's key data over time. Pricing Full Platform plus 50 claims/month: $174/month (each additional claim is only $0.99 cents) Full Platform plus Unlimited claims/month: $224/month Typical Promotional Offers: 50% off your first 4 months, plus Free Dedicated Success Coach for your first 90 Days No Startup Costs No Hidden Fees Free and Unlimited Live Support Free Training and Onboarding Assistance ​ TheraPlatform Basic $ 39 can not add additional providers Unlimited Clients Scheduling Documentation Billing Unlimited Telehealth ​ Pro $ 49 $39 each additional provider Unlimited Clients Scheduling Documentation Billing Automated Billing Insurance Billing Unlimited Telehealth Telehealth Tools ​ Pro Plus $ 59 $49 each additional provider Unlimited Clients Scheduling Documentation Billing Automated Billing Insurance Billing Unlimited Telehealth Telehealth Tools Interactive Therapy Apps ​ ​ Billing e-Guide Each payor will require you to complete a W9, here is the link ​ Mental Health Resources Map Belongly link ​ Credentialing For Hire: PLEASE NOTE.... Hiring an outside company to do your credentialing is costly, time consuming and confuses the process. You are better off credentialing yourself so that you become familiar with the process and so that you can monitor progress on your own. Groups use Group NPI and Group EIN. Individuals use your personal NPI and Personal EIN. Typically a credentialer will charge on average $100-200 per payer. They can also do your billing and charge on average 3%-8% ​​ ​ Federal No Surprise Act: Through new rules aimed to protect consumers, excessive out-of-pocket costs are restricted, and emergency services must C ontinue to be covered without any prior authorization, and regardless of whether or not a provider or facility is in-network. ​ Ohio LACTS/ OHMAS: Welcome to the OhioMHAS Licensure and Certification Tracking System (LACTS) Application web portal. LACTS allows you to electronically submit an initial or renewal application for an Adult Care Facility, an Adult Foster Home, a Residential Care Facility, a Communit y Mental Health Agency, and a Private Psychiatric Hospital; and review your licensure and or certification status, add sites, services, attach files, and update your facility and staffing information. The LACTS User Guide is available to provide detailed instructions for managing license or certification applications for submission to Ohio Department of Mental Health and Addiction Services. Liability Insurance Providers: You should have one that covers the space you are working in and the one for liability. Liability may cover you or your practice. Y ou should always carry your own liability insurance. Hiscox biBerk Simply Business Proliability CPH Associates HSPO CHUBB The Hartford Pearl Insurance Liberty Mutual Insurance Nexus Insurance Medpro Nexus Medpro Amtrust Financial AIG Insureon Progressive NASW Assurance CPH & Associates ​ OH Licensing Boards: LPC (Licensed Professional Counselor) MFT (Marriage & Family Therapist) LSW/ MSW (Social Work) LCDC (Chemical Dependency) Psychology Psychiatry ​ Find your own insurance Self Employed Medical : PikHealthInsurance License Reciprocity : Counseling Compact (Also contact your board) ​ SAMHSA State Certification: The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. ASAM Navigator Practitioner Training ASAM Levels of Care Recovery Map: How it works Inpatient Detox (3-10 days depending on acuity) Inpatient (28 days) Partial Hospitalization: PHP (2 weeks, individuals get to go home in the evenings but attend 6 days a week , 3 hours a day ) Intensive Outpatient: IOP (6 weeks, attend 3 days a week, 3 hours a day ) Sober Living (average length of stay is 6 months, continued programming) Outpatient Treatment: Independent Counseling (Varies) What you need to get started: Information you will need on a continuous bases are below. You should have this information saved in a folder on your desktop. Also, do yourself a favor and start a spreadsheet of all the numbers you'll need to have access to in the moment. Licence (s): License numbers and copies EIN Number (Tax ID) NPI #'s: NPPES CEU's (Ongoing tracking for your continuing education): CE Broker Psychology Today , we also have a list of clinicians here for referral BHealthy Contacts (you will want to set up profiles as soon as you can. Most have a cost associated with it, BHealthy is free with membership. You will also want to set up your profile with each of the payors you get credentialed with and set up a profile in the EHR You will use. Resume: FYI You must show what you were doing during gaps of employment in your CAQH File . Secretary of State Articles of Incorporation (where you register your business name and thats by state) CAQH: R egister and have access to your ID and Password ( credentials will want it if you hire out). CAQH Link . W9 Insurances Policy Information: Policy number, dates of coverage, coverage limits (Links above) Application to become a Medicaid Provider OH Medicaid Number : PECOS (Medicare provider Enrollment) Address/ Phone/ Fax (note you must have a fax to take medicaid. You can find several sources for efax & Esign sites online) Web Address : We used WIX and GoDaddy EHR: (Bhealthy uses TherapyNotes ) The place where you will submit notes, billing and create superbills. See the list below. While you are in waiting for your own credentialing, we recommend Headway , a quick and easy way to start taking private insurance clients without the months of waiting, and they pay well enough. Fee Sheet: You'll need to have a good understanding of what you want to charge and that will need to be posted in your office and your website. When you are negotiating fees with the payors, have these numbers ready. Average is $170/hr. until you have an established practice. You can renegotiate that annually with each payor. Link to Ohio medicaid fee sheet is a good place to start. Medicaid Fees will vary by state so make sure you know your own. You can choose a higher number, this is simply for illustration. Business Bank Account: You'll a front and back copy of a voided check Drivers License Copy Payers (Insurance Companies): Apply to each of the payors here once you have all your affairs in order ​ For Medicaid by state click this link Anthem Aetna Buckeye (Ohio) Caresource (Ohio) Cigna Humana ​Medicaid (Ohio) Medical Mutual Molina (Ohio) Ohio Health (Ohio) Oxford Oscar United health care Register with the Exchanges: They actually process the billing claims for the insurance companies Change Healthcare: (800) 956-5190 Post Enrollment Help: (877) 442-2293 Availity : portal for eligibility /benefits, submit claims, authorizations (depends on the payor what you have access to) ​ Availity Clearinghouse Provider Portal Availity Identity Verification Form Payer List... once your account is approved you will know​ Payers: A Aetna Phone (1-800-872-3862) Member Services: 1-855-463-0933 (TTY: 711) Member: Log-In/ Create a log in Provider Services: 800-624-0756 Provider Credentialing: 800-353-1232 Provider Portal Medicaid Registration Form Website Link: Aetna Individual & Families: Individual & Family Health Insurance Plans & Coverage | Aetna Providers Link Resources & Support for Health Care Providers | Aetna Credentialing: https://cldaz.aetna.com/pocui/ Insurance Precertification: Precertification Lists Insurance Verification: Provider Manual: Provider manuals Fee Schedule: Cost Estimator & Fee Schedules – Health Care Professionals | Aetna ​ Aetna Better Health Of Ohio (Aetna Medicaid) Phone: 855-364-0974 Credentialing: 800-353-1232 #3 Claims & eligibility: 888-632-3862 Provider Portal: Dual Plan Medicaid/Medicare/ Medical: 855-364-0974 Provider Number Ohio Rise: 833-711-0773 Managed Care Entity (MCE) Out of Network managed care provider application Website Link: Home | Aetna Better Health of Ohio Providers Link: For Providers | Aetna Better Health of Ohio Claims: Claims | Aetna Better Health of Ohio Clinical practice link: Clinical practice guidelines | Aetna Better Health of Ohio Behavioral Health: Behavioral Health Redesign | Aetna Better Health of Ohio Link: Provider Manual Link: Provider Orientation kit Link: Provider Application Link: Application for Ohio Medicade Number ​ Anthem Blue Cross Blue Shield Phone: 888-650-5748 Credentialing: 844-912-1226 Central OH Madeline Corn 234-201-5121 Website Link: Anthem Blue Cross Blue Shield Providers Link: Providers | Tools, Resources & More | Anthem.com Provider Maintenance: Provider Maintenance | Anthem.com Behavioral Health: Behavioral Health Provider Resources | Anthem.com Claims: Provider Claims Submission | Anthem.com Credentialing: Credentialing | Anthem.com EAP: Employee Assistance Program (EAP): Providers EAPClaims@Anthem.com EAPProviderNetworks@Anthem.com B Beacon Health Options Phone: 888-204-5581 Website Link: Beacon Health Options Providers Link: Providers | Beacon Health Options PCP Toolkit: PCP Toolkit Link- clinical tools page . EAP: EAP | Beacon Health Options Important EAP Case Activity and Billing Form Information Provider FAQ Provider Connect Portal EAP Provider Handbooks Achieve Solutions Client Resources EAP Forms Buckeye Health Plan Phone: 866-246-4356 Credentialing: 1-866-296-8731 #0 Website Link: Buckeye Health Plan For Providers : Ohio Medicaid and Health Plans For Providers Provider Resources: Ohio Provider Resources | Buckeye Health Plan Behavioral Health: Behavioral Health Become a provider: Become a Provider Practice Link: Find a Doctor | Buckeye Health Plan C Caresource Phone: 800-488-0134 Credentialing: 833-230-0210 Website Link: CareSource Providers Link: Provider Overview | CareSource Behavioral health : Behavioral Health | CareSource Provider Manual: Provider Manual | CareSource Practice Link: Find A Doctor/Provider Claims: Claims | CareSource ChampVA Phone: 877-327-0022 Website Link: Veterans Affairs Providers Link: Community Care (va.gov) Claims: Community Care Home Practice Link: Find VA Locations | Veterans Affairs Contact: EAP: Employee Assistance Program (EAP) Providers Cigna (EverNorth) Credentialing: 800-997-1654 Website Link: [Evernorth](https://www.evernorth.com/) Care+ : Evernorth Behavioral Health : Evernorth Provider Link: Evernorth Provider Resource Library: https://static.evernorth.com/ Practice Link: Evernorth Health Care Provider Directory Contact: EAP: https://static.evernorth.com/ CorpCare Phone: 877-843-6036 Website Link:CorpCareEAP For Providers: Providers – CorpCareEAP EAP Tier One-Service Tier 1 – CorpCareEAP Tier Two-Service Tier 2 – CorpCareEAP F First Health Phone: 800-226-5116 Website Link “MyFirstHealth.com Provider Link: Healthfirst Provider Portal H Healthsmart Phone: 304-556-1100 Website Link: HealthSmart Provider link: Provider Center | HealthSmart Credentialing : HealthSmart Payor List: HealthSmart Practice Link : HealthSmart Provider Lookup Provider Manual: HealthSmart Humana Phone: 888-526-0997 Credentialing: 844-825-7898 Website Link: Humana Provider: Humana for Healthcare Providers Claims: Claims Resources for Providers - Humana Credentialing Humana Forms Humana Practice Link: https://finder.humana.com EAP: Employee Assistance Program (EAP) Information for Providers - Humana Employee Assistance Program (EAP) Provider Experience Summary. M Magellan Email contact - Magellan Health Website Link Magellan Health Provider Link Magellan Health Medical Mutual Phone: 800-382-5729 Credentialing: 800-625-2583 Website Link Medical Mutual Providers Link Healthcare Providers | Medical Mutual Practice Link Medical Mutual Provider Search Provider Manual: Medical Mutual Credentialing: Provider Resources | Medical Mutual Medicare- OH Phone: 800-633-4227 Website Link: Medicare.gov Practice Link: Find Healthcare Providers: Compare Care Near You | Medicare Forms: Forms, help, & resources | Medicare Medicaid- OH Phone: 800-686-1516 Website Link: Ohio Medicaid Resources: Ohio Medicaid Provider Link: Ohio Medicaid Fee schedule: Schedules and Rates Mental Health Services: Mental Health Programs: Ohio Medicaid Enrollment: Enrollment & Support Contact: https://portal.ohmits.com/ Molina Healthcare of Ohio Phone: (866) 449-6848 Credentialing: 855-322-4079 ohprovcontractscentralse@molinahealthcare.com Website Link: Molina Healthcare Provider Link: Molina Provider Portal Multiplan/PHCS Phone: 800-950-7040 Website Link: MultiPlan Providers Link: MultiPlan Links: MultiPlan Handbook for Network Professionals, including Individual, Group, and IPA Providers MultiPlan Handbook for Network Facility and Ancillary Providers MultiPlan Provider Quick Reference Guide O Ohio Health Choice Phone: 800-554-0027; Credentialing: 800-455-4460 #4 Website Link: Ohio Health Choice Resources: Provider Resources Provider Manual: Ohio Health Choice - Provider Manual Forms: Ohio Health Choice - Provider Forms Payor List: Ohio Health Choice - Payor List Faqs: Ohio Health Choice - FAQ Practice: Ohio Health Choice - Provider Search ​ Optum VA: VACCN Provider Services 844-839-6108 Optum Prover Express Provider Express Onboarding Clinical Resources Fee Schedule (take 25% off non-facility price for clinical) Oscar Phone: 855-672-2788 Website Link: Oscar Insurance Providers Link: A health insurance partner that makes your job easier. Resources: https://provider.hioscar.com/resources/arkansas/Overview/ Oxford Website Link: Oxford Health Plans Provider Link: UHCprovider.com Practice Link: Home [provider.liveandworkwell.com] Claims and Payments: UHCprovider.com Important Links Find Network Bulletin articles online at UHCprovider.com/networknews Sign up to receive email updates at uhcprovider.com/subscribe NY External Appeal for Adverse Determination (paper form) NY External Appeal for Adverse Determination (online submission) Quick Reference Guide for UnitedHealthcare Oxford Administrative Updates for Oxford Commercial Plans P Paramount Advantage Phone: 419-887-2564 Website Link Paramount Health Care Resources Paramount Health Care T Tricare East ( Humana Military) Phone: (800) 444-5445 Website Link Humana Military Provider Link TRICARE East providers Resources Humana Military Behavioral Health Behavioral health information for TRICARE East providers U United Health Care Credentialing: (800)711-4555 Provider Line: (877) 614-0484 Phone View provider contact information by state Website Link UnitedHealthcare Providers link UHCprovider.com Claims UHCprovider.com EAP Employee Assistance Program | UnitedHealthcare Resources UHCprovider.com V VA/CNN (Optum) Phone: 800-888-2998 Website Link Optum Provider Link Solutions for Health Systems Credentialing Contact us EAP Optum

  • RESET | BHealthy For Life

    R E S E T Schedule Now WHAT IF the scars of trauma in our lived experiences could be relieved through a 20-minute outpatient medical innovation? WHAT IF Post Traumatic Stress is an INJURY to our sympathetic nervous systems, rather than a mental disorder? WHAT IF a second chance at life were real, allowing us to move through the world and connect deeply with everyone and everything around us? Stellate Ganglion Block (SGB) Schedule Now Neuro Sympathetic Reset Treatments can achieve remarkable, positive results, across a wide range of symptoms and conditions Schedule Now PTSD / PTSI Depression Panic Attacks Anxiety Clarity | Focus Productivity Eating Disorders Trigger Point Tension Insomnia Eating Disorders Irritability Restless Sleep Long Covid Hot Flashes / Menopause Symptoms Shame ADHD Adrenal Fatigue Impulsivity Hair Trigger Temper Hormonal Imblanace Suicidal Thoughts & Ideation Sexual Dysfunction Grief Chronic Pain ​Weight Loss RESET Medical & Wellness Center 8370 Dow Circle, Suite 400 Strongsville, Ohio 44136 Schedule Now Order Book Schedule Now Youtube More Videos Watch NOW

  • Apprenticeship | BHealthy For Life

    Apprenticeship & Clinical Supervision If you are interested in our Apprenticeship program & would submit an application, click the button below! Topics covered in the apprenticeship & supervision Masterclass: ​ Ethics Advocacy Path to licensure/ all the licenses & certifications DSM ASAM LOC Disorders Diagnosing Models of Therapy Populations you MIght Serve Addiction Recovery Specializing Training/ CEU’s Writing curriculum Grant Writing Business 101 Marketing 101 Sales 101 Social Media/ SEO Treatment facilities Private Practice Pay Student Loan Forgiveness Life Coaches Crossing borders/ reciprocal licensing Getting credentialed Insurance Companies/ Payer Electronic Health Records RCM/ Billing Public (501c3) vs. Private sector Starting your business Starting your non-profit Maintaining a balance between work and life Secondary trauma Multiple sources of income opportunity Contact Us Today to get started!

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  • Through the Veil: Lessons Learned from a Near-Death Experience

    A long time ago, I was fortunate enough to be one of the few people on this planet to experience a near-death encounter. My NDE came from one of the most difficult life lessons my soul could have chosen. My heart was shattered into a million pieces, and I was on the verge of giving up completely. One night, as I tried to release the pain and trauma of a failed marriage through tears and screams, I found myself dying. I thought I had fallen asleep and was merely dreaming, but after spending three days in the hospital and being diagnosed with broken heart syndrome, it became clear that I had truly been on the edge of leaving this life.   I’ll do my best to describe what I saw and experienced, though I know my earthly words can’t fully capture the essence of the other side. The love our Creator has for us is beyond anything we have words for. To clarify, when I speak of God, I’m referring to the traditional Christian God, as that’s how He appeared to me. However, God is all things, all beings, and all ideas—even little green men in spacesuits if that’s how you connect to the Source. He doesn’t mind how you perceive Him; He knew you long before you arrived here and understands your thoughts, beliefs, dreams, joys, sorrows, and especially your traumas and life lessons. Everything about you—the good and the not-so-good—is part of the journey that you and He planned together before you came to this "earth school." Some refer to it as your soul’s journey or divine destiny, and it truly is sacred. Every moment is uniquely designed for you. You have chosen every person, place, and experience along this path. Every lesson, every heartache, and every triumph—all of it is yours.   The day I decided to face the darkness that marked the end of my marriage, I settled into a comfortable spot on the floor of my bedroom. I had everything ready—a soft bear rug, pillows, blankets, candles, incense, and my journal—all the tools for deep soul-healing. I remember listening to soulful music, soaking in a hot bath, and preparing to cry until the pain no longer overwhelmed me. My last conscious memory of that night was sitting on the rug, forcing the memories I had buried deep within to surface as I began journaling. The tears flowed naturally. What happened next is something I hope to honor, even with my imperfect human words.   At some point during my crying, I must have exhausted myself and fallen into a deep sleep—at least, that’s what I thought was happening. But what I remember is seeing my ex-husband in a dark, swirling tunnel. I was telling him how sorry I was that I had to let him go, and that in this lifetime, we couldn't be together because we both had more "work to do." At the time, I believed he was what some would call my twin flame. In hypnotic visions, I’ve seen other lifetimes we shared together—there were multiple.   I intuitively knew he was here once again to teach me the lessons my soul needed to evolve, and I suppose I was that for him as well. But here we were, back in "earth school," and despite our deep soul connection, this wasn’t the lifetime where we were meant to stay together. I had agreed with Source that he would be part of my story (once again), but not the one who would stay until the end.   That night’s crying session was the most intense emotional experience I’d ever had. It was probably during this period that I triggered the broken heart syndrome, although I didn’t recognize it at the time. Later, medical professionals explained that my heart had slowed to a dangerously low rate, nearly reaching the point of death.   As I said my final goodbye to him, he faded away, and I was enveloped in darkness. The next thing I experienced was what I can only describe as a form of hell—everything was black and red, filled with a profound sense of fear magnified a thousandfold. I saw a mix of familiar and unfamiliar faces and experiences. Even though I didn't realize I was dying, I thought to myself, "No way, if this is hell, I don’t belong here! I’ve made mistakes, but I don’t deserve this. I deserve to be in heaven with my family in love and light!" Then a voice told me, “You don’t have to stay; you have free will. You can choose to leave.” My immediate response was, “How? And quickly!” The voice replied, “Just choose not to remain in hell, and you can leave.” I was surprised at how simple it sounded, but I believed I could leave, and suddenly, I woke up from that part of the dream. I found myself still on the floor of my bedroom, with candles burning, my journal open, and tissues soaked with tears scattered around. I was back on earth, safe from the horrors I had imagined. I decided it must have been a terrible dream and moved to my bed to settle in for the night. But, as it turns out, God wasn’t finished with me yet. . As I settled into bed with my dogs and drifted back to sleep, I found myself dreaming again, but this time I was engulfed in darkness. I lost track of time, but soon I was experiencing a non-linear view of my entire life. It was like watching a movie where every person, place, and event was presented all at once, without any sense of time. I could see and understand everything simultaneously, but it was overwhelming. I remember thinking, “Forget this place. If this is where I chose to be for a life experience, my next choice is a definite no.” I had no desire to come back to this life. It wasn’t that my life was particularly hard or frightening; it was more like an emotional rollercoaster—intense, exhilarating, and relentless. It felt like we’re all on this wild ride right now. The thought of coming back was something I wanted to avoid. But then, in an instant, I experienced the next phase of my journey. The sensation of being one with everything was beyond any description. There are no words in any language that can truly capture what it felt like to be connected as “one.”     When I refer to "the one," it's the best way I can describe a profound realization. After I told God I wasn’t interested in coming back, I was shown how everything and everyone is interconnected. Every action and experience affect all things, both living and non-living. The rocks, trees, people in Australia, and even the guy next door—everything is linked in this unified flow. It was awe-inspiring to witness this interconnectedness, and I heard God ask, “Do you understand now?” I responded with, “Oh wow, yes! When can I go back?” But then I wondered, did that mean I was dying? As I saw the opening to heaven, I realized that if given the choice to continue my current life or not, I would choose heaven without hesitation.   The love I experienced from heaven was beyond any words I could use to describe it—Divine love is simply too vast and awe-inspiring to capture in human language. The doorway to heaven wasn’t a dramatic Hollywood-style spectacle; instead, it was a gentle parting of clouds with a radiant, pure light emanating from it, embodying the most profound and incomprehensible energy of love. In that moment of divine love, I declared, “Oh yes, I’m going there!” But then two angels appeared beside me and gently reminded me, “You can go there if you wish, but remember, you have Christien and Colten on earth who need you.” I had momentarily forgotten about my life on earth, but as soon as the angels mentioned my children by name, I was instantly back in my body. I sat up, dialed 911, dressed hastily, and walked to the waiting ambulance outside. I was taken to the hospital, where I spent the next three days sleeping, interspersed with waves of sadness and tears.   During my three days in the hospital, it felt like angels were accompanying me. Every nurse who came into my room brought crystals—not to give to me, but to show that I wasn’t alone in my beliefs about energy work, breathwork, hypnosis, sound healing, reiki, and crystals. They all seemed to validate my experiences without me even asking. One nurse, who was the last I remember, noticed my tears between sleep and wakefulness and asked why I was crying so much. I shared my entire experience with her, including the end of my marriage. She then pulled out a collection of crystals from her pocket and revealed that she, too, was an energy healer. It felt like a divine confirmation that I was on the right path and that I needed to continue my work. It was a profound sign of support and guidance, and I truly believe I had guardians watching over me during that time.   This experience occurred many years ago. Going through that divorce was one of the toughest challenges I've faced in my life. I deeply loved that person and, truthfully, I will always hold love for them. I believe strongly that we will meet again in another lifetime, as there's still more for us to learn and do together (though only God knows the full extent). What I can say with certainty is that our lives and experiences here are not random. Everything that happens is part of a greater plan, journey, or destiny—whatever term resonates with you. Nothing is accidental; it’s all orchestrated by you and God before you arrived on this earth. The experiences you go through are not happening to you, but for you.   When I share the idea that "we chose this," some people react with shock, especially when it comes to profound suffering such as abuse, loss, illness, or accidents. I understand how distressing this notion can be, but I always return to the concept of “the one.” We create the lives we live, including the suffering and the joy. Every experience has its counterbalance—where there's darkness, there’s light of equal magnitude; where there's down, there's up; where there's negativity, there’s positivity. God encompasses all of it and loves all of it. Every moment of our lives is guided by divine hand, filled with His blessing and light. For instance, the world is marked by Pink October because of the efforts of a single woman, and there was a Black president in the White House because of Martin Luther King Jr.'s influence. Conversely, we also have examples of profound darkness in human behavior, like Ted Bundy, illustrating the complexity of our choices and experiences. God knew us all before we arrived and loves us equally, regardless of our paths or the challenges we face.   Regarding hell, it's a place we create ourselves and have the free will to avoid. On earth, we can manifest and shape our life experiences, whether they are positive or challenging. We choose difficult lessons that help our souls grow. In contrast, in heaven, there's no struggle; souls simply exist in eternal bliss without the need for evolution. Souls choose to come to earth to experience the greatest, most exhilarating roller coaster imaginable. It's designed for testing, growth, and progression, much like selecting college courses. Earth is our school, where joy, sorrow, triumphs, trials, and tribulations are the subjects we study. Remember, during tests, the teacher is silent—not absent. God walks beside us, providing all the tools we need each day. As long as we walk in faith, God will reveal the purpose behind our choices and experiences, leading to goodness and abundance. All we need to do is embrace that faith.   I don’t share this story to imply that I have all the answers—quite the opposite, actually. What I offer is my personal experience with near death and the lessons I’ve learned from it. One of the most challenging periods of my life was losing my husband to addiction and the subsequent end of my marriage. It was one of the most emotionally intense trials I’ve faced. In retrospect, the end of my marriage was not the cause of my struggles but rather the culmination of everything that came before it. He was a messenger, a teacher in my journey. I’m grateful for the chance to have met him again in this lifetime and for the role we played in each other’s lives. Although it took years to recover, I would not change a single moment of what that experience taught me. It significantly contributed to my growth as a healer. Now, I help others navigate through marriages, divorce, loss, and grief, guiding them to confront their own challenges and find their path. I feel honored to be a part of this work. I know that there are more lessons ahead and more work for me to do, which can be daunting. Yet, I understand it’s all part of my soul’s journey, and I embrace it all—the highs, the lows, and everything in between. I feel fortunate to have had these experiences, and without the end of my marriage, I might never have reached this place. By the Grace of God, here we are.

  • Beyond Tradition: A Non-Traditional Approach to Healing for First Responders

    I have skin in this game. I married a firefighter. Being an addiction and trauma specialist, it's not a stretch to say my love had both. Our marriage ended. Words don't exist for that kind of sorrow; I couldn't help him. I couldn't "reach" him. That makes me a (former) fire wife. I have lived experience with what you are going through, from the other side. My sons are in college for fire science right now, in this moment (it's Christmas Eve 2023; maybe by the time you read this, they are FF's). My Holistic Health Director is a former Memphis FF. One of the investors in my company is a FF. My point? I have skin in the game, and it scares the hell out of me that the rate of first responders committing suicide is so high. While talking to my 17-year-old sons last night about how they will handle this part of the job, even though they have support and they know better than to let trauma go untreated, they maintain that "men don't cry." "Not us, Mom, just in general." My confidence in their choices as future {traumatized} firefighters wanes. The brain does a lot of not good things under duress. Proper choices can't be made; the brain shuts down in fight, flight, or freeze. Trauma, it happens so slowly that the traumatized victim isn't even aware. Sometimes we find out too late how far "gone" we've "gone". But the people around you know. The people that love you know. Feeling like your losing your sh*t on the daily is par for the course. FYI, you're not losing anything, you have complex trauma. A pill {western medicine's idea of band-aiding the situation} won't cure complex trauma, a good clinical therapist with a solid proven program will. (sidebar Jim, I'm not that kind of Dr. This is not medical advice) Part of my commitment to the FR population is that I am always available. I built this app with YOU in mind. If you never want to tell anyone what's happening, I'm on board with that. Let's do that. But if you are brave enough to make that call and maybe even come to see us, I promise we will give you 100% of every trick in the book I know to help you get well and manage what you feel about the world—sh*t people, crap circumstances, life, death, all of it. If you haven't figured it out by now, my approach is non-traditional. That makes sense because your jobs require non-traditional ideas and models for healing. Your jobs are non-traditional, and that makes your COMPLEX trauma, well, complex. I am a clinical hypnotherapist. I specialize in complex trauma and addiction. I know your culture. I know your stories. I know what you see every day. I (we) know how to help. If you want tradition that's available on every corner, even through your EAP. Me or them, the key is to call us. We're a phone call away (833) 336-7543. Whenever you're ready. Nobody ever has to know. We're here to help. The BHealthy app is a self-guided behavioral health app. Look around, see if any of what you can find, sans a therapist, helps. Honestly though, complex PTSD requires professional help—there is no way around it; it takes a team to get through and unwire this mess from your brain. But, I get it, call when you're ready. On Trauma... Here's the skinny. An event happens that feels bad, lucky you, you're alive and now you have your first traumatic experience (probably something in childhood). Then another traumatic event happens, and another and another, ad nauseam. Trauma is as guaranteed as death and taxes. ALL humans have trauma to some degree. Firefighters have severe trauma due to the number of times it happens, ie. the number of times you experience second hand trauma because you see it so much. During a traumatic event, your body and brain do this cool thing with cortisol and adrenaline that forces you to go into survival ie. fight, flight, freeze or fawn. Stay and fight the bear or run? You are going to be the guy or woman that has to stay. That's the job you signed up for. So, you're experiencing trauma (again) your brain switches into survival mode (again), and sometimes it switches so much that you can't even recall accurately what happened (again), or anything at all (again). But it did happen, and your body stored it as a trauma. Imagine multiple times in your week (firefighters, combat veterans, police, ER staff, etc.) your body going into survival. That's not natural and eventually you reach capacity. Your brain and body says no more, we're done now... but you're not done because monday is coming and its time to go to work. Hopefully by now you see where this is headed... So what's the answer? If you are a new FR, you have to start early and keep a trauma therapist on speed dial. Honestly, I'm not sure how anyone does life without having a therapist. All people should see therapists like they see doctors and dentists because nobody is getting out of here without having some things happen to them. That's life! (in my best Frank voice). If you've been in the business awhile, it's time to do some heavy lifting in the subconscious and yes that has to happen with a therapist. THEN, keep your therapist on speed dial for the duration of your FR career. That's the math, that's the science, that's the job. Maybe I'm the first to tell you that your job, for your entire FR career, requires talking through the hard stuff. Im sorry it took so long. Maybe you've heard it a million times, so what are you waiting for? Don't do anything about what you experience in secondary trauma and you're brain will force you into some very dark places. Avoid that, for the love of all that is dear to you, avoid the dark places. The brain does what it does without your permission and this is your heads up superhero. You're human on this front, just like the rest of us. We need you, please take care of you. A note on EAP... We take your benefits and your insurance. That's a phone call to your HR to let them know you wish to use your EAP benefits through ANY program outside of your EAP. Those "free" sessions you get can go through any company, that's an insurance thing, not a company thing. Call it marriage counseling or counting blades of grass for wellness—who cares. They don't have to know; it's not their business what you're doing in therapy. They would probably jump for joy that you're doing it at all!! A Note on Suicidal Ideation (yep, we're going there!)... IF you are feeling suicidal right now in this moment, call 988 (you know the drill). If you tell me you have a plan, I (or anyone) has to report; we can't get past being mandated. But if you tell me you have ideation, that's okay, and that's between us. We just double down on our efforts, and I see you more often until we calm down the storm, and trust me, when you see the wellness center, it's insta-calm from the moment you cross my threshold (it's grandma's house, seriously). The speed in which you get through therapy is completely dependent on how bad you want to get better and your willingness to "do the work" OUTSIDE of session. It takes more than the time in my office a couple times a week to get you well. If I ask you to watch a video or read a book or count blades of grass for wellness, that's the job. We'll work together to figure out what works best for you though, so it will be enjoyable, I promise. The average time people spend with me is between 6 months to a year. Then it's just check in's quarterly, maybe twice a year (depending how well your doing self care), maybe annually, maybe you spot call me. In your work it's important we circle back. You're going to experience new trauma. We cleaned you up let's not get complex PTSD twice huh? A Note on Prevention... THAT'S WHAT'S MISSING!!! PREVENTION is the gap in all of this (my PhD brain is trained to find gaps in services). What if I told you when you first started that I could have taught you about the science of emotional well-being waaaaaaay at the beginning of your career and helped you to prevent complex PTSD? The good news is, I can still help the new folks AND it's not too late for you. Part of treatment MUST include education on the brain, how it rewires when trauma happens, treating a traumatized brain and body (rewiring the brain- yea, that's how this works), preventing new trauma, dot, dot, dot, blah, blah, blah. Treatment is a marathon, not a sprint, and believe it or not, therapy can be pretty cool (even fun!) when you start moving into the education part of why this happened and what makes you YOU. I base everything I do on the science of anything (especially complex trauma; I had it when my husband and I divorced. I know it intimately). I could go on and on... but here is where I let you digest what i've written and look around. Hopefully I "reached" you and we can get to work sooner than later. I hope this very long-winded blog post helps you lean in. We hope you get what you need to be well.. P.S. Nurses, doctors, firefighters, police, EMT's, clinicians with secondary trauma, this all applies to you too. Air~Hugs. V

  • Online Counseling

    Well, its not for everyone. I can tell you that from a clinical point of view I can have harder conversations when we have live interactions. That sounds weird I know, but, if I say something that doesnt feel awesome (and I inevitabley will, you're in therapy!) or that I can't pull you back from, I run the risk of losing you or hurting you (which is never the goal). I'm not a hard therapist to get a long with but let's be real. If you are interested in change, I'm your girl. If you need someone just to talk to and listen, I'm your girl. If you need some education about a mental health or recovery topic, I'm your girl. If you need space and grace while you move through the stages of change, I'm your girl. I just need you to decide which hat you want me to wear and I will hold space for whatever your needs. If Im on telehealth, and we haven't determned what that is yet, it may get awkward. Truth time: I have had peoples family members walk through rooms, naked babies walk into the frame, people cooking, I swear someone was going to the bathroom, but I digress... I meet you where you are however that looks and feels. Please don't let me see your bathing suit parts and we'll get along great! I think telehealth got real popular after COVID. THANK GOD if you ask me. We were long overdue for helping people across county lines. God willing we can move across state lines soon. Why bring geography into it? Because not all clinicians are created equal, are tenured, are seasoned, are experinced etc, ad nauseam. Sorry newbies, it's what it is. If you want to finds the skilled practitioners and you live in the hinterlands, you may have to go the telehealth route. Personally, I love the freedom in my schedule. I can have dinner cooked, dogs walked, laundry done, house cleaned, homework finished and be in bed at a decent hour by the time the day is done. Plus I can manage on demand therapy for folks in dire need. There are a lot of good reasons for us to be working on telehealth so I say for sure give it a try. If it doesn't work for you thats okay, but we have it as a flexible mechanism in the marketplace and that means success. V

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