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Ethical Insurance Credentialing: For Mental Health Professionals

Grades

Introductions & Course Expectations | 11 minutes

Course Expectations & CE Requirements

Course Introduction

Module 1: The Decision to Work with Insurance | 16 minutes

Video | Module 1: The Decision to Work with Insurance

Knowledge Check | Module 1: The Decision to Work with Insurance

Module 2: The Credentialing Process | 15 minutes

Video | Module 2: The Credentialing Process

Brief | Independent Practice Ownership: Key Credentialing and Compliance Considerations

Knowledge Check | Module 2: The Credentialing Process

Module 3: Understanding Your Provider Data | 21 minutes

Video | Module 3: Understanding Your Provider Data

Tool | Provider Data Checklist

Knowledge Check | Module 3: Understanding & Updating Your Provider Data

Module 4: Updating Your CAQH Data | 15 minutes

Video | Module 4: Updating Your CAQH Data

Knowledge Check Module 4:Updating Your CAQH Data

Module 5: Credentialing with Medicare | 1 hour 26 minutes

Video | Module 5: Credentialing with Medicare

Video | Medicare Individual Enrollment Application Walkthrough

Video | Medicare Group Enrollment Walkthrough

Guide | CREDENTIALING WITH MEDICARE: A Guide for Behavioral Health Providers

Knowledge Check Module 5: Credentialing with Medicare

Module 6: Contracting with Payors | 20 minutes

Video | Module 6: Contracting with Payers

Tool | Contracting Terms Every Provider Should Know

Brief | Independent Practice Ownership: Safeguarding Group Practice Operations and Clinical Oversight

Knowledge Check Module 6: Contracting with Payors

Module 7: Maintaining Compliance After Contracting | 10 minutes

Video | Module 7: Maintaining Compliance After Contracting

Tool | Payer Credentialing and Contracting Tracker

Brief | Independent Practice Ownership: Data Control, Billing Integrity, and Audit Preparedness

Course Conclusion and Post-Test | 5 minutes

Video | Course Conclusion

Post-Test: Ethical Insurance Credentialing for Mental Health Providers

Course Evaluation: Ethical Insurance Credentialing for Mental Health Providers

Course Bibliography

Knowledge Check | Module 3: Understanding & Updating Your Provider Data

Ethical Insurance Credentialing: For Mental Health Professionals Module 3: Understanding Your Provider Data | 21 minutes Knowledge Check | Module 3: Understanding & Updating Your Provider Data

Accurate provider data is important because it: *

Reduces the need for credentialing

Eliminates the need for payer communication

Guarantees higher reimbursement rates

Serves as an ethical and clinical safeguard for access, continuity, and trust

Centralized systems such as CAQH, NPPES, PECOS, and payer portals rely on: *

Consistent, matching provider information across systems

Manual verification by patients

Independent data that does not need to match

Only billing system data

Even small errors in provider data can result in: *

Faster credentialing approval

Denials, delays, recoupments, or network removal

Improved reimbursement rates

Automatic correction by payers

Ethical practice requires providers to: *

Rely on third parties for all credentialing data

Maintain direct ownership and oversight of their professional data

Allow payers to manage all data updates

Only update information during audits

Provider data maintenance should be: *

Handled only by billing staff

An ongoing responsibility with updates and required re-attestations

Optional unless issues arise

Completed once during initial credentialing

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