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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 6: Contracting with Payors

Ethical Insurance Credentialing: For Mental Health Professionals Module 6: Contracting with Payors | 20 minutes Knowledge Check Module 6: Contracting with Payors

Contracting in the insurance process refers to: *

Verifying provider qualifications

Defining the legal, financial, and operational terms of participation

Maintaining provider licensure

Submitting claims for reimbursement

Contract provisions such as rates, termination clauses, and data use policies can impact: *

Only provider income

Only administrative workflows

Provider sustainability, patient access, and network availability

Marketing and branding strategies

Why is legal review of insurance contracts important? *

To increase reimbursement rates automatically

To eliminate administrative requirements

To serve as an ethical safeguard protecting providers, patients, and continuity of care

To replace the need for credentialing

Which of the following are considered potential red flags in payer contracts? *

Flexible scheduling policies

Forced arbitration, data ownership clauses, and silent carve-outs

Basic contact information requirements

Standard reimbursement timelines

Ethical contracting requires providers to balance: *

Fair reimbursement, transparency, patient protection, and professional integrity

Technology platforms and billing systems

Administrative convenience and scheduling preferences

Office space and staffing levels

Ongoing compliance requires providers to: *

Complete credentialing only once

Actively track renewals, attestations, and revalidations

Update information only when claims are denied

Delegate all compliance responsibilities permanently

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