Credentialing for behavioral health group practices
Lanyard enrolls every clinician you hire with the commercial plans and Medicaid programs you pick, and puts each contract in your practice's name and tax ID. We stay on each provider until the first payment arrives.
What behavioral health credentialing covers
Behavioral health credentialing is the work of getting a therapist, counselor, psychologist or psychiatric prescriber approved by each insurance plan you want to bill. It has two parts. Credentialing checks the clinician's license, education, work history and malpractice coverage. Payer enrollment is the application to join each plan's network, one per payer, commercial and Medicaid.
You repeat it for every new hire and every payer you add. Plans re-check each provider later too (commercial plans every three years, Medicaid at least every five).
Every clinician a payer will enroll.
Platforms take some roles and turn others away. We enroll whoever on your team a payer or Medicaid program will pay for.
Therapists and counselorsLCSW, LPC, LMFT, LMHC, addiction counselorsCommercial and Medicaid enrollment, plus their CAQH profile and reattestation.
PsychologistsPhD, PsyDEnrollment for therapy and testing, under your group's tax ID.
Psychiatric prescribersPsychiatrists, PMHNPsEnrolled under the same group contracts as your therapists.
Roles Medicaid now pays forPeer support workers, community health workers, doulasMedicaid enrollment in states where Medicaid covers the role. Tell us your state and we'll check.
Leaving Headway, Alma or Grow? Keep seeing your insurance clients while you switch.
Platforms credential your clinicians under the platform's own contracts and set the rate. When you leave, those contracts stay with the platform. If you go direct, each contract carries your practice's name.
| Through a platform like Headway | Your own contracts | |
|---|---|---|
| Whose contract | The platform's | Your practice's |
| Who sets the rate | The platform | The payer (you can ask to negotiate) |
| Who bills claims | The platform | Your practice or your biller |
| Which clinicians | The roles the platform accepts | Every role the payer enrolls |
| If you leave | The contracts stay with the platform | The contracts stay with you |
- Keep billing through the platform.Nothing changes for your clients while your own applications are pending.
- We apply under your NPI and tax ID.One application per payer, per clinician, with a person reviewing each one before it goes out.
- Switch payer by payer.Move each payer's clients over once that contract is live and payment setup is done.
More detail in Headway or your own insurance contracts?
What we do, and what the payer controls
We won't quote you an approval date. The payer owns that clock. Most payers take four to six months to review, and payment setup takes about 30 more days after that.
The Lanyard Team
- Collects licenses and documents in the portal, with e-signatures
- Pulls CAQH ProView data and tracks reattestation
- Prepares and submits each payer application
- Follows up with the payer until it decides
- After approval, tracks and chases EFT, ERA and EDI setup, and sets up what we can by hand
- Tracks license, malpractice and Medicaid revalidation dates
The payer
- How long its review takes
- Whether its network is taking new providers in your area
- The rate it offers
- The effective date on the contract
More on the timeline: How long does credentialing take? and Approved isn't paid.
Medicaid enrollment for behavioral health
Most behavioral health groups that take Medicaid enroll twice: once with the state Medicaid program, and again with each Medicaid health plan that runs benefits in their area. We handle both.
States must revalidate every Medicaid provider at least every five years (42 CFR 455.414). A missed revalidation can stop payment on your claims, so we track those dates with the rest.
Questions group owners ask
Can my clinicians keep seeing clients on Headway while you apply?
Yes. Keep billing through the platform while we apply to each payer under your practice's NPI and tax ID. Move each payer's clients over once that contract is live and payment setup is done.
How long does credentialing take for a therapist?
Most payers take four to six months to review and approve a new provider, and the payer controls that part. After approval, payment setup (EFT, ERA and EDI enrollment) takes about 30 more days. We won't quote an exact approval date.
Do you enroll clinicians with Medicaid health plans as well as the state program?
Yes. We enroll behavioral health providers with the state Medicaid program and with the Medicaid health plans in your area, and we track Medicaid revalidation dates.
Can you credential peer support workers, community health workers and doulas?
Yes, in states where Medicaid covers the role. States decide which roles Medicaid pays for and how each one enrolls, so tell us your state and we'll check.
Do you handle CAQH for therapists?
Yes. We pull each clinician's details from CAQH ProView to fill applications and track reattestation, so a lapsed profile doesn't stall enrollment.
Does Lanyard do billing?
No. We handle credentialing and payer enrollment, and we stay on each provider until the first payment arrives. You'll need a biller or an EHR that sends claims.
Hiring a clinician?
Tell us who you're adding and which payers you want. You'll get a straight answer on how long it takes and which parts the payer controls.