Payer Updates for Therapy Practices

Illinois HB 1085: What to Do Before 2027

Illinois HB 1085 sets a 141.7%-of-Medicare floor starting in 2027. What that is in dollars for 90837 and 90791, and what to do about your contracts now.

Evernorth Paused New Therapist Applications

Evernorth paused new individual and clinic behavioral health applications. Learn who is affected and what therapists should do before September.

Sentara Waitlists Behavioral Health Providers

Sentara is waitlisting new behavioral health providers. Learn what its current notice means and what Virginia therapists should do next.

Optum/UHC Waitlists on Headway and Alma

Therapists report Optum/UHC platform waitlists, and Alma documents one. Learn what is confirmed and what to do without risking claims.

Nevada Provider Flex: Give Biller Access

How a Nevada Medicaid practice gives a biller named delegate access and transfers an active Provider Flex enrollment without sharing passwords.

Give Your Biller Arizona Medicaid APEP Access

How an Arizona Medicaid provider adds a biller to an existing AHCCCS APEP group domain without sharing passwords or creating a duplicate enrollment.

Quest Behavioral Health Is Shutting Down

Quest Behavioral Health will cease operations Dec. 31, 2026. What therapists should do about coverage transitions, network status, and claims.

2027 Medicare Fee Proposal for Therapists

CMS's proposed 2027 Medicare fee schedule could move psychotherapy codes differently. See what changes, what does not, and what therapists should do.

How to Change EIN With Insurance Companies

Changing your medical practice EIN? Use this Medicare, payer, NPI, credentialing, EDI, and EFT checklist to avoid preventable payment gaps.

How to Remove an Old Group TIN From Optum

A step-by-step guide for clinicians who need to end an old group TIN affiliation in Provider Express before adding a new practice.

Is Aetna Auditing Therapists?

Aetna can review therapist records before or after payment. Learn what its current rules say, what a request means, and how to respond.

Maryland MPRIME Hold: Therapist Guide

Maryland therapists: check your Medicaid provider type, meet the August 1 ePREP hold, and understand MPRIME backdating and exceptions.

Give a Biller Access to Kansas Medicaid KMAP

How a Kansas Medicaid provider adds a registered billing or credentialing partner as a KMAP Provider Delegate without sharing a portal login.

TMHP IAMOnline: July 30 Therapist Checklist

Texas therapists: verify your TMHP email by July 30, activate IAMOnline, and prepare every portal user for the August access changes.

Update a Wyoming Medicaid Service Location

A step-by-step guide for updating a Wyoming Medicaid service location through the DyP Provider Portal without filing a new enrollment.

TriWest Credentialing: Two Tracks in Parallel

TriWest contracting takes months. Filing the non-network application alongside it gets you authorized and billing now — and what that does not do.

How Bomi Improves VOB Accuracy

How Bomi checks benefits, handles uncertain network and cost-share answers, compares VOB estimates with remittances, and improves payer-specific rules.

Why Verification of Benefits Is Often Wrong

Why electronic and phone VOBs can miss deductible, network, authorization, Medicare, and Medicaid details before the first claim is processed.

What Is SIGMA for Michigan Medicaid?

Learn what a Michigan SIGMA Vendor/Customer ID is, why many Michigan Medicaid providers need it before CHAMPS enrollment, and how to register for one.

CMS-1490S and Unenrolled Medicare Providers

CMS-1490S is a patient-submitted Medicare claim path. It does not turn an unenrolled therapist into a reimbursable Medicare provider claim.

What Is CAQH and Why Do Providers Need It?

What CAQH is, why therapists and other providers need a Provider Data Portal profile, and how it affects credentialing, directories, and payer access.

Idaho Medicaid Credentialing

A plain-English map of Idaho Medicaid enrollment, TPA/Gainwell, Magellan/IBHP, CAQH, Availity, and dual-plan exceptions for therapists.

Washington Medicaid Credentialing Guide

ProviderOne, CAQH/DataSpring, OneHealthPort, and Apple Health MCO credentialing explained for Washington therapy practices.

Montana Medicaid Credentialing

Map Montana Medicaid credentialing, ICAP, Provider Services, MATH, PCMT, and the planned MTHCS claims transition for therapists.

How to Enroll in Idaho Medicaid as a Therapist

How Idaho therapists start Medicaid enrollment through TPA registration, the Provider Enrollment Application, and Magellan follow-up.

How to Enroll in Washington Apple Health

A therapist-friendly guide to choosing the right Washington Apple Health ProviderOne enrollment path and preparing the application.

Enroll as Montana Medicaid Therapist

How therapists enroll in Montana Medicaid, choose the right provider record, prepare documents, and avoid common application mistakes.

Create an Idaho Medicaid TPA Account

What an Idaho Medicaid Trading Partner Account is, which TPA type therapists usually need, and how it connects to enrollment.

ProviderOne vs CAQH in Washington

ProviderOne, CAQH/DataSpring, OneHealthPort, and retired ProviderSource explained for Washington Medicaid therapists.

Create Montana ICAP Account

How to create Montana ICAP access for the Provider Services Portal and keep enrollment, maintenance, and user setup organized.

Idaho Medicaid Biller Access

How Idaho therapy practices can associate a billing agent with a Medicaid TPA without sharing the provider login.

TRICARE East Contracting and CAQH

Understand the contract, CAQH, credentialing, final approval, and effective-date steps before TRICARE East network go-live.

How to Set Up ProviderOne Access

Set up ProviderOne organization access, System Administrator users, security profiles, and first operational checks for Washington therapy practices.

Give Biller Montana Portal Access

How Montana practices should give billers separate Provider Services Portal access without sharing owner credentials.

Idaho Medicaid Enrollment Types

How Idaho therapists should think about individual, group, FAO, and ORP Medicaid enrollment before submitting the wrong application.

TRICARE East Claims Go-Live Setup

A TRICARE East go-live checklist for provider self-service, electronic claims, payer ID 99727, EFT/ERA, eligibility, and referrals.

Give Your Biller Access to ProviderOne

How Washington therapy practices can add a biller to ProviderOne with named users, profiles, and no password sharing.

MPATH vs MATH vs ICAP

Plain-English guide to ICAP, MPATH, Provider Services, MATH, and MTHCS so Montana therapists know which portal to use.

Idaho Medicaid Group Enrollment

How Idaho Medicaid group practices align billing NPI, rendering clinicians, locations, affiliations, and Magellan records.

Apple Health Provider Types

Washington Apple Health provider enrollment categories explained for solo therapists, groups, rendering clinicians, and managed-care-only records.

Montana Medicaid Enrollment Types

Compare Montana Medicaid sole proprietor, rendering, ORP, group, and facility enrollment paths for therapy practices.

Idaho Enrollment vs Magellan

Why Idaho Medicaid state enrollment and Magellan/IBHP credentialing are separate requirements for many therapists.

Apple Health Enrollment vs MCO Credentialing

Why Washington ProviderOne approval does not equal active Apple Health managed-care participation for therapy practices.

Montana Group Practice Enrollment

How Montana therapy groups should think about tax IDs, rendering clinicians, locations, subparts, and provider records.

Magellan Idaho Credentialing

How Idaho therapists should think about Magellan of Idaho credentialing, CAQH, contracting, and recredentialing.

Verify Apple Health Eligibility

A Washington therapy-practice workflow for checking Apple Health eligibility, managed-care payer, FFS coverage, and claim route.

Provider Linking vs Affiliations

Understand current Montana provider linking and future MTHCS affiliations so group claims do not break during modernization.

Availity for Idaho IBHP

How Idaho therapists should place Availity Essentials in the Magellan/IBHP workflow without confusing it with the state TPA.

Apple Health Claims: ProviderOne vs MCOs

How Washington therapists should route Apple Health claims between ProviderOne fee-for-service and managed-care plans.

Verify Montana Medicaid Eligibility

How Montana therapists should verify Medicaid eligibility, program, coverage, and authorization needs before sessions.

Verify Idaho Medicaid Eligibility

A therapist-focused checklist for verifying Idaho Medicaid, IBHP, MMCP, and Idaho Medicaid Plus eligibility before billing.

Apple Health Prior Auth for Therapists

How to route Washington Apple Health prior authorization through ProviderOne or a managed-care plan for therapy services.

Montana Medicaid Claims for Therapists

Montana Medicaid claims guide for therapists using portal claims, MATH, EDI, clearinghouses, remittance, and denial tracking.

Idaho Medicaid Claims Routing

How Idaho therapists should route Medicaid claims among Magellan, Gainwell, Molina, and UnitedHealthcare after eligibility verification.

Apple Health Telehealth Billing for Therapists

Washington Apple Health telehealth billing guide for therapists: HCA policy, mental health services, audio-only, and MCO checks.

Montana Medicaid Prior Authorizations

How therapists should approach Montana Medicaid prior authorization checks, documentation, tracking, and renewals.

Idaho IBHP Prior Authorizations

How therapists should check Idaho IBHP prior authorization requirements without assuming every therapy visit has the same rule.

Apple Health Provider Revalidation

How Washington therapists can keep ProviderOne enrollment active through revalidation, provider-file updates, and documentation checks.

Montana Medicaid Telehealth Billing

Montana Medicaid telehealth billing guide for therapists covering source hierarchy, GT, POS 02, telephone, and current rules.

Idaho Medicaid Telehealth Billing

A practical checklist for Idaho Medicaid telehealth billing across state, IBHP, and dual-plan workflows.

Apple Health Behavioral Health Enrollment

Washington Apple Health behavioral-health provider enrollment for outpatient therapy, FFS, IMC, BHSO, and CMHA-related workflows.

Montana Medicaid Revalidation

How Montana Medicaid provider revalidation works, why the five-year cycle matters, and how practices protect payment.

Idaho Medicaid Provider Revalidation

How Idaho therapy practices should manage Medicaid provider revalidation notices, deadlines, records, and Magellan maintenance.

CHPW Credentialing for Therapists

Community Health Plan of Washington Apple Health credentialing checklist for therapy practices and behavioral-health providers.

In-Training Mental Health Enrollment

Montana Medicaid enrollment guide for in-training mental health professionals, supervisors, settings, and billing readiness.

Idaho Medicaid Denials and Appeals

How Idaho therapists should classify Medicaid denials before deciding on correction, review, reconsideration, dispute, or appeal.

Coordinated Care Credentialing for Therapists

Coordinated Care Apple Health credentialing guide for Washington therapists, groups, behavioral-health providers, and Apple Health Core Connections.

Adult vs Child Behavioral Health

How therapists route Montana Medicaid behavioral health rules across adult, child, SUD, provider-type, and general manuals.

Idaho Medicaid Plus and MMCP

How Idaho therapists should handle dual-plan Medicaid members whose behavioral-health workflow may not follow standard IBHP routing.

Molina Apple Health Credentialing

Molina Washington Apple Health credentialing guide with HCA NPI prerequisites and stale ProviderSource warning.

Primary Care Montana Replaced Passport

What therapists and billers need to know after Primary Care Montana replaced Passport, CPC+, and PCMH on July 1, 2026.

Idaho YES for Child Therapists

A provider-facing map of Idaho YES, Magellan/IBHP, Liberty assessments, authorizations, and claim routing for child therapists.

UHC Community Plan WA Credentialing

UnitedHealthcare Community Plan of Washington credentialing paths for behavioral-only and integrated therapy practices.

Montana Medicaid Denials and Appeals

How Montana therapists triage Medicaid denials, corrected claims, reconsiderations, appeals, and behavioral health disputes.

Idaho WITS Sunset 2026

A time-sensitive checklist for Idaho SUD providers moving off WITS in July-October 2026.

Wellpoint Washington Credentialing

Wellpoint Washington Apple Health credentialing guide for therapists, including Amerigroup naming and Availity enrollment.

Montana Claims System 2027

What therapy practices should do now for Montana Healthcare Claims System 2027 readiness, affiliations, training, and testing.

Idaho Medicaid Managed Care 2030

What Idaho therapy practices should monitor as DHW plans a comprehensive Medicaid managed-care transition targeted for 2030.

HMK vs HMK Plus for Therapists

How child therapists should distinguish Healthy Montana Kids, HMK Plus, Medicaid, network setup, authorization, and claims.

Montana SUD Provider Enrollment

Montana Medicaid enrollment guide for SUD providers covering state approval, ASAM/service levels, Medicaid setup, and claims.

Tighter Illinois Cigna Directory Deadlines

Illinois Cigna providers must report directory changes electronically within 10 business days. Learn the deadlines, submission routes, and practice checklist.

Virginia Medicaid Credentialing for Therapists

How MES, PRSS, Cardinal Care, and MCO contracting fit together for Virginia therapists.

Enroll in Virginia Medicaid as a Therapist

A plain-English PRSS enrollment checklist for Virginia therapists and behavioral health groups.

Access Virginia Medicaid MES and PRSS

How therapists use MES and PRSS provider portal access for enrollment, maintenance, eligibility, claims, and records.

PRSS vs Cardinal Care MCO Credentialing

Why Virginia Medicaid PRSS enrollment and Cardinal Care MCO credentialing are separate steps.

Verify Virginia Medicaid Eligibility

How Virginia therapists should verify Medicaid eligibility, Cardinal Care plan assignment, and claim lane.

Virginia Medicaid Claims for Therapists

How Virginia therapists route Medicaid claims between fee-for-service and Cardinal Care MCOs.

Virginia Medicaid Service Authorizations

How Acentra, Atrezzo, MES, and Cardinal Care MCOs fit into Virginia Medicaid behavioral health authorizations.

Virginia Medicaid Telehealth Billing

What Virginia therapists should check before billing Medicaid telehealth services.

Virginia Medicaid Behavioral Health and ARTS

A billing and credentialing map for Virginia Medicaid mental health and ARTS providers.

Virginia Behavioral Health Redesign

What Virginia Medicaid’s behavioral health redesign delay means for CMHRS and therapy providers.

Cardinal Care MCO Credentialing

How therapists should approach Virginia Cardinal Care MCO contracting and participation checks.

Tennessee Medicaid Credentialing

How Tennessee therapists should think about TennCare registration, Data Spring/CAQH, Medicaid IDs, Online Services, and MCO credentialing.

How to Enroll in TennCare as a Therapist

A therapist-friendly TennCare enrollment guide covering the provider registration portal, Data Spring/CAQH, Medicaid IDs, and next steps.

Authorizing Your Biller for CHAMPS Access

How to add your biller as a user in Michigan Medicaid's CHAMPS portal and grant full access for eligibility, claims, and prior authorizations.

The TennCare Provider Registration Portal

How the TennCare Provider Registration Portal works with Data Spring/CAQH for therapist Medicaid ID setup and maintenance.

What to Do If You Lost Access to CHAMPS

Locked out of Michigan Medicaid's CHAMPS portal? Reset your MiLogin password, restore missing access, and recover Domain Administrator rights.

TennCare Group Practice Registration

What Tennessee therapy groups should understand about TennCare Medicaid IDs, ownership, rosters, locations, and individual clinician links.

Michigan Medicaid Credentialing for Therapists

Learn how CHAMPS, MiLogin, Medicaid Health Plans, PIHPs, and CMHSPs fit together for Michigan therapy practices.

TennCare Medicaid ID vs MCO Credentialing

The Tennessee credentialing mistake that delays therapy claims: confusing a TennCare Medicaid ID with managed-care network participation.

How to Enroll in Michigan Medicaid

A practical guide to Michigan Medicaid provider enrollment in CHAMPS for therapists and behavioral health practices.

Set Up TennCare Online Services

How Tennessee therapy practices should use TennCare Online Services / Interchange for eligibility and transaction workflows.

Create MiLogin Access for CHAMPS

Learn how MiLogin fits into CHAMPS access for Michigan Medicaid provider enrollment, claims, eligibility, and prior authorization.

TennCare Biller Access

How a Tennessee provider should give a biller separate TennCare Online Services staff access instead of sharing an administrator password.

Verify TennCare Eligibility

A practical eligibility checklist for Tennessee therapists seeing TennCare members, including date span, MCO assignment, and claim routing.

CHAMPS vs Medicaid Health Plan Credentialing

Understand why Michigan Medicaid CHAMPS enrollment is not the same as Medicaid Health Plan network credentialing.

TennCare Claims for Therapists

How Tennessee therapists should think about TennCare MCO claims, crossover claims, Online Services, and claim-route verification.

Verify Michigan Medicaid Eligibility

Learn how Michigan therapists should verify Medicaid eligibility, Benefit Plan IDs, MHP assignment, and TPL before sessions.

TennCare Telehealth Billing for Therapists

How Tennessee therapists should verify TennCare telehealth billing rules across state guidance, MCO policies, eligibility, and claim routing.

Michigan Medicaid Claims for Therapists

A practical guide to Michigan Medicaid claim routing for therapists: fee-for-service, Medicaid Health Plans, PIHPs, and CHAMPS.

TennCare Behavioral Health for Therapists

How Tennessee therapists should understand TennCare behavioral health routing, MCO assignment, Health Link context, and network checks.

Michigan Medicaid Prior Authorization

Learn how Michigan Medicaid prior authorization works in CHAMPS and what behavioral health providers should verify first.

TennCare Revalidation

How Tennessee providers keep a TennCare Medicaid ID active through revalidation, current provider updates, licenses, locations, and CAQH/Data Spring.

Michigan Medicaid Telemedicine Billing

A practical Michigan Medicaid telemedicine billing guide for therapists covering audio-visual, audio-only, modifiers, and verification steps.

BlueCare and TennCare Select Credentialing

What Tennessee therapists should verify before applying to BlueCare or TennCare Select, including TennCare Medicaid ID, CAQH, and provider-load checks.

Michigan Medicaid Behavioral Health Routing

Learn how Michigan Medicaid behavioral health routing works across Medicaid Health Plans, PIHPs, and CMHSPs.

Wellpoint Tennessee Credentialing

How therapists should prepare for Wellpoint Tennessee credentialing, including TennCare Medicaid ID, CAQH/Data Spring, Availity, and provider-load checks.

Michigan Mental Health Framework Delay

What Michigan Medicaid providers should know about the delayed Mental Health Framework and MHP vs PIHP responsibility changes.

UHC Community Plan Tennessee Credentialing

What Tennessee therapists should verify for UnitedHealthcare Community Plan of Tennessee credentialing, behavioral health, authorization, and claims.

Michigan Medicaid Health Plan Credentialing

Learn how therapists should approach credentialing with Michigan Medicaid Health Plans after CHAMPS enrollment.

Oregon Medicaid Credentialing for Therapists

How OHP enrollment, the MMIS Provider Portal, Open Card, and CCO credentialing fit together for Oregon therapists — the plain-English map.

Enroll in Oregon Medicaid as a Therapist

A practical guide to OHP provider enrollment for therapists: what to gather, where the online request lives, and why CCO steps come afterward.

Create an Oregon Medicaid MMIS Account

How therapists set up Oregon Medicaid MMIS Provider Portal access after OHP enrollment — the PIN letter, supported browsers, and what the portal does.

Give Your Biller Access to Oregon MMIS

How Oregon Medicaid Provider Portal access works: add your biller as a clerk under the site administrator, and never share your login.

OHP Enrollment vs CCO Credentialing

OHP enrollment and CCO credentialing are not the same. Learn the difference before seeing Oregon Medicaid clients.

Verify OHP Eligibility Every Session

OHP eligibility is more than active coverage. Learn how Oregon therapists check CCO enrollment, Open Card status, and claim routing.

Oregon Medicaid Claims: Open Card vs CCO

When do therapists bill OHA/Open Card vs a CCO? A claims-routing guide for Oregon Medicaid — payer ID ORDHS, the portal, EDI, and why the lane matters.

OHP Prior Authorizations for Therapists

A practical guide to Oregon Medicaid prior authorization for therapists — when routine outpatient therapy needs PA, and OHA vs. CCO routing.

OHP Telehealth Billing for Therapists

Oregon OHP telehealth billing for therapists under OAR 410-120-1990: consent, licensure, POS 02 vs POS 10, and modifier 95 vs modifier 93.

OHP Billing Change for BH Associates

OHA is changing OHP Medicaid billing rules for board-registered behavioral health associates. Learn the July 1, 2027 date and what to verify.

Lane County OHP: PacificSource to Trillium

PacificSource no longer serves as a Lane County OHP CCO. What providers should verify now for Trillium — eligibility, claims, authorizations, contracting.

CareOregon / Health Share Credentialing

What therapists should know about CareOregon/Health Share provider contracting, OHP Medicaid IDs, and CareOregon Connect before applying.

Medi-Cal Group vs. Individual NPI-2 Rules

Your PC's NPI-2 doesn't automatically make it a Medi-Cal group. Learn when a California professional corporation enrolls as individual vs. group.

Ohio Medicaid Credentialing for Therapists

How ODM enrollment, the PNM portal, centralized credentialing, and per-MCO contracting fit together for Ohio therapists — the plain-English map.

How to Enroll in Ohio Medicaid as a Therapist

Step-by-step guide to enrolling as an Ohio Medicaid provider through the PNM module: OH|ID setup, individual vs group enrollment, and what happens next.

Create an OH|ID & PNM Account (Ohio Medicaid)

Set up your OH|ID, reach the Ohio Medicaid PNM provider portal, and understand what you can do once you're in. OH|ID vs PNM, explained.

Give Your Biller Access to Ohio Medicaid PNM

How to delegate Ohio Medicaid PNM access to a biller or billing partner the safe way: add them as an Agent under their own OH|ID, not by sharing your login.

Ohio Medicaid: Credentialing vs Contracting

In Ohio you're credentialed once by ODM, but you still contract with each managed-care plan. Here's the difference and why it drives denials.

Verify Ohio Medicaid Eligibility Each Session

How to check Ohio Medicaid eligibility in PNM and identify which MCO, OhioRISE, or FFS a member is in — before every session — to avoid denials.

Ohio Medicaid Claims: FFS vs Managed Care

How Ohio Medicaid claims route: fee-for-service through PNM vs managed care through each plan, behind one EDI front door (OMES / Gainwell).

Prior Auth for Ohio Medicaid Therapists

How prior authorization works across Ohio Medicaid FFS, each MCO, and OhioRISE — plus the 2026 CMS-0057-F rules and standardized BH/SUD PA forms.

Ohio Medicaid Telehealth Billing Guide

How Ohio Medicaid covers telehealth therapy under OAC 5160-1-18 (effective 1/1/2026): place of service, the GT modifier, U-modifiers, and 2025-2026 codes.

Ohio Medicaid License Tiers for Therapists

Independent (LPCC/LISW/IMFT) vs dependent (LPC/LSW/MFT) — who can enroll with Ohio Medicaid and bill, and who needs supervision.

Ohio Medicaid 2026: BH Prior-Auth Changes

What Ohio's 2026 behavioral health prior-authorization changes mean for therapy practices and billers.

CareSource Ohio Credentialing for Therapists

How to contract and get in-network with CareSource in Ohio after ODM centralized credentialing — for therapy practices.

UMR Is Moving Optum Pay Payments to Zelis

UMR-administered plans are moving provider payments off Optum Pay and onto Zelis, which can default you into a virtual card that skims 2–3% per payment.

Bill Under a PLLC or PC, Not Your SSN

Billing insurance under your SSN works at first but quietly creates credentialing and contract problems. A PLLC or PC with its own NPI Type 2 is cleaner.

Meritain Health & Echo Health: Avoid 3% Fee

Meritain Health (an Aetna company) routes payments through Echo Health / QuicRemit as virtual cards that skim 2–3%. Switch to no-fee standard ACH EFT.

Insurance Virtual Cards: Switch to EFT

Payers send therapy payments as single-use virtual cards that skim a ~3% fee. Here's how to get reissued as a check and enroll in EFT direct deposit.

Out-of-Network Billing for Therapists

Whether you can bill a payer you're not paneled with, and your client's options: out-of-network benefits, a superbill, a single-case agreement, or self-pay.

Medicare Incident-To & Supervised Billing

Why Medicare generally won't let you bill a pre-licensed therapist's psychotherapy under a supervisor like commercial payers do — and what to do instead.

UnitedHealthcare (UHC) Supervised Billing

How UnitedHealthcare (UHC) handles supervised billing for pre-licensed therapists — the most restrictive major commercial payer, and contract-dependent.

Aetna Supervised Billing for Supervisees

How Aetna handles supervised (supervisory) billing for provisionally- and pre-licensed therapists, and why roster contracting is often the cleaner path.

BCBSIL Pass-Through & Trainee Billing NPIs

BCBSIL says licensed behavioral health providers should bill under their own rendering NPI, while qualifying trainee services may use a supervisor's NPI.

Aetna Mental Health On Demand & Therapists

Aetna is rolling out Mental Health On Demand for self-insured plans in 2027. What independent therapists should watch on access, referrals, and AI workflows.

Add an Unregistered Biller to Virginia PRSS

How a Virginia Medicaid provider adds a first-time biller as an Unregistered Delegate in MES/PRSS.

Add a Registered Biller to Virginia PRSS

How a Virginia Medicaid provider adds an existing PRSS biller as a Registered Delegate using a last name and Relationship Code.

CAQH Is Becoming DataSpring: Therapist Guide

CAQH has rebranded as DataSpring. What therapists and group practices need to know about profiles, attestations, and credentialing data.

Minnesota Medicaid Revalidation & Cash Flow

Minnesota's Medicaid revalidation shows how credentialing, enrollment, and documentation gaps become a cash-flow crisis for behavioral health providers.

Medicare Teletherapy Billing Rules in 2026

Medicare behavioral telehealth is more stable in 2026, but therapy practices still need clean POS codes, modifiers, and documentation for claims.

Illinois 90837 Rates Could Jump in 2027

Illinois HB1085 (Public Act 104-0446) sets a 2027 reimbursement floor for in-network mental health services. What therapists billing 90837 should know.

BCBSNM and Lovelace Reach a New Deal

BCBSNM and Lovelace reached a new four-year agreement, avoiding a major New Mexico network disruption. What therapists and providers should note.

Therapy Platforms & the Reimbursement Squeeze

Alma, Aetna, Optum, and Headway reimbursement changes point to a trend: therapy platforms scale fast while payer contracts turn less favorable.

What's Going On With Alma, Aetna, and 90837?

Alma providers face an Aetna-related reimbursement change for CPT codes 90837 and 90834. Here's what is changing, what isn't, and what to document.

BCBSIL Behavioral Health UM Changes for 2026

BCBSIL's 2026 behavioral health update, tied to the Illinois Health Care Protection Act, changes utilization management rules for solo and group therapists.

BCBS IL: Use Medicaid ID for BCCHP Claims

As of February 1, 2026, BCBSIL says providers must use the Medicaid RIN instead of the subscriber ID on claims for BCCHP members, as required by HFS.

Aetna Credentialing for Illinois Therapists

A step-by-step guide for Illinois LCPCs, LCSWs, and LMFTs to navigate Aetna credentialing—prerequisites, application process, and common pitfalls.

Illinois Medicaid Credentialing: IMPACT PE

A step-by-step guide for mental health providers to credential with Illinois Medicaid via the IMPACT Provider Enrollment system—timelines and common pitfalls.

How to Credential Medicare as a Therapist LLC

A guide for Illinois therapists (LCPC, LCSW, LMFT) to navigate Medicare credentialing for a PLLC or group practice—PECOS setup and common pitfalls.

Authorize Your Biller for Medicare Enrollment

Learn how to authorize your biller for Medicare enrollment and get started with your billing process.

Carle Health's 2026 Insurance Change to Cigna

Prepare for the upcoming insurance change from Health Alliance to Cigna for Carle Health employees in 2026.

Credentialing with BCBS IL for Therapists

A step-by-step guide for LCSWs, LCPCs, and LMFTs to get credentialed with Blue Cross Blue Shield of Illinois—timelines, rates, and common mistakes.