Provider Resources

PROVIDER FAQ

Does BHPI have a medical person on staff?

BHPI employs a number of licensed clinicians and health care professionals. Our Medical Director is a contracted position rather than an employed position.

Will providers be made aware of any restrictions prior to beginning the credentialing process?

At this point there are no restrictions that would need to be identified prior to a provider undergoing the credentialing process.

Will BHPI use CAQH during the credentialing process?

We are investigating the possibility at this time.

Will graduating students with their Master’s Degree and their temporary license be able to treat and bill patients through the Health Plans?

All individuals that meet the requirements identified within the description of appropriate service level providers within the CPT codes will be eligible.

What is the fee schedule and will it be tiered?

The fee schedule will be based upon the product design. Different benefit program types may have differing fee schedules.

Will there be an authorization process?

Some services will require pre-authorization.

What if I don’t take Medicaid or Medicare?

Participation with Medicare and/or Medicaid is not a requirement to become a provider; however, non-participants may experience less opportunity for patient referrals.

Can I be a provider in other networks and still be a provider with BHPI?

Certainly, we encourage providers to participate with other organizations in order to maintain a complete practice schedule.

Will each practitioners areas of specialization be noted?

Yes, each practitioners area of specialization will be noted. This is noted within our Provider Search as well.

Will the providers get paid for psychological testing (ADHD and Anxiety Test)?

Yes, assuming it is a covered benefit under the member’s benefit plan.

Can a provider choose to use a sliding scale?

Providers are always able to utilize whatever fee structure they deem appropriate for their practice. The reimbursement rates will be fixed and some programs may preclude “balance billing” above the stated co-payment level.