Counties See Faster Credentialing Process With CalMHSA Program
Key staff: Courtney Vallejo, LMFT, Director of Managed Care Operations
Counties of diverse types and locations are getting help from CalMHSA with the time-consuming and costly credentialing process.
CalMHSA’s partnership with a National Committee for Quality Assurance (NCQA)-certified Credentialing Verification Organization not only accelerates the time to credentialing but increases counties’ capacity to serve clients. In the last quarter, the average credentialing turnaround time for participating counties was just four business days.
The program has successfully credentialed nearly 940 providers in nine participating counties. Some benefits for counties include:
- Regulatory Compliance: Ensures adherence to DHCS and NCQA requirements for credentialing and recredentialing of providers
- Cost Effectiveness: A streamlined process allows providers to begin seeing clients and submitting claims for services more quickly
- Efficiency: A centralized credentialing data repository reduces administrative burden and staff effort
- Centralized Administrative Functions: Automated recredentialing notices, provider outreach, file readiness for adjudication and expirables monitoring
- Virtual Committee Functionality: Built-in business logic quickly distinguishes between “clean” and “non-clean” files for a simplified decision-making process
- Reporting and Analytics: Provides comprehensive insights into credentialing data
To explore greater credentialing effectiveness and efficiency with CalMHSA, email [email protected].
March 7, 2025
