Complete the New Associate Form.
Carelon credentialed associates will have the Simple Practice account with their NPI and license numbers. The associate NPI will be included on all Carelon claims.
Associates serving Anthem, Cigna, or United Healthcare/Optum members will display the supervisor NPI on all claim forms.
Note:
For all associate claims, the supervisor must be credentialed through PBH and not PBH-Headway. Headway currently does not permit associate services.
Create a ticket on-line to activate a simple practice account.
a. Let us know if you wish to create any specific consent forms linked to the associate.
b. Do want the associate to be added to the group email?
In addition to the Simple Practice activation, the following will also be completed:
Associate will be added to PBH clinician webpage.
Associate shared drive will be added to supervisor shared drive.
Associate will be added to the New Client Notification System.
Associate will be added to the PBH New Client Database.
Associated will be added to the PBH group email (unless supervisor declines).
Associate practice location will be added.
Associate Monthly Report will be created.
PBH will send the Associate Volunteer Form.
1. Would they be employed by my EIN and volunteer with PBH or do they get employed under PBH EIN?
A document that outlines the different relationships is sent to the associate, employer, and PBH for signature.
The associate maintains a volunteer status with PBH.
The associate maintains an employee W-2 relationship with the employer/supervisor (Clinician).
2. On the claim is it just my NPI or also my EIN?
The Carelon claims will have the associate NPI. Carelon no longer credentials associates but does require that two forms be submitted to register the associate and link the associate to the employer/supervisor.
Cigna, Optum/UBH, Anthem, MHN, and Magellan claims will include the employer/supervisor's NPI on the claim.