Join Our Network

Facility or Hospital-Based Providers

  • Do you offer licensed/certified Mental Health and/or Substance Use Disorder (SUD) inpatient and/or lower level of care services (i.e., Inpatient, Detox, Residential, Partial Hospitalization (PHP), and Intensive Outpatient (IOP) programs?
  • Do you have minimum professional liability coverage of $5 million/$5 million for acute inpatient services, and minimum professional and comprehensive liability coverage of $1 million/$3 million for non-acute inpatient services (unless state requirements vary)?

If meet above requirements, please click on the Facility Application link below to complete and select all applicable Level(s) of Care you provide.

Facility Application

Please note following documents will be required (As Applicable):

  • Current State License(s)/ Certificate(s) for all behavioral health services you provide, i.e. psychiatric, substance abuse, residential, intensive outpatient, etc. A18 – include all documentation for multiple facility locations.
  • Accreditation status (i.e. The Joint Commission, CARF, COA, etc.)
  • Medicare or Medicaid certification letter with Medicare number (REQUIRED if applying for participation in Medicaid or Medicare networks)
  • Program Description-including any specialty program descriptions and hours per day/ days per week
  • Copy of completed Ownership & Disclosure Form (REQUIRED if applying for participation in Medicaid networks)
  • Copy of completed Ownership & Disclosure Form (REQUIRED if applying for participation in Medicaid networks)
  • Current Professional and General Liability insurance certificates showing limits, policy number(s) and expiration date(s). If self -insured, attach a copy of an independently audited financial statement which shows retention of the required amounts.
  • W9 form: If multiple tax ID numbers used, one W9 must be submitted for each (NOTE: required if adding or changing tax ID or entity name)
  • Staff Roster for all behavioral health staff involved with your programs. Please list their degrees, licenses and/or certificates.
  • We do not need an actual copy of their licenses or certifications.
  • Daily Program Schedule(s) – include an hour-by-hour schedule showing a patient’s daily treatment for each level of care you provide. Include weekend scheduling, where appropriate,
  • Policy and Procedure on Intake/Access Process to Behavioral Medicine
  • Policy and Procedure on Intake/Access Process if done through E.R.
  • Policy and Procedure on Holds/Restraints
  • Policy and Procedure for Discharge Planning

Improve the Speed of Processing - Tips for Applying to the Network

  • It is important to attach all correct and required documents as applicable.
  • Levels of Care will require appropriate state licensure and/or certification to be provided as part of the application process.
  • If not accredited, a site audit will need to be scheduled and conducted
  • Please include a signed completed W-9 form
  • Current Liability Insurance Certificate is not expired.

For help with this process, you can go to Network Management then click on "Network Management Contact Information" in the Network Management section.

Group/Practice Providers

If you are part of a group practice that is contracted with Optum/OHBS-CA, please consult with your group administrator regarding joining the network.

Group contracts are available under limited circumstances. You can contact Network Management about a Group Contract (the contact information is located under "Network Management Contact Information" in the Network Management section).

Agency/Group Providers

  • Are you a Community Mental Health Center, Federally Qualified Health Center, Rural Health Center, or other Federally or State licensed or certified Entity?
  • Does your entity have the minimum Liability insurance of $1 million/ $3 Million for both General Liability and Professional Liability? 

If you meet these requirements, click here to complete the agency application.

If your agency only provides ABA services, click here to complete the Autism/ABA/BCBA application.

Please note that the following documents will be required (as applicable):

  • A current state license or certificate for all services and locations where you offer services
  • Accreditation status
  • Medicaid and/or Medicare certification letters with applicable registration numbers
  • Current General and Professional  Liability insurance certificates with Liability limits and expiration dates
  • W9 form
  • Current Staff roster including license, taxonomy and NPI
  • General Policy and procedures
  • Daily schedule

Please note:

If you are not accredited, a site audit will be required before the credentialing process will be complete. 

A group contract including fee schedule will be sent to the credentialing contact person at your agency after the application is reviewed.  This will need to be completed before the formal credentialing process begins. At that time, you will have an opportunity to discuss which lines of business your agency would like to serve.

For help with this process, you can go to Network Management, then click on “Network Management Contact Information” in the network management area.

Individually-Contracted Clinicians

Click here