As a provider-owned managed behavioral health organization, CBHA values our provider network as one of our most valuable assets. CBHA is proud of the collaborative relationships we have with our network and CBHA is always open to feedback from our Providers as we strive to improve our policies, programs and processes. CBHA reviews and updates the Provider Manual annually. CBHA also communicates with our Provider Network via our Provider Newsletter.
Part of our commitment to quality is maintaining a comprehensive network of providers and facilities for our members. CBHA maintains a network of over 1,950 individual providers and more than 45 facility-based providers throughout North Carolina and several other states. With an extensive panel of contracted providers, CBHA expects members to receive outpatient treatment within a travel standard of 30 miles or 30 minutes. The accessibility travel standard for facility-based care is 45 miles or 45 minutes.
The Professional Relations department is responsible for network development, credentialing/recredentialing, provider orientation, and monitoring provider compliance with CBHA’s policies and procedures. The Professional Relations department is also responsible for conducting site reviews and record audits in some practices to insure compliance with CBHA’s record keeping standards.
Network adequacy is measured against covered lives in each geographic area to determine that sufficient numbers of providers are available to meet the demand for services. Prior to joining the CBHA network, providers must be contracted and credentialed. Credentialing is handled by the CBHA Professional Relations department which performs primary source verification including education, licensure, board certification, malpractice liability coverage, DEA registration (if applicable), and National Practitioner Data Bank reports. After all primary source verification is complete, CBHA’s Behavioral Health Quality Improvement Committee (BQIC), whose membership is comprised of a cross-section of the provider network, is responsible for the final approval for credentialing.
Any Provider questions or concerns should be directed to the CBHA Professional Relations Department by calling 1-800-475-7900 or emailing firstname.lastname@example.org.