How to Get Credentialed with Carelon Behavioral Health in Wisconsin
Quick Overview
Timeline
30 - 60 days
CAQH
Required
Re-credentialing
Every 3 year(s)
Delegated
No
Wisconsin-Specific Requirements
Step-by-Step Enrollment Process
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Wisconsin.
Complete Your CAQH ProView Profile
Carelon Behavioral Health requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.
Submit Your Application
Submit your completed enrollment package to Carelon Behavioral Health.
Track & Follow Up
Credentialing typically takes 30-60 days. Monitor your application status and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with Carelon Behavioral Health?
Our specialists handle the entire Carelon Behavioral Health enrollment process: applications, follow-ups, and approvals in Wisconsin.
Required Documents Checklist
Board Certification
ConditionalRequired if board certified in psychiatry or behavioral health specialty
CV/Resume
5-year work history minimum
DEA License
ConditionalRequired if prescribing controlled substances (psychiatrists, APRNs)
Malpractice Insurance
Current malpractice insurance certificate
Medical License
Active state license (MD, DO, PhD, PsyD, LCSW, LPC, etc.)
NPI Certificate
Active NPI number required
Enrollment Forms
Carelon Behavioral Health Provider Application
Provider application for Carelon Behavioral Health (formerly Beacon Health Options) network.
RequiredFree Tools for Your Carelon Behavioral Health Enrollment
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Key Credentialing Terms
- CAQH
- The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
- Collaborative Practice Agreement
- A formal written agreement between a physician and a nurse practitioner or physician assistant defining the terms of the...
- Credentialing
- The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
- Effective Date
- The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
- NPI
- The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
- Peer Review
- A process in which a provider's clinical performance, decision-making, and outcomes are evaluated by other qualified pro...
- Primary Source Verification
- The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...
- Provider Enrollment
- The process by which a healthcare provider applies to participate in an insurance payer's network, allowing the provider...
Credentialing Checklist
Make sure you have everything ready before applying to Carelon Behavioral Health.
View Physician Credentialing Checklist →Contact Information
Provider Credentialing
National1-800-397-1630
Mon-Fri 8am-5pm
Provider Services
National1-800-397-1630
Claims & Billing
National1-800-397-1630
Quick Links
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Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.