Credentialing Process

  1. Applicant provider must submit the appropriate Letter of Intent (LOI)
  2. Site Review (for certain types of providers)
  3. An invitation to the New Provider Orientation is sent to qualified applicants who meet the preliminary credentialing criteria
  4. The application packet is distributed to the individual provider at the end of the New Provider Orientation.
  5. Completed packet must be returned to HBI within 30 days.
  6. HBI conducts Primary Source Verification per NCQA and URAC standards
  7. Findings are submitted to HBI Network Credentialing Committee for approval
  8. If approved, a welcome packet is sent to the new provider.

Each of the above steps must be satisfied before proceeding to the next. Qualified applicants with clean records usually take about 60 business days to process.

If you would like to enroll into the HBI Provider Network, please contact HBI’s Provider Services Department at credentialing@hbinetwork.com or submit a completed Letter of Intent with all the necessary supporting documents by fax to (702) 248-9640.

Credentialing Criteria

HBI does not make credentialing or re-credentialing determinations based on a provider’s race, ethnic/national identity, gender, age, sexual orientation, or the types of services (e.g. Medicaid) in which the provider specializes. Practitioners are selected using the following criteria:

All HBI Providers must

  • Meet the geographic access needs of HBI.
  • Hold membership in a national professional association that ascribes to a professional code of ethics (i.e., American Psychiatric Association, American Psychological Association, National Association for Social Workers, American Nursing Association, Employee Assistance Professional Association, or National Association of Marriage and Family Therapy).

Psychiatrists and Physicians

  • Graduate of an accredited medical school.
  • Completed a psychiatric residency program accredited by the Accreditation Council for Graduate Medical Education for Psychiatry or the American Osteopathic Association.
  • Unrestricted license.
  • Board Certified or Board Eligible physicians in a primary care specialty (i.e., Internal Medicine, Family Practice, Pediatrics, or OB-GYN) with more than five years of experience working with substance abuse patients are eligible to provide services to substance abuse patients. (Note: American Society of Addictions Medicine Certification is preferred, and in the absence of this must have documentation of five years of training.)
  • Board Certified in Psychiatry/Neurology (qualified to take the exam for Board certification for the American Psychiatric Guidelines for Psychiatry and Neurology).
  • Demonstrate a minimum of two years recent clinical experience.
  • Child Psychiatry must demonstrate at least one year of supervised experience working with disturbed children, and satisfactory completion of an approved fellowship in adolescent and child psychiatry (experience and training must be documented on the specific Children Credentialing form).
  • Must be in good standing with all facilities that are contracted with the HBI network (if applicable).

Allied Practitioners

  • Graduate of an accredited school or certification program in one of these special disciplines of practice:
    • Ph.D. in Psychology
    • Master Degree in Social Work
    • Psychiatric Registered Nurse
    • Marriage and Family Therapist
    • Drug and Alcohol Counselor
    • Physician Assistants
    • Nurse Practitioners
  • Clinicians must have an unrestricted license by their selective state boards in the state in which they practice, and should have certification specific to their specialty area.
  • Demonstrate two years of recent clinical experience (post licensing).
  • Completed postgraduate internship in perspective discipline.
  • Chemical dependency must demonstrate at least one year of supervised experience working with chemically dependent patients in an inpatient setting, and have two years of experience in an outpatient setting.
  • Clinicians who provide services to children must document experience and training on the Children Credentialing form.
  • Must be in good standing in all facilities contracted with HBI (if applicable).