Provider Criteria and Credentialing

Provider Criteria
In order to be eligible for referrals, FIRSTCALL network providers are required to undergo the credentialing review process prior to being accepted into the network. Contact our Provider Relations Coordinator for details of our requirements for qualifications of network providers.

Provider Credentialing  
FIRSTCALL requires the following documentation for credentialing its network of providers, prior to finalizing a contract:

• Copies of Licenses & Certifications
• Providers are required to be Masters level, licensed mental health providers, i.e. Psychologists or Clinical Social Workers, in applicable state.
• Providers are required to maintain malpractice insurance liability limits of $1,000,000 per occurrence/$3,000,000 aggregate and to provide evidence of same.
• Providers must complete the FIRSTCALL Provider Application and Profile , detailing specialty areas, populations served, language and special needs capabilities, as well as information of insurance/managed care participation.
• Providers must submit a Curriculum Vitae – summary of education and work experience
• W-9 Form must be submitted prior to the processing of any reimbursement for sevices rendered

In addition to the documents required for individual providers, group or organizational providers must submit a staff roster and Group Provider Profile.

Re-credentialing
Individual provider credentials are reviewed every two years. Our data system tracks expiration dates of licenses, certifications and insurance certificates. This information is utilized to automatically generate annual requests for updated information. Providers will be asked to submit license and insurance renewals as appropriate.

A chart audit may be required as part of the recredentialing process.

Updating Information
Prompt notification of changes in practice information will help us maintain an efficient and effective referral process and facilitate timely and accurate claim payments. Please notify FIRSTCALL promptly when any of the following changes occur:

• Demographic changes
• Telephone number changes
• Changes in status or availability
• Taxpayer identification number changes
• Group practice membership*

New or updated information can be faxed to 484-337-4426 or mailed to:

FIRSTCALL
101 South Bryn Mawr Ave., Suite 260
Bryn Mawr, PA 19010

Group Provider Changes

Please notify FIRSTCALL of any changes as indicated above. The FIRSTCALL Group Provider Profile, may be used for this purpose as well as to inform us of additions or deletions to your staff roster. To have additional staff members credentialed by FIRSTCALL, please submit the appropriate documentation including the FIRSTCALL Provider Application and Profile .