Provider criteria and credentialing

Provider criteria and credentialing 2018-06-28T16:26:59+00:00

Provider Credentialing Standards

FIRSTCALL is an Employee Assistance Program (EAP) sponsored by Main Line Health, a prestigious healthcare system with acute care hospitals and an inpatient substance abuse treatment facility located in the suburbs of Philadelphia.  Main Line Health also offers all levels of behavioral health care within its system. FIRSTCALL’s national provider network is composed of clinical professionals from many different disciplines who are interested in delivering counseling services to FIRSTCALL’s client organizations within an EAP session model.  All FIRSTCALL’s network providers are required to be fully credentialed and meet all standards in order to be accepted into the network.

Credentialing Requirements

  • Providers are required to be Masters-level, licensed mental health providers, e.g. Psychologists, Clinical Social Workers, Marriage and Family Therapists, who are licensed at the highest independent level in their state of practice.
  • Current license must be in good standing with no active sanctions.
  • A Curriculum Vitae must be submitted which includes summary of education and work experience. Providers must have 3-5 years of direct clinical counseling experience.
  • Copies of current license and any certifications held. Many providers have a CEAP (Certified Employee Assistance Professional) certification which is definitely a plus.
  • Providers are required to maintain malpractice insurance with liability limits of $1,000,000 per occurrence/$3,000,000 aggregate and need to provide evidence of same.
  • Providers must complete the FIRSTCALL Provider Application and Profile detailing:
    • Specialty Areas
    • Populations Served, e.g. LGBT
    • Cultural Competencies
    • Languages
    • Special needs capabilities
    • Information on health plans or panels in which providers participate, e.g. Aetna, Optum/United, Cigna, Humana, etc.

A W-9 Form must be submitted prior to the processing of any reimbursement for services 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 are required to submit proof of license, insurance renewals and certification renewals.  A Provider’s file must be current in order for him/her to continue to receive EAP referrals.

Updating Provider Information

Providers are required to promptly notify FIRSTCALL of changes in practice information to help us maintain an efficient and effective referral process and facilitate timely and accurate claim payments. FIRSTCALL is notified when any of the following occur:

  • Demographic changes
  • Telephone number changes
  • Change in email address
  • Changes in status or availability
  • Extended vacations
  • Taxpayer Identification changes
  • Group practice membership changes
  • Retirement

New or updated provider information can be faxed to 484.337.4426 or mailed to:

FIRSTCALL Provider Relations

101 South Bryn Mawr Avenue, Suite 370

Bryn Mawr, PA 19010-3123

Group Provider Changes

Provider groups 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, Provider groups must submit the appropriate documentation including the FIRSTCALL Provider Application and Profile.