Navigate the credentialing climb with total confidence.

The map before the trail - Medicare's two checkbooks, the fork between enrolling a person and enrolling an entity, the three federal systems, the CMS-855 forms, screening levels, your MAC, and the PTAN. Nine mini-lessons you can watch in 1-3 minutes each, or play them all at once.

1. 1The Two Checkbooks3 min
2. 2The Fork: Two Trails3 min
3. 3Three Systems, One Login2 min
4. 4The Forms2 min
5. 5The Other Fork: Opting Out1 min
6. 6Screening Levels and the Fee2 min
7. 7Your MAC1 min
8. 8The PTAN1 min
9. 9The Map, Complete2 min

Medicare pays a benefit category, and the license a clinician holds is what decides it. The eleven provider types on Colorado's Part B list, what a Colorado license actually reaches, and the percentages each category is paid. Seven mini-lessons, or play them all at once.

1. 1The Same Hour2 min
2. 2The Category List2 min
3. 3The Category She Chooses3 min
4. 4The Percentages3 min
5. 5You Must Take It4 min
6. 6What Your Category Lets You Do3 min
7. 7Staffing on Purpose4 min

A hands-on PECOS walkthrough for enrolling an individual provider in Medicare - from first login to Complete Submission, and the traps that get applications rejected. Twelve mini-lessons of about a minute each, or play them all at once.

1. 1The Setup2 min
2. 2The I&A Foundation1 min
3. 3The Operating Model1 min
4. 4Starting the Application2 min
5. 5Navigating the Topics2 min
6. 6The Specialty Translation1 min
7. 7Supporting Documents2 min
8. 8Reassigning to a Group2 min
9. 9Errors & Warnings1 min
10. 10Signatures & Deadlines2 min
11. 11Timelines & Fallout2 min
12. 12The Next Steps1 min

The 855B walkthrough for enrolling a behavioral health group practice as an organization in Medicare - who may act for the entity, the disclosures the individual application never asked for, and the timing math that decides when money moves. Eleven chapters, playable one at a time or all at once.

1. 1The Applicant Is Not a Person4 min
2. 2Who Holds the Keys4 min
3. 3Authorized, and Delegated5 min
4. 4What the IRS Calls You3 min
5. 5Who Is Behind the Entity3 min
6. 6The Question You Answer Honestly2 min
7. 7The Paperwork Behind the Paperwork2 min
8. 8Your Billing Agent Is Not Your Excuse1 min
9. 9Who Signs, and What the System Does2 min
10. 10Timing3 min
11. 11The Practice Stands3 min

When a behavioral health organization steps up to facility-level care, Medicare stops enrolling people and starts certifying a building. The CMS-855A path - up-the-chain disclosure, license-and-accreditation-first, the survey and the three gates, and the effective-date trap that wrecks cash flow. 14 mini-lessons of a few minutes each, or play them all at once.

1. 1Levels of Care and the Two Ledgers3 min
2. 2The Three Enrollments2 min
3. 3What Makes a Facility1 min
4. 4One Service, Two Claims1 min
5. 5The Higher Bar1 min
6. 6A Check on the Whole Business2 min
7. 7Every Location Is Its Own Enrollment1 min
8. 8The Identity Must Match1 min
9. 9License and Accreditation First3 min
10. 10Three Gates, Three Actors4 min
11. 11The Effective-Date Trap2 min
12. 12The OTP Chain and the Fee Trap2 min
13. 13The Revenue Break4 min
14. 14The Record Is Yours3 min

An approved Medicare enrollment is a living record with three clocks running against it. The PTAN up close, revalidation and its six-month window, the two change-reporting deadlines, the six quiet months that can take a number down, and the two roads back when a notice arrives. Ten mini-lessons, or play them all at once.

1. 1The Record Is Alive1 min
2. 2Your PTAN, Up Close2 min
3. 3The Mapping2 min
4. 4Three Clocks2 min
5. 5Revalidation3 min
6. 6Two Windows3 min
7. 7When Someone Leaves3 min
8. 8The Silent Deactivation3 min
9. 9Appeals3 min
10. 10What You Now Hold2 min

The compliance guardrails around the Medicare enrollment you built - opt-out, ordering & referring only, mandatory claim submission, the ABN, and Medicare Secondary Payer. Nine mini-lessons you can watch in 2-4 minutes each, or play them all at once.

1. 1The Five Edges2 min
2. 2Opting Out4 min
3. 3Filing the Affidavit3 min
4. 4Undoing an Opt-Out4 min
5. 5Ordering & Referring Only2 min
6. 6You Must Bill2 min
7. 7When Coverage Is Uncertain4 min
8. 8The Close2 min

The orientation before the applications - the three gates Health Care Policy and Financing publishes (license, enroll, contract), why a RAE contract is no longer automatic, the three agencies and how their licenses interlock, Medicaid versus CHP+, the four ACC regions and member attribution, and the enrollment record with its compliance calendar. Seven mini-lessons you can watch in 2-3 minutes each, or play them all at once.

1. 1The Question2 min
2. 2Three Gates3 min
3. 3Three Agencies3 min
4. 4Two Programs2 min
5. 5Four Regions2 min
6. 6One Record3 min
7. 7The Path Ahead2 min

The Behavioral Health Administration hands your organization five building blocks - the Behavioral Health Entity license, its endorsements, Comprehensive approval, Essential approval, and the individual licenses your clinicians hold - and those blocks unlock two doors: enrollment with Health Care Policy and Financing and a contract with your regional Behavioral Health Administrative Service Organization (BHASO). Who needs the license, what it costs, the 90-day and 60-day clocks, what safety net approval commits you to, and how it changes enrollment and payment. Eight mini-lessons you can watch in 1-3 minutes each, or play them all at once.

1. 1Five Building Blocks2 min
2. 2Do You Need the License2 min
3. 3Endorsements2 min
4. 4Getting Licensed2 min
5. 5Living Under the License2 min
6. 6Joining the Safety Net3 min
7. 7What It Does to Enrollment1 min
8. 8Who Pays3 min

How Health First Colorado sorts every provider before a claim can pay: the NPI that sets the path, the numbered provider type that names what you do (LCSW, LPC, LMFT, and LAC all roll into one code; behavioral health groups are a Provider Type 77), the enrollment type that decides whether you bill, render, or refer, and the three front doors Hope Behavioral Health ends up managing under one tax ID - the RAE for therapy and the substance use disorder continuum, fee-for-service for E/M visits and physician-administered drugs. Follows Hope Behavioral Health and Claire onto one claim form. Seven mini-lessons of 2-5 minutes each, or play them all at once.

1. 1Two People on One Claim2 min
2. 2Your Provider Type5 min
3. 3Your Enrollment Type4 min
4. 4Which Door Is Mine2 min
5. 5Two NPIs, One Claim2 min
6. 6Who May Render2 min
7. 7Three Dials2 min

Elena has hired Claire, and Anna, Hope Behavioral Health's credentialing coordinator, files Claire's Health First Colorado application before her first day. Follow that one application from a blank form to a Welcome Letter: who needs an enrollment of their own, the lane and the group-goes-first rule, the Provider Type 38 checklist, the portal walk, the return list in the state's own words, the backdate field, and the Medicaid ID and login that stay Claire's for her whole career. Ten mini-lessons of 1-3 minutes each, or play them all at once.

1. 1The Gate1 min
2. 2Who Gets an Application2 min
3. 3Your Lane, and the Group Goes First3 min
4. 4Your Checklist3 min
5. 5The Walk2 min
6. 6The Return List3 min
7. 7The Backdate Field3 min
8. 8The Kit1 min
9. 9This Record Is Yours1 min

Hope Behavioral Health has billed clean at its first location for years. Now Elena opens a second site, a substance use disorder program, and Anna enrolls that location with Health First Colorado as its own billing entity before the first session. Follow the Facility application from a signed lease to a welcome letter: the two kinds of provider identity, Provider Type 64 and its ASAM levels of care, the Behavioral Health Administration license that anchors it, one NPI per location, the checklist, the six disclosure sections, the walk, the backdate field, the location-first order, the organization's record, and how the first location became a Provider Type 77. Twelve mini-lessons of 1-19 minutes each, or play them all at once.

1. 1The Second Door1 min
2. 2Two Identities2 min
3. 3The Provider Type19 min
4. 4The Levels of Care1 min
5. 5One NPI Per Location2 min
6. 6The Facility Checklist3 min
7. 7The Disclosures3 min
8. 8The Walk and the Return2 min
9. 9The Backdate1 min
10. 10The Location First, Then the People1 min
11. 11How the First Location Became a 775 min

Hope Behavioral Health is enrolled at both locations and Claire renders under it. The welcome letter is filed, and the record on the desk stays true only because a named person keeps it that way. Follow Anna through the five-year revalidation clock set by the approval date, cleaning the record before half of it locks, the walk through revalidation, what actually happens in Colorado when the date passes and the way back that reconnects the same Provider ID, the annual license clock that comes due five times as often, the roster of clocks a delegate watches for an organization, and Claire's own pen on her own record. Ten mini-lessons of 2-4 minutes each, or play them all at once.

1. 1The Record on the Desk3 min
2. 2The Clock on the Face4 min
3. 3Clean the Record First3 min
4. 4The Walk Through Revalidation4 min
5. 5The Day the Date Passes3 min
6. 6The Way Back3 min
7. 7The Second Clock3 min
8. 8The Roster of Clocks4 min
9. 9The Record Stays Lit2 min

Enrolling with the state is not the same as getting paid. State enrollment validates you; your RAE pays you. See how your members' attribution picks your Regional Accountable Entity, meet all four, and learn the two gates between you and a paid claim: credentialing and contracting for each RAE you serve. Plan backward from the contract effective date, and ask about network need before you apply. All four RAEs, concrete: the front door, the credentialing source, and the contact for each. Closes the Colorado Medicaid credentialing arc.

1. 1Before the First Session3 min
2. 2Two Bodies, Three Verbs3 min
3. 3The Map, Four Regions3 min
4. 4Meet the Four RAEs3 min
5. 5One Key, Four Doors4 min
6. 6The Packet and the Effective Date5 min
7. 7When the Door Is Narrow4 min
8. 8How You Actually Get Paid5 min
9. 9Staying In, Own Your Record5 min

Paid does not mean closed. Under Health Care Policy and Financing rules, your legal obligation to prove that care happened continues long after payment arrives. This capstone of the Colorado Leg teaches Elena's two-column worksheet method: line the claim against the progress note, check note completeness and medical necessity, verify diagnostic coding and provider qualifications, audit telehealth place-of-service and modifier traps, confirm third-party payer order, and - when an overpayment surfaces - complete the 60-day self-disclosure process that best protects Hope Behavioral Health LLC's standing. Nine chapters of 1-4 minutes each, or play them all at once.

1. 1Paid Is Not Closed2 min
2. 2Claim vs. Record4 min
3. 3Prove the People2 min
4. 4The Improper-Payment Patterns2 min
5. 5Documentation Red Flags2 min
6. 6Telehealth Traps1 min
7. 7Payer of Last Resort2 min
8. 8Producing the Record2 min
9. 9Find It Before the Auditor Does2 min

Step out of the government-payer world and into commercial insurance. CAQH is the one profile that Aetna, Cigna, Anthem, nearly every Medicare Advantage plan, and the Colorado Medicaid RAEs pull from. Build it once: register, complete every section, gather your documents, watch the work-history trap, attest, authorize each plan, and collect your CAQH ID. Then understand what CAQH verifies versus what the health plan decides, and why the effective date is where the money lives. Seven mini-lessons you can watch in 2-8 minutes each, or play them all at once.

1. 1The Universal Key7 min
2. 2Who Runs on CAQH5 min
3. 3Building Your Profile8 min
4. 4When Your Group Does It2 min
5. 5Verify, Not Decide3 min
6. 6The Clock and the Money2 min
7. 7This Profile Is Yours2 min

Part 1 built the individual CAQH profile. Part 2 is the group side, for an organization's credentialing team. The organization has its own account in the CAQH Provider Data Portal: a Practice Managers account where the team enters the shared data once - the credentialing contact, hospital affiliations, and liability insurance, plus every service location with the group's Type 2 NPI, group Medicare and Medicaid numbers, and Tax ID - instead of re-keying it into every profile. See how a team brings a new hire on, the two ways that shared data reaches each provider's profile, why every location is revenue, what the group account can and can't do, the delegated-credentialing fork and the Provider Groups roster, and why only the provider can attest to her profile. Seven mini-lessons you can watch in 2-3 minutes each, or play them all at once.

1. 1The Practice Managers Account3 min
2. 2Bringing a New Hire On3 min
3. 3Every Location Is Revenue3 min
4. 4The Delegated Fork3 min
5. 5The Seam2 min

A CAQH profile is a living record with its own clocks. Re-attest every 120 days or the profile goes to Expired and payers can no longer rely on it as a current attested record. Learn when CAQH sends reminders, why saving a change is not the same as attesting it, how licenses and the malpractice policy each expire on their own schedule, how to keep your name and address matching across CAQH, NPPES, and DORA, how the 90-day location confirmation keeps the provider directory current, how plans recredential on a 36-month cycle, and how to keep plan authorizations set correctly. Eight mini-lessons you can watch in 2-4 minutes each, or play them all at once.

1. 1The Hidden Clock4 min
2. 2What an Expired Profile Stops2 min
3. 3Updating Is Not Attesting2 min
4. 4Documents on Their Own Clocks3 min
5. 5One Identity, Three Records2 min
6. 6The Directory Patients See2 min
7. 7The Long Clock3 min
8. 8Own the Clock3 min

Credentialed is not contracted, and neither one is paneled. Follow Hope Behavioral Health as it adds UnitedHealthcare: find the company that runs the plan's behavioral health network, sign the group contract, credential each clinician on Colorado's new clock, and panel each one with an effective date in writing. Then see why Medicare Advantage is its own door. Seven mini-lessons you can watch in 1-3 minutes each, or play them all at once.

1. 1What Puts a Clinician in a Network2 min
2. 2The Right Door for Behavioral Health1 min
3. 3Step One, the Contract2 min
4. 4Step Two, Credentialing3 min
5. 5Step Three, Paneling3 min
6. 6Medicare Advantage Is Its Own Door3 min
7. 7In Network, and What It Protects1 min

Credentialed and contracted - now what did Hope Behavioral Health LLC actually sign? The group agreement with Optum is not one document: it is four, each carrying a different layer of rules. Follow Anna as she opens the agreement, locates every piece, finds where each rule lives, and reads what the Colorado appendix adds on top of the agreement. Eight mini-lessons you can watch in 1-3 minutes each, or play them all at once.

1. 1The Contract Is a Stack3 min
2. 2Where the Rules Actually Live2 min
3. 3The Rules That Get You Paid3 min
4. 4The Colorado Appendix1 min
5. 5After the Payment Lands2 min
6. 6The Contract Keeps Moving3 min
7. 7Term, Renewal, and Leaving2 min
8. 8Three Questions2 min

Follow the Credentialing Team from an HCPF provider-type entry to a verified enrollment checklist. Read enrollment roles, specialty codes, screening risk, fees, identifier flags, location rules, and attachments.

1. 1The Catalog at the Desk2 min
2. 2Identity and Enrollment Role2 min
3. 3Provider Type and Specialty2 min
4. 4Risk and Application Fee2 min
5. 5NPI and Medicare Flags2 min
6. 6Location Rules2 min
7. 7From Attachments to a Checklist3 min
8. 8Read, Verify, Hand Off3 min

Enroll a Colorado behavioral health group as Provider Type 77. Choose the specialty, prepare the application, connect clinicians, and protect the appropriate billing paths.

1. 1The Group1 min
2. 2Separate Records, One Relationship2 min
3. 3Protect Both Service Paths2 min
4. 4Choose the Right Specialty2 min
5. 5Enroll the Group and Clinicians1 min
6. 6Build the Application Packet1 min
7. 7Protect the Date of Service1 min
8. 8Read the Manual Before Billing2 min

1. 1What Changed in 20241 min
2. 2Comprehensive and Essential1 min
3. 3Build the Complete Service System2 min
4. 4Prove Access and Readiness3 min
5. 5Obtain BHA Approval4 min
6. 6Enroll Each Location1 min
7. 7Complete the Packet and Affiliation3 min
8. 8Check Readiness Before Billing2 min

1. 1Two Records Behind One Visit1 min
2. 2Choose the Group Path2 min
3. 3Connect the Two Enrollments2 min
4. 4Pick One Specialty2 min
5. 5Enroll Every Location2 min
6. 6Build the Current Packet2 min
7. 7Protect Both Claim Streams2 min
8. 8Complete the Readiness Review2 min

1. 1One Visit, Two Records1 min
2. 2Choose the PT 25 Door2 min
3. 3Connect Group and Practitioner1 min
4. 4Pick One Specialty1 min
5. 5Enroll Every Location1 min
6. 6Build the Current Packet1 min
7. 7Protect Every Claim Path2 min
8. 8Complete the Readiness Review2 min

1. 1One Session, Two Records1 min
2. 2Choose the PT 83 Door2 min
3. 3Connect Clinic and Therapist2 min
4. 4Qualify Every Therapist2 min
5. 5Enroll Every Location1 min
6. 6Build the Current Packet2 min
7. 7Route Every Service2 min
8. 8Complete the Readiness Review2 min

Decide whether to enroll: the Behavioral Health Administration license, peer supervision and records, PT 89 enrollment by location, and the Regional Accountable Entity contract.

1. 1One Decision, Many Commitments1 min
2. 2Know When the License Applies2 min
3. 3Obtain the BHA License3 min
4. 4Supervise the Peer Workforce2 min
5. 5Certify and Record the Peers2 min
6. 6Choose the PT 89 Door2 min
7. 7Connect Group and Practitioner2 min
8. 8Pick One Specialty2 min
9. 9Enroll Every Location2 min
10. 10Build the Current Packet2 min
11. 11Route Every Peer Service2 min
12. 12Complete the Readiness Review3 min