Accreditation & Credentialing for Behavioral Health Facilities

by | Aug 11, 2023 | Behavioral Health, Credentialing, Outsource

Billing Solutions Team
Billing Solutions provides medical billing services for behavioral healthcare practices.

Building a reputable behavioral health facility takes time, resources, and the efforts of an entire team of professionals. The most important piece, however—and one that can determine the fate of your facility—comes just when you are ready to throw open your doors: accreditation and credentialing.

Accreditation and credentialing allow you to show prospective clients and colleagues that you have been thorough and diligent in establishing appropriate protocols, processes, and programs at your facility. They also indicate to insurance companies that you have met the requirements for performing services in your field. In fact, many insurance providers will not even compensate you for your services if you are not nationally accredited, and certainly not if you are not credentialed.

Even for the most well-prepared facilities, however, accreditation and credentialing is not a simple matter. Here’s what you can expect when you are ready to pursue your accreditation and credentials.

What’s the Difference Between Accreditation & Credentialing?

Accreditation and credentialing are both a necessary step towards becoming a respected behavioral healthcare provider. The main difference is that credentials are issued by government bodies, such as the state or federal government, while accreditation is done by a non-governmental third party.

Requirements for Accreditation

The specifics of each accreditation process depend upon the agency that is issuing accreditation. (There are many options at the national, state, and local levels.) Still, the overall process and purpose remains the same across the board.

To start, you and your team must gather business documents, records of client care, documented processes and protocols, and information regarding the licensing, education, and experience of your staff for third-party review. From there, you must undergo a series of paper audits and on-site visits, both of which will ensure that your practice is in compliance with HIPAA and other industry standards.

CARF (The Commission on Accreditation of Rehabilitation Facilities), for example, outlines the following areas for review: program, service structure, screening, medication use, discharge, records management, core treatment program standards, and core support program standards, among others.

Who Issues Behavioral Health Accreditation?

Two of the most respected accreditation agencies are the Joint Commission (commonly known as JCo) and the Commission on Accreditation of Rehabilitation Facilities (CARF). They both hold behavioral health and addiction treatment centers to a high level of professionalism, and are therefore well regarded across the industry.

Which Is Right for You?

The Joint Commission is America’s oldest and largest accrediting body. To date, it has accredited more than 22,000 healthcare practices and programs in many different fields. JCo (formerly known as JCAHO, the Joint Commission for Accreditation of Healthcare Organizations) is known for their robust accreditation standards, developed with the goal of constantly striving towards “zero harm” in the healthcare industry. The only downside, for some, is that The Joint Commission only works with facilities in the United States.

CARF, on the other hand, has the ability to accreditate facilities in Canada and Europe, and may be a better choice for programs with plans to expand across borders. Their stated mission is “to promote the quality, value, and optimal outcomes of services through a consultative accreditation process and continuous improvement services that center on enhancing the lives of persons served.” Founded in 1966, CARF is also extremely well-respected, but their services are limited to rehabilitation facilities.

Helping Your Staff with Credentialing

The process of preparing for and undergoing credentialing and accreditation can be overwhelming. One simple mistake could derail your entire program.

At Billing Solutions, we work with clients to prepare a customized plan of action for pursuing accreditation, credentials, and the insurance contracts that each can expedite.

Our core services can include:

  • Providing a checklist of the necessary documentation
  • Filling out credentialing applications
  • Corresponding with insurance’s credentialing departments
  • Submitting paperwork
  • Ensuring that documentation is in compliance with insurance policies
  • Adding and removing insurance providers from your plan
  • Following up with insurance companies for further contract negotiations
  • And more

If you are ready to begin the process of accreditation and/or credentialing, and even if you’re not sure what’s best for your facility, please give us a call for a free consultation. Over more than ten years of business, we’ve helped hundreds of behavioral health programs achieve the accreditation and credentials that they deserve.