Credentialing & Provider Enrollment Services

MHMR Credentialing ensures the highest quality of services will be provided to the people we serve.

MHMR credentials licensed practitioners, and non-licensed Qualified Mental Health Professionals (QMHPs). Practitioners are credentialed according to the regulatory guidelines and standards set forth by the National Committee for Quality Assurance, the Centers for Medicare and Medicaid Services, the Texas Administrative Code and the Department of Health and Human Services.

Credentialing activities assess and validate the qualifications and competencies of practitioners and direct care workers based on the evaluation of the direct care worker and practitioner’s current license, certification, education, training and experience.

Please download and review our Credentialing Policy, which includes information about the credentialing appeals process. If you are a practitioner who is interested in serving on our Credentialing Committee,  review our Credentialing Committee Policy.

Applicant Information and Credentialing Applications

Practitioner Credentialing:

All practitioners are required to submit a complete and current Texas Standardized Credentialing Application (TSCA.) The TSCA is available in a pdf via the hyperlink, or in various formats available on the Texas Department of Insurance website link found below:

Texas Standardized Credentialing Application (TSCA) Application (TSCA – Typable PDF version)

https://www.tdi.texas.gov/forms/finmcqa/lhl234.pdf (Access to TSCA in various electronic formats)

Return your completed Credentialing Application:

• Email: Credentialing@mhmrtc.org
  Subject Line: Last Name, First Initial – Credentialing Application
• Fax to our confidential fax line: (817) 810-3042
  Subject Line: Last Name, First Initial – Credentialing Application

Practitioner Enrollment

Licensed Practitioner Enrollment:

All licensed practitioners are required to complete and submit the appropriate provider enrollment packet for Medicaid and/or Medicare, and CAQH enrollment within three (3) business days from the date you sign the job offer.

Use this packet for the following licenses:

Enrollment Packet

• APRN
• PA
• Psychologists(PhD/PsYD)
• Psychiatrists(MD/DO)
• LCSWs NOT working in ECS (Early Childhood Services)

Use this packet for the following licenses:

Enrollment Packet

• OT
• SLP
• RDLD/Dieticians
• LPCs working in ECS (Early Childhood Services
• LCSWs working in ECS (Early Childhood Services)
• LMFTs working in ECS (Early Childhood Services)

Use this packet for the following licenses:

Enrollment Packet

• PT (Early Childhood Services)

Use this packet for the following licenses:

Enrollment Packet

• LPCs Not working in ECS (Early Childhood Services)
• LMFTs Not working in ECS (Early Childhood Services)

Use this packet for the following licenses:

Enrollment Packet:

• RN
• LVN
• LBSW
• LMSW
• LCDC
• BCBA

Return your completed provider enrollment packet:

• Email: Credentialing@mhmrtc.org Subject Line: Last Name, First Initial – Provider Enrollment Packet
• Fax to our confidential fax line: (817) 810-3042 Subject Line: Last Name, First Initial – Provider Enrollment Packet

Informational Fact Sheet About the CAQH