Resource center
A working library of guides, SOPs, templates, and trackers — organized the way credentialing actually happens.
Showing 20 of 20 resources
Payer Guides
A step-by-step guide for submitting and following up on a provider legal last name change with Carelon Behavioral Health — request details, supporting documents, a sample email, follow-up contacts, and recordkeeping reminders.
Payer Guides
A simple, step-by-step guide for requesting and following up on a provider legal last name change with Evernorth/Cigna Provider Services — contact information, automated phone navigation steps, what to have ready before calling, name-change request guidance, reference number and follow-up instructions, and final verification reminders.
Payer Guides
A step-by-step guide for updating and verifying a provider legal last name through the Lucet Provider Portal for applicable Florida Blue behavioral health provider records — portal navigation, provider search by NPI, last name update instructions, Lucet Provider Support contact information, follow-up guidance, and final verification and documentation reminders.
Payer Guides
A simple, step-by-step guide for submitting and following up on a provider legal last name change with Aetna — preparing the name-change request, submitting supporting documentation, faxing the request to Aetna, following up with Credentialing, and verifying the update was completed. Includes Aetna name-change submission instructions, information to include in the request, and supporting documentation guidance.
Payer Guides
A simple, step-by-step guide for submitting a provider legal last name change to Sunshine Health. This payer-specific guide walks through the demographic update process, including what information to enter, supporting documentation to prepare, submission, follow-up, and final verification. Includes Sunshine Health demographic update instructions, required provider and organization information, supporting documentation guidance, submission and follow-up steps, and final verification reminders. Designed for ABA, behavioral health, and therapy practices that want a clear process for completing provider name changes with Sunshine Health. Please note: this guide is specific to Sunshine Health; the general Provider Last Name Change Guide™ and guides for other insurance payers are sold separately.
Provider Maintenance
A step-by-step guide designed to help healthcare, ABA, and therapy practices manage a provider legal last name change across credentialing systems, professional records, and insurance payer records. This guide walks through the recommended update sequence for NPPES/NPI, professional licenses, board certifications, provider profile systems, Availity, and insurance payers, along with follow-up, verification, and documentation best practices. Includes the recommended name-change update sequence, NPI/NPPES, license and board certification guidance, provider profile system and Availity update guidance, insurance payer notification guidance, and follow-up and verification steps.
Compliance
A simple step-by-step guide designed to help healthcare and therapy practices understand OIG exclusion screening, why it matters, and how to complete and document a search using the official OIG LEIE database. Includes what OIG exclusion screening is, why practices should conduct OIG checks, when screening should be completed, step-by-step OIG LEIE search instructions, how to review and verify potential matches, documentation and recordkeeping guidance, individual vs. large-batch screening, OIG vs. SAM clarification, and a quick screening workflow. Perfect for ABA, therapy, and healthcare practices looking for a simple, practical approach to exclusion screening and ongoing compliance monitoring.
Credentialing Foundations
A simple step-by-step guide designed to help credentialing teams verify provider licenses and professional certifications, document verification, and keep credential information current. Includes license and board certification verification steps, primary source verification guidance, verification documentation tips, credential profile review and updates, attestation guidance, and credential expiration monitoring reminders. Includes visual guidance to help practices locate and review applicable credential information.
Compliance
A comprehensive, editable policy template designed to help healthcare and therapy practices track provider credentials, monitor expiration dates, and prevent credential lapses. Includes credential monitoring requirements, a 90/60/30-day expiration workflow, provider notification and follow-up, escalation procedures, the expired credential process, renewal verification, documentation, and periodic audits.
Compliance
A comprehensive, editable policy template designed to help ABA and therapy practices establish a clear process for identifying and supporting patient/client language and communication needs. Includes language needs identification, interpreter and translation procedures, qualified language service guidance, vital document considerations, and payer and program requirements.
Compliance
A comprehensive, editable policy template designed to help ABA and therapy practices establish a clear process for reporting, documenting, escalating, reviewing, and managing patient/client incidents. Includes incident definitions and reporting requirements, immediate response and internal escalation procedures, payer/external reporting review, and an Incident Report Form.
Compliance
A professional, editable Code of Conduct template designed for ABA and therapy practices to establish clear expectations for ethical, professional, and compliant conduct. Covers professional and ethical conduct, patient/client rights and safety, documentation and billing integrity, fraud, waste and abuse, privacy and confidentiality, conflicts of interest, non-discrimination and non-retaliation, reporting compliance concerns, accountability and staff responsibilities, with acknowledgment included.
Compliance
A comprehensive, editable policy template designed to help ABA and therapy practices establish a clear process for managing patient/client complaints and grievances. Includes the Grievance & Complaint Policy, a Complaint/Grievance Intake Record, and Escalation & Resolution Procedures covering intake and documentation, urgency assessment, investigation and resolution, corrective action, confidentiality and non-retaliation, payer-specific requirements, and ongoing compliance monitoring.
Templates & Trackers
A practical provider data review system for accurate NPI, taxonomy, address and enrollment information. This operational toolkit gives ABA and therapy practices a structured process for reviewing individual and organizational NPIs, taxonomy codes, addresses, practice locations, provider names, and cross-system data, while identifying discrepancies before they create credentialing, enrollment, or billing issues. Includes NPI audit checklists, provider readiness reviews, cross-system data checks, corrective-action tracking, change verification, red-flag guidance, maintenance reviews, final quality checks, and a quick-reference audit workflow. Perfect for credentialing teams, practice owners, administrators, and provider relations staff.
Enrollment & Contracting
A practical system for tracking, following up, escalating, and closing provider enrollment applications. The Payer Follow-Up Toolkit gives ABA and therapy practices a structured system for managing credentialing and enrollment follow-up from submission through final approval and effective date, so payer applications no longer sit in pending with no clear next step. Includes a payer follow-up workflow and checklist, application status definitions, payer contact and follow-up records, an additional information request tracker, an escalation workflow and tracker, an enrollment issue log, and ready-to-use payer email templates.
Provider Maintenance
A complete offboarding system to protect your practice, maintain payer accuracy, and preserve your records. This comprehensive policy helps practices create a clear, organized process for managing provider departures from start to finish, coordinating payer terminations, credentialing closure, billing, provider rosters, authorizations, system access, patient transitions, and record retention while maintaining a documented offboarding trail. Includes the comprehensive Provider Departure & Offboarding Policy, a Provider Offboarding Checklist, and a Payer Termination Tracker.
Compliance
Build Your FWA Compliance Program — Without Starting From Scratch. Give your practice the policies, training materials, employee documentation, assessment tools, and audit-support resources needed to establish a structured Fraud, Waste & Abuse compliance program. It helps practices establish documented FWA policies and responsibilities, train employees and document completion, identify billing, documentation and service-verification risks, create reporting and escalation procedures, maintain evidence of monitoring and compliance activities, organize records for payer, program and compliance reviews, and demonstrate that a real compliance process exists — not simply a policy sitting in a folder. Don't just have an FWA policy — build the system behind it.
Compliance
Customizable Compliance Policy Template for ABA & Therapy Practices. Strengthen your practice's internal controls with a comprehensive policy designed to support accurate timekeeping, service verification, billing integrity, and audit readiness. This customizable policy provides a structured framework for identifying, reviewing, documenting, and resolving overlapping services, impossible or implausible service days, documentation discrepancies, and potential billing concerns. Includes timekeeping & service documentation standards, impossible/implausible service-day controls, overlapping service prevention & review procedures, supervision time controls, payroll, scheduling & billing reconciliation, monitoring & auditing procedures, error correction & corrective action guidance, Fraud, Waste & Abuse reporting procedures, evidence-of-compliance & record-retention standards, and the Impossible/Implausible Service-Day Review Checklist.
Enrollment & Contracting
From Provider Acceptance to Payer Readiness — Build a More Organized Credentialing Process. The BYOND™ New Provider Onboarding System is a comprehensive, practice-focused guide designed to help ABA and therapy organizations create a structured process for onboarding new providers — from initial document collection through credentialing, payer enrollment, billing readiness, and ongoing maintenance. Designed for practices onboarding BCBAs, BCaBAs, RBTs, OTs, and SLPs, this system helps your team reduce missed steps, identify enrollment delays, maintain organized provider records, and build with audit readiness in mind. Inside the Guide: new provider intake & onboarding workflow, required provider documentation, primary source verification & documentation, exclusion and compliance screening, NPPES & provider profile review, BCBA, BCaBA, RBT, OT & SLP onboarding guidance, payer enrollment tracking, and provider billing readiness.
Provider Maintenance
Manage provider last name changes with confidence using this comprehensive toolkit. Includes organized workflows, checklists, tracking logs, verification tools, and printable worksheets to help ensure no critical update is missed. This toolkit provides the overall process and tracking tools; payer-specific submission instructions are available separately for select insurance companies.
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