Credentialing & 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. 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 please review our Credentialing Committee policy
.

Applicant Information and Credentialing Applications

Licensed Practitioner Credentialing
All licensed 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)

Non-Licensed Provider Credentialing
Non-Licensed Providers applying to a position which provides direct care services and requires a minimum of a Bachelor’s degree in a Behavioral Health major per the MHMR job description requirements should complete the following Credentialing Application:

Non-Licensed Provider Credentialing Application

Please return your completed Credentialing Application at your earliest convenience by:

• 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.

Please click on the hyperlink which corresponds to your license type to download the payer enrollment packet that is appropriate for your specialty.

Please use this packet for the following licenses:

Enrollment Packet

• APRN
• PA
• Psychologists
• Psychologists
• Dieticians
• LCSW

Please use this packet for the following licenses:

Enrollment Packet

• SLP
• OT
• PT
• LPC
• LMFT

Please use this packet for the following licenses:

Enrollment Packet

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

Please return your completed provider enrollment packet at your earliest convenience by:

• 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