BlueChoice HealthPlan

providers

Mental Health Practitioners

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Mental Health Practitioners

Companion Benefit Alternatives, Inc (CBA) handles credentialing for mental health practitioners for the CBA and BlueChoice HealthPlan networks. On behalf of BlueChoice HealthPlan, CBA administers mental health and substance abuse benefits. CBA is a separate company that administers behavioral health benefits.

    Here is a checklist of the tasks you must complete for credentialing:

  1. Read, complete, sign and return the CBA Practitioner Credentialing Application.
  2. Read, sign and return the CBA Professional Agreement (Please contact CBA at 1-800-868-1032, ext. 25744, to get this document).
  3. Sign and return each HMO Hold Harmless Agreement (Appendix C of the CBA Professional Agreement).
  4. Enclose a copy of the S.C. State License(s).
  5. Enclose a copy of the DEA License (if applicable).
  6. Enclose a copy of the protocol (Nurse Practitioners only).
  7. Enclose proof of current malpractice coverage.


Download the CBA Credentialing Application.


Please return the completed application to:

Companion Benefit Alternatives, Inc.
ATTN: Network Coordinator AX315
PO Box 100185
Columbia, SC 29202
Fax: (803) 714-6456