Bluebonnet Trails Community Services

BLUEBONNET TRAILS COMMUNITY SERVICES

CREDENTIALING PROCEDURE

PROVIDER ELIGIBILITY INFORMATION GRID

ELIGIBLE PROVIDERS / HEALTH PLANS / COMMENTS
MEDICARE / MEDICAID / CHAMPUS / STAR PCA / STAR BC/BS / TMF
MD or DO / X / X / X / X / X / X / Physicians must be credentialed through
Texas Medical Foundation (TMF)
LPHD / X / X / X / X / X / N/A
LMSW-ACP / X / X / X / X / X / N/A
LPC / N/A / X / X / X / X / N/A / LPCs are not recognized by Medicare and may not enroll in that program
MSN or ANP / X / X / X / X / X / N/A / Meet CompCares Requirements for
credentialing for Blue and PCA STAR
LMFT / N/A / N/A / X / X / X / N/A
QMHP / N/A / N/A / N/A / X / X / N/A / Be approved as QMHP by BTCS QMHP Review Committee.
Meet TDMHMR Standards Guidelines.
Meet CompCares requirements to be certified as Blue & PCA Star provider.
ECI staff (CCP, OT, PT, Dietitian) / N/A / X / X / X / X / N/A / Must enroll in Medicaid as individual providers only. May not enroll as a group.
LMSWs, LMFTs, LCDCs, and all non-licensed staff providing designated QMHP services (e.,g., community-based crisis assessment, crisis stablization and initial assessments for service delivery / Must be clinically supervised by a qualified licensed clinician (ACP, LPC, MD, LPHD) who is credentialed by CompCare to provide Blue and PCA STAR services.
NOTE: To receive reimbursement these services must be billed using the supervisors Medicaid number.
QMHPP (non-professional staff ) / Non-professional MH staff providing direct care services must have a high school diploma or GED, demonstrate competency in the work to be performed or be involved in ongoing in-service training to acquire required compentencies and have verification of supervision by a QMHP or other professional, with ultimate supervision by a licensed practitioner .