Mental Health Consultants (MHC) manages the carve-out behavioral health and substance abuse benefits for the member or dependent you have inquired about.  Our records indicate that you do not participate in the MHC Preferred Provider Network.  In order to complete the non-participating facility registration process, please submit the required documentation below to the MHC Clinical department via e-mail: Note: You must include the patient’s file # that was provided to you by the MHC Case Manager.

Required Documentation:

  • State License
  • Certification of accreditation from Joint Commission or CARF
  • Professional and General Liability Insurance certificates
  • W-9
  • 5-Year claims history report from your insurance carrier.  Access the form by clicking the following link: Request for Claims History Report Form

Disclaimer: Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time services are rendered.  All authorizations are contingent upon the receipt and review of the information and documents requested above. Late submission could result in a 20% penalty fee. Incorrect or incomplete information may prevent payment of your claims.