EAP Credentialing for Therapists in California: How to Join the Major EAP Networks

EAP vs. regular insurance benefits

Two rules that apply to almost every EAP: do not start without the EAP authorization, and do not go past the authorized sessions expecting the EAP to pay. Most EAPs also have rules about whether you can keep seeing the client yourself afterward; Carelon’s EAP handbook, for example, restricts self-referral. Read your EAP agreement.

Quick comparison

How to join an EAP, step by step

1. Pick your EAPs. Start with the ones attached to networks you are already in (Optum, Carelon, Magellan), then add standalone EAPs that employers in your area use.
2. Check each EAP’s requirements. Experience after licensure, malpractice limits, and license type vary a lot (see below).
3. Get your documents ready: license, NPI, malpractice certificate, CV, W-9, and an up-to-date CAQH ProView profile, which some EAPs use.
4. Apply through each EAP’s official form or portal, using the links below.
5. Sign the EAP agreement or addendum and read the billing and session rules carefully.
6. Set up each EAP portal, and write down how authorizations, case numbers, and billing work for each one.
7. Build an intake step that asks every new client whether they are using an EAP, and gets the authorization or case number before the first session.

The EAPs, one by one

Optum Emotional Wellbeing Solutions (Optum EAP)

• Joining: Optum says no special certification is needed; all network therapists who have completed Optum’s credentialing and contracting can provide Emotional Wellbeing services (Provider Express: Emotional Wellbeing Solutions). See getting in network with Optum.
• Authorization: The member requests authorization through their Live and Work Well account or by phone. You can ask the member for the authorization information or use the Auth Look-up tool in the Provider Express secure portal.
• Billing: Optum lists five codes with the HJ modifier: 90832HJ (30 to 37 minutes), 90834HJ (38 to 52 minutes), 90846HJ, 90847HJ, and 90853HJ, with a diagnosis code, submitted by EDI or the portal. Optum says there is no member copay.
• After EAP: Optum says once the session limit is reached you can continue to see the member under their behavioral health benefit. Provider Service Line: 1-877-614-0484 (Provider Express).

Carelon Wellbeing (Carelon EAP)

• Joining: Carelon’s EAP page says its EAP providers come from its network of MFTs, counselors, clinical nurse specialists, psychologists, and social workers; join through Carelon’s Availity enrollment (Carelon: EAP providers; Carelon: join our network).
• Authorization: Carelon’s EAP handbook says participants are referred by a care manager, that you should confirm the sessions have been authorized, and that session models range from one to three sessions to as many as eight, depending on the employer (Carelon EAP provider handbook).
• California caveat: That handbook says it applies to participants outside California and that providers seeing California members should use the state-specific handbook. Ask Carelon for the California EAP handbook and follow its billing rules.

Kaiser Permanente EAP

Carelon’s California resources page, in its Kaiser Permanente of Northern California section, tells providers to call the KP National EAP Provider Line at 888-677-9993, available 24/7, for EAP (Carelon: California resources). Kaiser EAP is separate from Kaiser’s outside referrals for regular therapy; see getting in network with Kaiser through Carelon and billing Kaiser through Carelon. Some Kaiser-sold employer EAPs are run by other vendors (for example, a 2023 Kaiser broker notice in Hawaii names TELUS Health), so always check which EAP the client’s employer uses (Kaiser broker notice).

Magellan Healthcare

• Joining: Magellan’s EAP page says new providers should use its Join the Network page, and current Magellan providers should call Provider Services at 1-800-788-4005 to add EAP services to their contract (Magellan: join the EAP network).
• Billing: To be paid, you complete the Employee Assistance Service Information (EASI) form, online through the EAP Services portal or on paper, within 90 days of the end date in the case registration (Magellan: EAP reimbursement).
• Sessions: Magellan’s EAP FAQ says it does not pay for no-shows, a family in a five-session model gets five sessions total (not five per person), and members can use their insurance or self-pay after the EAP sessions are used (Magellan EAP FAQ).

ComPsych

ComPsych’s credentialing page lists requirements including a master’s degree or higher, malpractice coverage of at least $1 million per claim and $3 million aggregate, three years of post-graduate experience, and the highest level of licensure for your discipline. You submit an interest form, then an application if invited; ComPsych uses CAQH for recredentialing, and its Provider ResourceCenter handles referrals, claims, and requests for additional sessions (ComPsych: credentialing).

Lyra Health

Lyra contracts therapists to see members on its platform; apply on Lyra’s provider careers page (Lyra: providers). Scheduling, session limits, and documentation follow Lyra’s platform and contract, so read them before you accept.

Spring Health

Spring Health’s provider page lists an unrestricted license, at least three years of post-graduate clinical experience including one year post-license, and training in evidence-based treatment. The process includes an interview, credentialing, and a background check; it does not take clinicians who require supervision; providers use Spring’s own EHR; and Spring says onboarding can be as fast as 14 days (Spring Health: for providers).

Modern Health

Modern Health recruits therapists through its provider page and an application on its hiring portal, and runs a provider help center for onboarding and platform questions (Modern Health: providers; apply; provider help center).

AllOne Health (formerly ACI Specialty Benefits)

ACI’s website now redirects to AllOne Health, which has a provider page and an online provider application (AllOne Health: providers; application). Ask about session models and billing when you are approved.

CuraLinc Healthcare

CuraLinc’s network participation request form lists a master’s degree, five years of post-master’s experience, malpractice coverage of $1 million/$3 million, and an independent license. After you submit the form, CuraLinc says it sends a credentialing packet, typically within five business days. Network questions: networkgrowth@curalinc.com or 1-800-490-1585, option 2 (CuraLinc: network participation request).

Uprise Health

Uprise Health has a join-our-network page; its provider quick reference guide lists provider relations at providerrelations@uprisehealth.com, the provider portal, and 1-800-395-1616, and notes it combined several behavioral health companies (Uprise Health: join our network; provider quick reference guide).

Health Advocate

Health Advocate’s Care Connect page has a Join Now sign-up where you upload your license and liability insurance; after activation, Health Advocate’s care team checks your availability before referring a member. Support: AffiliateSupport@HealthAdvocate.com (Health Advocate: Care Connect).

Running EAP cases without denials

• Get the authorization or case number before the first session, and record the number of sessions and the end date.
• Use the codes, modifiers, or forms the EAP requires (for example, Optum’s HJ modifier, Magellan’s EASI form) and meet the EAP’s billing deadline.
• Do not bill the client for EAP sessions. Charge no-show fees only if your EAP agreement allows it (Magellan’s FAQ allows it with a signed agreement, capped at your Magellan rate).
• When the sessions end, follow the EAP’s rules for referring the client on or continuing under their health plan.

Bill for what you legitimately provide and document, and follow the payer’s authorization and documentation rules.

Associates and groups

Many EAPs require independent licensure and years of post-license experience, so associates usually do not qualify. Don’t have an associate see an EAP case that was authorized to you unless the EAP confirms in writing that it allows it. Associate billing must be confirmed in writing with each payer. See Can associates bill insurance in California?.