How to Get In Network With Kaiser Through Carelon Behavioral Health (California Therapists)

How Kaiser outside mental health care works

Kaiser is a closed system. Kaiser’s own member page says members can get mental health care with no referral needed, that Kaiser starts with an assessment, and that “depending on where you live and the care you need, we may recommend a provider outside of Kaiser Permanente” (Kaiser: mental health care). So outside therapists only see Kaiser members after Kaiser decides to send the member out.

In Northern California there are at least two outside paths I could verify in official documents:

• Carelon Behavioral Health. Carelon’s California provider resources page has a section titled “Kaiser Permanente of Northern California” with Carelon’s authorization line and portal instructions for Kaiser members (Carelon: California forms and resources). Carelon’s Q3 2025 provider newsletter, under Kaiser Northern California, says to submit claims directly to Carelon for any Kaiser member referred to Carelon for outpatient therapy or medication management, and that those members “should never be billed to Kaiser” (Carelon provider newsletter, Q3 2025).
• KP Direct Mental Health Network. Kaiser’s 2024 Northern California HMO Provider Manual describes KP Direct as behavioral health providers contracted with and credentialed by Kaiser itself, where Kaiser’s local mental health clinics evaluate members first and then refer to contracted providers (KP NCAL HMO Provider Manual 2024, section 12.5). That is a direct Kaiser contract, not Carelon.

This page is about the Carelon path. Billing those referrals is its own topic: see how to bill Kaiser through Carelon.

Northern vs. Southern California

Be careful with what you hear in consultation groups. Here is what I could and could not confirm as of October 19, 2026:

If you are in Southern California, call Carelon’s National Provider Services line before you build your plan around Kaiser referrals, and ask whether Kaiser Southern California members are part of the network you are applying to.

Before you apply

1. License and NPI. An active, unrestricted California license (LMFT, LCSW, LPCC, or psychologist) and an individual (Type 1) NPI. If you bill through a professional corporation, you will also have a Type 2 NPI and an EIN.
2. CAQH ProView. Complete, attested, and current. Carelon tells CAQH participants to keep their information updated in CAQH and to authorize Carelon to view their profile (Carelon: contact information). Walkthrough: CAQH for therapists.
3. Malpractice, W-9, and a practice location you are comfortable having in a directory.
4. Openings. Carelon’s join page says you must currently be accepting new patients to apply as a facility, and Kaiser referrals are about access. In my experience, being able to offer a new client an appointment quickly matters more than anything else on the application.
5. An Availity account. Carelon says all new enrollment requests must be submitted through the Carelon Behavioral Health payer space in Availity, and you must be registered with Availity first (Carelon: join our network). Availity registration is free.

Step by step: joining the Carelon network

1. Register with Availity at availity.com. Each staff member who needs access should have their own login, per Carelon’s portal page.
2. Open the Carelon Behavioral Health payer space in Availity (Carelon’s standard payer ID in Availity is BHOVO, per Carelon’s portal page).
3. Start a new enrollment request in the Enrollment section and choose the right type: individual, group, or a provider joining an existing group. Carelon notes that a provider joining an existing contracted group also enrolls through the Carelon payer space.
4. Upload your documents and double-check every field against CAQH and NPPES. Carelon says incomplete, incorrect, or illegible forms may delay or prevent processing.
5. Say what you want. Applications are reviewed by network and need. Tell Carelon you are applying to serve Kaiser Permanente of Northern California members (if that is your goal), and list your languages, specialties, ages served, and telehealth or in-person availability.
6. Track status in Availity. Carelon says you can track your application there. Keep a log of dates and reference numbers.
7. Review and sign the contract. Carelon says that once you meet eligibility requirements, it sends the contract through its secure application to the email you used to register.
8. Save your welcome letter. It has your Carelon provider ID, which you need to register for the portal.
9. Register for ProviderConnect and link it to Availity for single sign-on (steps below).
10. Confirm your effective date in writing before you accept a Kaiser referral.

Sutter Health Plan members also come through this same Carelon enrollment process; see Sutter Health Plan and Carelon.

ProviderConnect vs. eServices

Carelon has two legacy provider portals, and both are now reached through Availity. Carelon’s provider handbook says ProviderConnect and eServices are “aligned with your health plan,” and that depending on your plan you may need to use both (Carelon Provider Handbook, section 2.01).

So the short version, which matches what I have experienced: Kaiser through Carelon is ProviderConnect; most other Carelon California lines, especially Medi-Cal, are eServices; and Availity is the front door for both. If you serve Kaiser and Partnership members, expect to use both.

To link them, Carelon’s handbook says: register for a ProviderConnect and/or eServices account, register for an Availity account, and then use organization administration in the Carelon payer space to link the accounts. You only do that once.

Credentialing and what to expect

• Credentialing verifies your license, education, malpractice, work history, and sanctions. Carelon credentials and periodically recredentials network providers; keep CAQH current so recredentialing does not stall.
• Timeline. Carelon does not publish a general timeline on its join page. Sutter Health Plan’s Carelon FAQ says it can take up to 60 business days for a Carelon network enrollment to be completed, which is a useful benchmark, not a promise (Sutter Health Plan: Carelon FAQ).
• Status questions. Carelon’s National Provider Services line is 800-397-1630, Monday to Friday, 8 a.m. to 8 p.m. Eastern (Carelon: join our network).
• Payments. Carelon is moving electronic payments to the Zelis ePayment Center; it asks providers not yet enrolled to register at carelon.epayment.center (Carelon: Zelis transition).

After you are in: how Kaiser referrals reach you

Being in the Carelon network does not mean Kaiser members can book with you the way a PPO member can. A Kaiser member has to be referred out first, and you need a Carelon authorization before you treat. The whole workflow, including the scripts I use, is on the Kaiser/Carelon billing and authorization page.

Carelon’s Q3 2025 Kaiser Northern California reminders also flag California’s timely access law (SB 221): follow-up therapy appointments within 10 business days unless the treating therapist documents that a longer wait will not be detrimental. Build your schedule so you can actually meet that.

Associates and group practices

Associate billing must be confirmed in writing with each payer, including Carelon. Carelon’s handbook says participating providers should not submit claims in their own name for services provided by an intern or another clinician, and it also lists a separate Supervised Clinician Group Roster form. I couldn’t find a public Carelon rule that says whether, or how, Kaiser referrals can be seen by associates, so get Carelon’s answer for your contract in writing first. Read Can associates bill insurance in California? before you put an associate on a Kaiser case.

If you are a group, decide whether you are contracting as a group (with a Type 2 NPI) or as individuals before you apply; changing tax IDs later usually means amending your contract. Carelon uses an amendment request process for TIN changes and new locations.

Common mistakes

• Applying to Kaiser’s general provider contracting line for outpatient therapy when the referral path you want is Carelon.
• An incomplete CAQH profile, or not authorizing Carelon in CAQH.
• Treating a Kaiser member before you have a Carelon authorization in hand.
• Sending the claim to Kaiser instead of Carelon.
• Registering for eServices only, then not finding Kaiser authorizations (they live in ProviderConnect).

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