Behavioral Billing® Credentialing Guide
Humana Healthy Horizons of Virginia
Credentialing and revenue-cycle enrollment reference for behavioral health and speech therapy practices. Start with your provider type: the credentialing route may differ even when the insurance brand is the same.
Choose the correct provider pathway
Do not assume behavioral-health participation includes speech therapy, or that an SLP network contract includes behavioral-health services.
Mental / Behavioral Health provider
Behavioral-health credentialing route
Complete DMAS/MES enrollment and Humana Healthy Horizons join-network/credentialing steps. Confirm BH-specific participation requirements.
Open BH credentialing source ↗Speech Therapy provider
Speech / therapy credentialing route
Complete DMAS/MES enrollment and Humana Healthy Horizons join-network/credentialing steps. Confirm the SLP/therapy provider type; do not assume BH participation covers speech therapy.
Open speech credentialing source ↗Where the pathways differ: Credentialing may share a network framework, but benefit and authorization workflows remain specialty-specific.
Shared credentialing + network setup
Credentialing prerequisitesVirginia Medicaid enrollment active; provider/group data ready for Humana network process.Open source ↗
Network / payer enrollmentComplete DMAS/MES enrollment and Humana Healthy Horizons join-network/credentialing steps.Open source ↗
State Medicaid enrollmentRequired — DMAS/MES.Open source ↗
Portal / identity setupAvaility Essentials registration.Open source ↗
Revenue-cycle enrollment
EDI / claims enrollmentElectronic claims through Availity using Humana Medicaid route.Open source ↗
ERA enrollmentERA enrollment available in Availity.Open source ↗
EFT enrollmentEFT enrollment available in Availity.Open source ↗
Clearinghouse / EDI routeAvaility EssentialsOpen source ↗
Payer ID61101Open source ↗
Before you start billingVerify DMAS status, Humana participation, E&B, PA access, claim acceptance, ERA and EFT before production billing.Open source ↗
Before you bill: provider credentialing, specialty network participation, EDI, ERA, and EFT are separate checkpoints. Verify the correct specialty network before treating the first member.
Last reviewed: 2026-08-14 · Billing setup reviewed; confirm remaining credentialing details
Payer processes change. Reverify the current payer instructions before submitting an application or changing a production billing configuration.