Behavioral Billing® Credentialing Guide
UnitedHealthcare Community Plan 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
Mental / behavioral health and speech therapy can sit in different payer networks even under the same insurance brand.
Mental / Behavioral Health provider
Behavioral-health credentialing route
Complete DMAS/MES and UHC Community Plan participation; BH clinicians may also require Optum Behavioral Health / Provider Express depending on service and contract.
Open BH credentialing source ↗Speech Therapy provider
Speech / therapy credentialing route
Complete DMAS/MES. UHC directs outpatient PT/OT/SLP credentialing through Optum Physical Health; confirm the Virginia Community Plan product is added to the Optum Physical Health participation record.
Open speech credentialing source ↗Where the pathways differ: State Medicaid enrollment is shared, but specialty network is not: Provider Express is BH; Optum Physical Health is SLP.
Shared credentialing + network setup
Credentialing prerequisitesVirginia Medicaid enrollment active; provider/group data ready for UHC network process.Open source ↗
Network / payer enrollmentComplete DMAS/MES; use UHC Network Management Support. Behavioral-health participation may route through Provider Express.Open source ↗
State Medicaid enrollmentRequired — DMAS/MES.Open source ↗
Portal / identity setupOne Healthcare ID required.Open source ↗
Revenue-cycle enrollment
EDI / claims enrollmentElectronic claims/clearinghouse route using payer ID 87726.Open source ↗
ERA enrollmentUse UHC Provider Portal/remittance setup for 835/ERA.Open source ↗
EFT enrollmentUse UHC electronic payment enrollment/payment tools.Open source ↗
Clearinghouse / EDI routeUHC EDI / approved clearinghouseOpen source ↗
Payer ID87726Open source ↗
Before you start billingVerify DMAS + UHC participation, Optum BH routing if applicable, E&B, PA access, claim acceptance, remittance and EFT.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 · Core requirements reviewed
Payer processes change. Reverify the current payer instructions before submitting an application or changing a production billing configuration.