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Provider Information

 


Welcome to PMHM's section for mental health care professionals.

PMHM's provider network serves clients in all 50 states, the District of Columbia, and Puerto Rico.  PMHM staff psychologists help clients clarify what type of help they are seeking, and refer them to a therapist or psychiatrist in their area.

PMHM prefers providers with five or more years of post-graduate experience who have a cognitive behavioral, problem-focused approach.  These approaches empower the patient with the knowledge and tools needed for self-mastery and problem resolution.  PMHM providers exceed the industry standard for training, credentials and experience.

If you meet the following minimum criteria, there are two ways that you can apply to the PMHM provider panel.  You may click the link below the criteria and download an application.  You can also call the Provider Relations Department at 1-800-776-6793.

The minimum criteria are:

  • You hold a current license or certificate issued by a state board in one of the following disciplines:  psychiatry, doctoral-level psychology, independent clinical social work, or alcohol/drug counseling.

  • You have an unrestricted license or certificate.

  • You have current malpractice insurance with a minimum limit of $1,000,000/$3,000,000 or maximum state allowable, if less.

  • You have a minimum of three years (preferably five years) of postgraduate professional practice.

  • You subscribe to a theoretical orientation consistent with PMHM's philosophy of treatment.

Psychiatrist Application
Psychologist, Social Worker, CD counselor Application
 

All Application Forms Require Adobe Acrobat Reader

If you are a current PMHM provider, you may need forms for submitting claims.  The links below allow you to download several of the forms you need.  If you have any questions, please call us at 1-800-776-4357.

Downloads:  
HCFA 1500 Form (Requires Adobe Acrobat Reader)
HCFA 1450/UB 92 Form (Requires Adobe Acrobat Reader)
   
Treatment Outcome Report (TOR) (Requires Adobe Acrobat Reader)
Initial Medical Evaluation Report (IMER) (Requires Adobe Acrobat Reader)

 

PMHM also refers people for inpatient mental health or substance abuse treatment.  If you are a licensed facility, you can apply to the PMHM panel.  You may click the link below and download an application.  You can also call the Provider Relations Department at 1-800-776-6793.

Inpatient Facility Application
 

All Application Forms Require Adobe Acrobat Reader

 

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"At PMHM our mission is to provide quality behavioral healthcare

 to our nation one employee at a time".

 

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