If you are a licensed provider, the first step is to register as a provider here. Once you have registered, you will be asked to complete the onboarding application and upload all necessary documentation. A Mountain Strong Behavioral Health Provider must be credentialed by EVBH prior to contract execution. The submission of a provider application does not guarantee that EVBH will accept the provider in the EAP network.
In preparation for the onboarding process, you must be prepared to complete and submit the following:
- Copy of current CV/Resume with schools attended and dates of degree earned
- Proof of current Registration with the Colorado Department of Regulatory Agencies (DORA)
- Verified copy of your state license with active and expiration dates
- Proof of current Professional Liability Insurance Certificate of Coverage, including effective and expiration dates, policy number, limits, and the names of individuals covered. Please include Mountain Strong as a named additional insured on the policy.
- W-9 form; identify formal name filed with IRS for Tax Identification Number and submit with your signature. Please know that Mountain Strong will make all payments in accordance with the name listed on the W-9.
- Current Federal Drug Enforcement Agency Registration (If applicable).
- State Issued Controlled Substance License (if applicable).
- Copy of Board or Professional Certification (if applicable).
- Copy of ECFMG Certificate, if you attended a foreign medical school.
- Authorization to complete a criminal background check.
- Any explanatory statements needed for positive responses on the Confidential Questionnaire.
- Once the application is submitted, you will be contacted regarding next steps by a member of the Mountain Strong EAP team.
Once the application is submitted, you will be contacted regarding next steps by a member of the Mountain Strong EAP team.