Becoming a Provider:

What qualifications do I need to be on ACI’s provider panel?

All ACI providers must:

  • Provide evidence of a current state license as MFT, LCSW, or Psychologists. In some states, an alcohol provider or equivalent certificate is acceptable for M.A. level providers.
  • Demonstrate experience in working with corporations and/or EAPs.
  • Have extensive knowledge of community resources.
  • Provide proof of professional liability insurance at $1 million occurrence, $3 million aggregate, or higher.

How much paperwork do I need to fill out to join ACI’s Clinician Network?

You will find that there is minimal paperwork involved. To register as a clinician with ACI, follow the steps listed here. All forms may be downloaded and submitted through the website, or emailed to our Provider Relations team at

Can I self-refer the clients after the initial sessions?

Yes, ACI allows clients to self-refer to panelists following the EAP assessment and referral process. However, it is also expected that you will provide clients with at least two additional referrals to allow for their freedom of choice.

Where can I find the forms to join?

For your convenience, important documents that providers frequently access are located here. Feel free to contact our office at 858.736.0047 or if you have any questions.

Where can I find the billing forms?

You can find the W-9 and Program Utilization Form on the clinician section of our Providers page. Please contact Provider Relations at 858.736.0047 or if you have any questions.

Can I use any other billing forms, such as HICFA?

To keep the billing process simple for our providers, ACI only accepts our Program Utilization Form on the clinician section of our Providers page.

When do I send my billing forms?

Please send the completed Program Utilization Form within 30 days of your final session. If you choose to do so, you can send us your billing forms after each individual session as well.

Where do I send my billing forms?

You can email your billing forms to, fax to our Billing Department at 858.452.7819, or send these forms by mail to:

ACI Billing
6480 Weathers Place, Suite 300
San Diego, CA 92121

What is the billing turnaround time?

Billing is completed within 60 days from the date it is received.

I have further questions about billing. How can I contact ACI?

You can email, or call 858.736.0047.