Getting Started with Insurance
Insurance can be a great way to create accessibility for your clients.
Navigating the process of joining insurance panels can prove challenging though. From dealing with lost applications to enduring lengthy hold times, many therapists opt to work solely with direct pay clients. Even for those willing to tackle the hurdles, becoming paneled can take up to four months.
Follow this step-by-step guide to smoothly navigate the process of joining insurance panels:
Step 1: Gather Your Documentation Prepare essential information and paperwork, including:
Licensure details
Practice address
NPI number
Resume
Proof of malpractice insurance
Taxonomy code (for Medicare/Medicaid billing)
Liability insurance proof (if applicable)
Any advanced training or credentialing documentation
Step 2: Complete Your CAQH Profile Utilize the Council for Affordable Quality Healthcare (CAQH) for credentialing, ensuring your resume is meticulously formatted with no employment gaps. Complete your application online through CAQH.org to avoid the cumbersome paper process. Maintain prompt responses to re-attestation requests to prevent delays in the credentialing process.
Step 3: Engage Provider Relations Select desired insurance panels based on reimbursement rates, provider support, and other factors. Seek recommendations from your network and contact each company's provider relations department for an application.
What to Do if Panels Are Full: Build rapport with the provider and emphasize your unique skills. Consider expanding services or offering specialized features to increase your appeal. Regularly revisit the company's capacity status and adjust your approach accordingly.
Step 4: Submit Applications Allocate approximately 10 hours per panel for application completion, follow-up calls, and contracting. Maintain proactive communication with insurance companies to prevent application stagnation or expiration. Keep thorough records of all submissions.
Post-Approval Checklist: Review and understand your contract terms thoroughly. Familiarize yourself with the provider portal for efficient claims management. Maintain a comprehensive contact list for pertinent departments.
While the journey may resemble a job application process, the benefits are substantial. Best of luck!