Today, Medical Credentialing is an important part of starting or building a private practice. In fact, even many veteran health providers, who have had successful cash-only private practices for 10 years or more, are now clamoring to begin or complete the process of medical credentialing (that is, they are working quickly to get on insurance panels).
This change has happened quickly, as universal healthcare has taken root in some parts of the USA (such as in Massachusetts) and will soon be nationwide. In addition, over only a few short years, the attitudes of patients (or clients) has changed.
In the not so distant past, clients / patients were willing to pay out of pocket for services rendered by therapists, counselors and other mental health providers. In contrast, clients today expect–and demand–that their counselor will be able to accept their insurance. Hence, if counselors don’t want to turn potential new patients away, they need to be credentialed with insurance companies.
It’s no secret that the process of medical credentialing isn’t something many health providers look forward to.
While medical credentialing will probably never become your favorite pastime, there are a few things you can remember that will make the process easier.
1) Expect to devote about 10 hours for every insurance panel you wish to be credentialed with.
Expecting that credentialing is going to involve just a few minutes of filling out an application will lead only to frustration. Instead, expect 10 hours of focused labor for each company you want to be credentialed with. This time will include retrieving applications, filling our applications, organizing necessary documentation, and following up with insurance companies by telephone.
2) Follow up with the insurance company often.
Insurance companies have a way of losing provider applications, or putting them in “limbo”–where they are not being reviewed properly and the medical credentialing process goes nowhere. The problem with credentialing application “limbo” is that if an application is stuck there for more than a few weeks, it might expire and be automatically rejected, leaving the provider (that’s you) with no option but to start again, from step one. Hence, you will want to call each insurance company every time an application (or any documentation) is faxed, emailed, or mailed to them. After that, you will want to call every insurance company about every 2 weeks, to check up on the status on your credentialing applications.
3) Consider getting medical credentialing help
For many health professionals, it makes pragmatic sense to find a reputable service to help with medical credentialing. Not only does using a credentialing service alleviate the frustration and headache of the process (many providers have heard the ‘nightmare’ stories from their colleagues), using a service may also save money, and a reputable service will likely have better success getting you credentialed efficiently–meaning you can start seeing those clients with insurance sooner, rather than later.
Interested in medical credentialing?
Give us at Thriveworks a call anytime at 1-855-4-Thrive. We’d love to have a no-pressure conversation with you about medical credentialing.
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