Insurance Credentialing

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Overview: What is Insurance Credentialing?

Insurance credentialing is the process of becoming affiliated with an insurance company, so that you (the provider) can see customers/patients. As healthcare benefits are becoming increasingly universal across the United States, becoming credentialed with insurance companies is becoming more crucial than ever to running and growing a successful healthcare practice.

Consider this: a new clients walks through the door and is excited about scheduling a therapy session ASAP. Unfortunately, however, you don’t take their insurance (because you aren’t credentialed with any companies). More likely than not, they’ll have no choice but to leave and find a different healthcare provider who DOES accept their insurance. Because they can’t afford to pay out of pocket for the services, or simply don’t want to because they know they don’t have to.

Now, the process of insurance credentialing involves submitting extensive paperwork to insurance networks (which will take around 10 or so hours per company), and then weeks or months of follow up calls and letters with those networks/insurance companies. (You first have to make sure they’ve received your application and then continuously call to see that the process is progressing along.) If you are looking into getting credentialed, be prepared to provide documents and information including, but not limited to insurance board certifications, transcripts and other relevant education materials, training results, references, and any previous affiliations with doctors or hospitals.

Insurance Credentialing Process

With all of these documents and so much content to submit, the credentialing process can often be overwhelming to healthcare providers, who are simultaneously trying to provide excellent care to their patients and clients. The good news is you don’t have to do this process if you don’t want to. You can hire someone to do it for you so that you can focus on providing quality health care.

Getting Credentialed: We Know Someone Who Can Help!

*If you’re looking for help with medical billing or credentialing, consider our friends at Credentialing.com. They’re available to offer a timely quote, or help you find a solution. You can reach them at 1-855-664-5154 or by filling out this quick and easy form here:

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