Medical Credentialing is Important for Building a Successful Practice — What else do I Need to Know?
Medical Credentialing is the process of becoming affiliated with insurance companies so that you (the medical provider) can accept third party reimbursement.
While important for the success of a clinical practice, medical credentialing is an unwelcome distraction from providing quality care to patients–but it doesn’t need to be!
Today’s Patients Want to Use their Insurance
Just a few years ago, health professionals considered medical credentialing to just be optional for building a practice. Today, it has become more necessary than ever for providers to be networked with insurance companies. This is partly because more people in the U.S. have health insurance than ever before, but even more-so because patients desire (even demand) to use their health insurance when seeking healthcare services (rather than out-of-pocket payment).
Insurance Plans are Covering more Services (Pre-existing conditions, Mental Health, etc.)
Medical credentialing is becoming more important as health insurance plans are becoming broader in regards to the scope of treatments they cover. These changes include Mental Health and Behavioral Health parity, less restrictions on pre-existing conditions and the coverage of supplemental services, such as physical therapy, massage therapy, acupuncture and other holistic health services.
Insurance Panels are Getting Full and Closing!
Unfortunately, insurance panels (for providers) are increasingly becoming full — meaning the process of medical credentialing is becoming more difficult every day, as insurance companies close provider panels and make the barrier for physicians, counselors or any health professionals higher and more difficult to climb.
**That being said, some panels that claim to be “closed” are really just being selective about which providers they are adding. Knowing how to position one’s self and expertise can go a long way when it comes to getting into “closed” panels.**
Medical Credentialing Help!
This website will provide helpful articles and tips for getting credentialed with insurance companies. Alternately, if you’re looking for a medical credentialing service that can take the burden of credentialing off of your plate, we can do that too. We’d love to talk with you about our full-service medical credentialing offer that guarantees success. Please feel free to call us at 1-855-4-THRIVE (1-855-484-7483).
How Long Does the Process take?
The process of credentialing can be a challenging and lengthy one, and generally takes between 3-4 months to submit the paperwork, submit supplementary documentation, and correspond with insuranace companies’ credentialing departments.
Because of the large amount of paperwork and correspondence that is required, medical providers generally find the process to be undesirable, and very time-consuming. That is why many counselors choose to be cash-only practices. But every client that you turn away for not accepting their insurance, is money that you can never recover from. In fact, many patients today are demanding that their counselor accepts their insurance.
Hence, insurance credentialing services such at Thriveworks (that’s us) are often an affordable and effective alternative to the DIY approach.
After wading through the process of credentialing ourselves, we have developed and mastered the credentialing process. It does not have to be so challenging. For more information or to get started on insurance credentialing, give us a call today.