Is Getting Credentialed Worth the Effort?
As a medical health provider, you may be wondering whether getting on insurance panels would be worth the time, money, and energy. The credentialing process involves many steps from the creation of your CAQH profile to the signing of your insurance panel contract, so the pros and cons of becoming associated with insurance companies must be weighed carefully.
The Benefits of Getting on Insurance Panels
Medical provider practices that do not accept insurance may cut themselves off from a significant portion of their potential client base. Since these providers do not appear on an insurance companies’ in-network list, these businesses may be less likely to be easily found by potential clients. Those clients who do find them may struggle to afford their services, and in some cases, will end up down the street with a competitor who is networked (or more affordable).
Getting on insurance panels increases your exposure to potential clients who are not only interested in your services, but also more likely to be able to afford them due to their insurance coverage. Despite the potential benefits, though, going through the insurance credentialing process has its downsides. The service rates you receive through an insurance company may be lower than what you could charge directly. In addition, the added billing responsibilities might prove challenging, especially if you do not have support from a billing service provider.
A Unique Practice Calls for a Unique Solution
At Reliant Practice, we understand that there is no one-size-fits all billing and payment plan. If you are a therapist, physician, or other healthcare provider considering joining insurance networks, we can help you answer all of the big questions:
What does it mean to be credentialed?
What is CAQH, and what is a CAQH profile?
What billing code should I add to this invoice?
Big questions need big answers—that is why we offer customized credentialing services to fit your business’s unique structure, needs, and goals.
Establishing Your Go-To-Market Strategy
If you have not yet decided whether joining insurance networks is worth the effort, we will give you the information you need to make an educated decision based on your goals and local market conditions. We can also help you identify which companies may be the most beneficial and effective with which to network.
If you are a therapist considering joining a mental health panel, we can advise you of the potential speed bumps you might encounter. Insurance paneling for therapists can be complicated, but we will help you navigate common occurrences, such as an insurance company’s coverage plan or employee assistance program (EAP) being managed through a partner company.
Completing the Application Process and Establishing New Billing Procedures
Once you have identified an insurance network you would like to join, we will be able to help you complete the application process as quickly and painlessly as possible. If you need help gaining access to closed panels, we can guide you with how best to plead your case by identifying and clearly communicating your unique value proposition or appealing their denial position.
If you are in the process of establishing new, insurance-based billing practices that adhere to insurance companies’ requirements, we will be able to assist with that as well. Having a claim denied for a lack of “medical necessity” or another technicality can be frustrating and confusing. However, our experienced team of professionals can help you navigate snags like these, ensuring you are paid the money you are owed. (Learn about our billing services).
Adapting to Change and Facilitating Future Growth
If your practice is moving from solo to group, you are adding a new location, or you have other ambitious growth goals, we can help you add or change insurance networks as needed. If that change includes dropping one of your current networks, we can help you decide whether to assist your clients with out-of-network claims or provide them a superbill with which to submit their own claims.
We understand that your insurance credentialing decision has the power to affect many different aspects of your practice. From practice management to billing to corporate workshops, we will help you head off potential setbacks and set you up for success.
Make Things Easy on Yourself With Reliant Practice’s Credentialing Services
We have years of experience running both self-pay and insurance-pay practices. When you hire Reliant Practice to guide you through the insurance credentialing process, you can count on a customized solution that is right for you. Whether you just need a quick consulting session or would like hands-on help with your application, we will give you as little or as much help as you need with the process.
The decision to pursue credentialing may be a scary one. Many private practice owners fear they will go through the time and trouble only to be denied, or that they will be accepted but unequipped to take on the added clients or billing workload.
We firmly believe that just because you can get credentialed with a given insurance company does not mean that you should. The guidance we provide will assist you with getting the help you need to get on the right path and prepare for any bumps you may encounter along the way. Contact us today to discuss how our medical and mental health credentialing services can support your professional goals.
It is true that joining insurance panels can open you up to a whole new pool of clients who will be able to afford your services through their insurance providers. But it is not as simple as just going through the application process and joining up.