Credentialing for mental health providers is a necessity. For those who are unfamiliar with the process, it can be an intimidating amount of paperwork and requirements.
Here, in order to aid in the credentialing process, we answer the most frequently asked questions surrounding credentialing for mental health professionals.
The first question many prospective clients ask is “Do you take my insurance?” and “Will your office file my claims?” If your answer is “No” you could be turning away potential business.
What is Credentialing?
If you are a mental health professional, you may have heard of credentialing, but how does it affect you directly as a practitioner?
Credentialing is the process mental health providers go through to become an in-network provider with the insurance.
As an in-network provider, it’s a win-win. Not only your clients can maximize their benefits, but it also allows you to be reimbursed directly by the insurance company.
What are the Benefits of Credentialing?
Along with reimbursement, becoming connected within a system of insurance companies allows you to grow your client base.
For example, many employers in the United States offer health benefits to their employees, and if your mental health services are affiliated with the insurances these companies offer, then more patients can receive your care.
What’s the Credentialing Process?
We recommend starting the credentialing process as early as possible. Insurance panels have a tendency to fill up fast. Here is a list of the basic documentation that you should prepare:
- Personal references
- Academic references
- Transcripts
- Board Certifications
- Licensure information
- Practice address
- Resume
- NPI number
- Proof of malpractice insurance
Which Insurance Network Should I Join?
Before you apply, do your research. Insurance companies can vary widely in their reimbursement rates, payment turnarounds, and restrictions.
Some of the more popular insurance companies include:
- Blue Cross Blue Shield
- Aetna
- Cigna
- Humana
How Do I Apply to Get on a Insurance Panel?
Let’s break down the basics of getting credentialed.
- First, gather all of the information you will need for the documentation moving forward, including the information for the documents listed above.
- Fill out an application for the Council for Affordable Quality Healthcare (CAQH) online. Your resume must be pristine with no gaps in employment. Don’t lose any of your application information because you will be asked to “re-attest” to it 2-4 times a year.
- Submit your application to your chosen panels.
What Happens After I Apply?
After you apply, be sure to follow up.
Keep in mind, some insurance panels may say they are full or not currently accepting applications. Insurance companies are hit with thousands of applicants a day. While your application can be delayed or even denied, don’t be afraid to reapply if necessary.
How Do I Stand Out in the Credentialing Application Process?
Make sure to stay in contact and build a relationship with the insurance panels that you wish to join until they have openings available. Update them frequently on your skillset and experience while reviewing what services they require.
There are also a few ways to expand your services to differentiate the skills you offer. This can include:
- Being fluent in multiple languages
- Handicap-accessible facilities
- Offering crisis services
- Evening and weekend availability
How Much Does It Cost to Get Credentialed?
The cost of getting credentialed varies depending on how much of the application process you outsource.
There are companies that provide credentialing services that will do the application process for you. They offer to enroll in commercial and private insurance, Medicare and Medicaid, and register for CAQH and NPI among other services. These services will obviously cost more than doing the process yourself. These companies don’t guarantee becoming paneled.
The amount of time that it takes to complete the credentialing process varies by insurance. It’s best to connect with the insurance company to see what they outline in their policies.
How Long Does My Credentialing Last?
To ensure all your information is up to date, you will be required to go through recredentialing every 1-3 years. Each insurance company varies in their recredentialing requirements, so be sure to verify directly with them.
Resources for Applying for Credentialing
Here are a variety of quick links to help you kickstart your credentialing process.
Once I’m Credentialed, How Do I Start Billing Insurance Companies for My Services?
At Anchor Point Billing Solutions, we’re a team of psychologists and mental health billing experts working exclusively with psychologists, therapists, and social workers nationwide to help streamline your mental health billing processes and increase revenue.
We simplify the process by working with insurance companies, coding the billing correctly, assessing appropriate fees for services rendered, and helping you collect your fees.
We are here to help you get back to focusing on your passion: caring for your clients. Contact us today to learn more.