[expand title=”Q: What is the process of medical credentialing?”]
A: If you choose us to do your credentialing for you, we take 4 simple steps:
- Together, we identify which insurance panels work best for you.
- We provide you with a master survey to complete. This survey contains all of the basic information that insurance companies will need when considering your request.
- Using your master survey, we contact the insurance panels of your choosing, we retrieve the necessary applications, complete them, and submit them.
- After your applications have been submitted, our work still isn’t done. We will consistently follow up with the insurance companies to make sure that progress is being made and that your request is being considered.
Instead of spending hours completing and submitting paperwork and following up with insurance companies, you can spend your days giving your clients the excellent care they deserve.
[expand title=”Q: Which insurance panels are the best for me?”]
A: First, you’ll want to consider a few larger panels, such as Blue Cross Blue Shield, Tricare, Humana, Nationwide, United Health Care, and others. Secondly, you may want to consider being on a few smaller, more region-specific panels unique to your area.
We maintain a large database, complete with information about panels in your area as well as the applications for those panels. If you don’t contact us with certain panels in mind, we are more than happy to help you decide which ones are best for you.
[expand title=”Q: How long does medical credentialing take?”]
A: Typically, the credentialing process takes between 60 to 120 business days, or 3 to 4 months. This time frame can be relative to the panels you choose – some panels take a smaller amount of time, while other panels may require more information and therefore may take longer to respond to your request. Medical credentialing is a process that does involve some waiting, so it is wise to plan ahead with this in mind.
[expand title=”Q: About how many hours of work does medical credentialing require?”]
A: We dedicate an enormous amount of time to credentialing our providers.On average, credentialing a client on one panel takes around 8 to 10 hours of work. So, if you applied for 10 insurance panels, we would dedicate between 80 to 100 hours of work on your credentialing process alone.
[expand title=”Q: Am I guaranteed to get on the panels of my choice?”]
A: Do you remember applying for college and waiting months to know whether or notyou were accepted? Agonizing, wasn’t it? Credentialing doesn’t typically work that way. We often know at the very beginning of the process whether or not a panel is going to accept your request or not. If you are denied, we can do two things: 1) We can make an appeal to the insurance company on your behalf, or 2) we can get you credentialed witha comparable panel. Either way, you won’t lose out if a panel denies your request.
[expand title=”Q: What if a panel that I want to be on is closed?”]
A: If one of your panels tells us it is closed, the first thing we will do is submit an appeal. The insurance company will either formally deny your request and we will have to seek out another panel, or the company will push your application through anyway so you can finish the credentialing process. Sometimes, just a bit of persistence on our part is all that is needed to make insurance companies reconsider your request, and we always exercise every option at our disposal before moving on to another panel.
[expand title=”Q: What if all of my panels are closed?”]
A: The chance of all of your panels being closed is slim to none. As we said earlier, even if a panel does claim that it is closed, persistence on our part is generally enough to push through the closed door and get you on the panel of your choice.
[expand title=”Q: How much does medical credentialing cost?”]
A: For $200 per panel, our staff will work 8 – 10 hours on your credentialing process and any appeals that must be made. The time that you you would spend submitting your request and following up with the insurance companies can be better spent providing your clients with excellent care. Special discounts are available to practices with several providers.
[expand title=”Q: Will I be able to track the progress of my credentialing?”]
A: You can track your credentialing process in a few ways. We can provide you with a log-in to track your process on an online dashboard. Or, you can call us at 1-855-664-5154 and we can check the process for you. As we said earlier, whether you take on credentialing yourself or if you allow us to do it for you, credentialing is a process that does involve playing the waiting game, so chances are you will not receive an update daily. However, we will be contacting you each and every time we receive an update on your credentialing process, and you are always free to contact us with questions.
[expand title=”Q: Can a LMHC accept Medicare?”]
A: Currently, laws are being presented before Congress that could allow all mental health providers (LMHCs, LPCs, LMFTs, LCPCs, etc.) to accept Medicare as a third party payment. There are a small number of areas in the U.S. where this is not permitted. If the laws in your area don’t allow you to accept Medicare, we will work with you to find a comparable panel.