FAQ – Getting on Insurance Panels

What is the credentialing process, when working with you?

Essentially, we manage all of the tedious, time-consuming work you don’t have time for.

We start by sending you a simple application we call the Master Survey. It asks you basic questions about what your education, expertise and license. This allows us to get to know you and so that we can identify the best way to get you on the panels you want.

Once this is done, we work with you to determine which insurance companies are a great match for your practice. We’ll provide a list of our best recommendations after researching the area you operate out of.

At that point, we handle the strenuous process of retrieving the credentialing applications, filling them out, submitting them and then following up continually to ensure that the insurance company approves the applications timely and efficiently.

We update you throughout this process via phone and an online dashboard that displays the status of your applications. We let you know immediately whenever we need additional information for your application, such as signatures.

How long does it take to get on an insurance panel?

On average, the credentialing process takes at least 3 to 4 months. That is why we highly recommend practices to begin the process as soon as possible in order to prevent losing clients who want to use their insurance. If you’re getting ready to start your practice, now is the perfect time to get started.


What if I don’t get on the panels I want?

Thanks to our experience in the industry, we’ve learned that it’s easy to figure out early on whether or not an insurance company is willing to approve your application and be in network with your practice. We use this information to determine which panels are worth the time necessary to apply for, making the chances of rejection pretty low.

It’s possible that your request for an application will be denied, but we can still appeal on your behalf to the insurance company. Otherwise, the best step is to move forward and focus on getting on other panels.

Is it possible to get on panels that are closed?

An important thing to know about closed panels is that they aren’t always literally closed. Often, insurance providers will say their panels are closed when they’re really just restricted. In that case, we’re able to appeal to the insurance companies and use the benefits of your practice to persuade the insurance company to let you on their panel.

Here are some of the advantages you may offer that are alluring to insurance companies:

1)  Your area is an underserved population

2)   You offer appointments for weekends

3)   You are affiliated with a credentialed practice that is referring clients to you

4)   You have a colleague who prescribes medication and is willing to refer patients to you

5)   You work with children

6)   You have extended office hours Have a handicapped accessible office

7)   You offer therapy in a second language

8)   You are certified in a niche therapy

9) Your office is handicap accessible

10) You have some other benefit such as an appealing specialty or resource that is appealing to insurance companies

Unfortunately, there are times when panels are actually closed, and appeals won’t help. But our success rate has been quite impressive to our current and past clients who have managed to get on closed panels.


How much does this whole process cost?

We strive to make our rates affordable and manageable by providing packages based on how many panels you want to be on. Put another way, it only takes a handful of appointments with a new patient/client to make your money back. That is money you would have lost had you waited to finish the credentialing process.


Who are you? And how did you get into medical credentialing?

We are Thriveworks Medical Credentialing (Thrive Counseling LLC), and we started out as a counseling practice in Cambridge. We experienced firsthand how tumultuous the credentialing process is, so we developed our own service for helping other good practices get on insurance panels without all of the hassle we had to go through.

Our expertise and credentials have been quoted in multiple news publications, such as the Boston Globe, ABC News, Boston Business Journal and many more. Our company is also a member of the Better Business Bureau and we currently maintain the highest possible grade rating with the Boston Chapter BBB!

If you’re running a chiropractic practice, or are getting ready to strike out on your own, can you be credentialed?

Absolutely! We’ve worked with chiropractors, doctors, surgeons, etc…

 

Credentialing with Medicare: Is it a Good Company to be Networked with?

Medicare is a really good insurance to accept, as it pays well, pays timely, and a lot of people have Medicare. However, the medical credentialing process is one of the trickiest.

Which Insurance Panels Should I be Credentialed With?

 

How Long Does Medical Credentialing Take (Update!)

 

How Long Are Insurance Applications?

While some applications are electronic, the vast majority still need to be printed and completed by hand. In this video, we show the Texas Medicaid Enrollment Application, that appears to be about 100 pages long. We printed this for one of our customers, and will need to fill it out, and mail it in to Medicaid!


 

How Many Hours of Work Does Insurance Credentialing Take?

 

What if the Insurance Panel I want is Closed?

 

What if All the Insurance Panels are Closed?

 

How can I Track my Insurance Credentialing Progress?

 

Can an LMHC Accept Medicare?

 

I have more questions. How can I get in touch with you guys?

We’d love to talk to you about your practice and credentialing goals.

Call us anytime a 1-855-4-THRIVE (1-855-484-7483).

Comments

  1. Ravi Lakkaraju says

    I have been in private practice in Michigan from last 14 years. I am planning to open a second practice in California. I don’t have a medical office address yet in California. However, I already have CA state medical licensure. I would like to use my California home address for credentialing applications. Do you deal with medical credentialing in California state ?

  2. Lori says

    I am in private practice in Deerfield Beach Florida. I am also on most insurance panels and understand the process of how difficult it can be. My question is that I have grown to be able to hire two contract workers and constantly market my office. I am so grateful that I have been able to do this but I am now stopped by the insurance companies who say that the contract workers need to be on the panels individually and most of the big ones are closed. My contract wrkers have different specialties than me, one works with substance abuse and trauma and one works wth children and adolescense. I have written to the insurance companies several times describing the differences of the therapists, the availability as we are open 6 days a week. Our emergency services which has a therapist on-call, as well as stating how important it can be for continuity of care if a family can be seen in one place andthe convenience for the family. I hve also hired a psychologist and have added that to my request and continue to get denied. At this point, I am ready to grow, but I am stuck! Any help would be beneficial. Thanks Lori

  3. Faith says

    I am credentialed with several insurance companies through the agency with which I contract. I am thinking about moving out from that agency. Will I need to start over with all credentialing under my own PLLC business name or will I be able to just coordinate with the insurance companies to move it to my own business?

    • supervisor says

      Hi Faith,

      Thank you for your question. If you are credentialed individually under your agency then you are only required to do a demographic update. A demographic update is a form that is filled out to change your information. This “update” can take up to 45 business days. However, if you are credentialed under the group through your agency then you have to start over. This requires for you to be dis-enrolled at your current location then filling out a new application. Basically if you are credentialed individually you can take your credentials with you when you leave and if you are credentialed under the group you cannot take them with you. I hope this answers your question. Please let me know if you have any further questions or would like to move forward with either process.

      Thank you,

      Chelse’ Matheny

  4. Nancy B. says

    I am moving from CO where I had a cash practice (and per State Laws did NOT need to be licensed) to NY – so I am unlicensed. I will register for a limited permit for NYS but am wondering if I am under supervision in private practice, can my Supervisor bill insurance companies for my work while I am pre-licensed/unlicensed? Or, in NY can I only be supervised and gain hours for licensure and be paid by a Medicaid funded facility. Thanks in advance!

    • Anthony Centore says

      In general (95% of cases) you cannot accept insurance, even under the supervision of a licensed and credentialed supervisor. Sorry!

  5. says

    I am setting up a new private practice in a new part of my state. I do not have an office yet and I want to start the credentialing process through CAQH. Is it any more of a hassle to use my home address while I look for office space? I just don’t understand how I am to afford an office while waiting to be credentialed.

    Thank you.

    • Anthony Centore says

      Hi Laura,

      What you are experiencing is actually pretty common. Credentialing is a lengthy and complicated process and the address issue is just one of many catch 22s. If you use your home address, you will need to eventually change it to your work address. The credentialing process takes 90-120 days, and the address change process can take up to about 30 days. Laura, if you think we could be of help, give us a call anytime at 1-855-4-THRIVE.

  6. Laura says

    I just passed my LCPC exam. I know it will take some time for my license to actually post but I was wondering if there is anything I can be doing now to get the process if medical credentialing started?

    • Anthony Centore says

      Absolutely! You can begin reaching out to the insurance companies that you want to work with, and requesting their giant applications. You can begin filling them out, putting your resume into the crazy format they request, and get everything ready with the exception of your license #. Once your license # comes in, fill in that final blank, and get those applications in to the insurance companies! –We have a lot of providers contact us after they’ve taken their exams, and we get started with their credentialing even before their license # comes in. –I hope this helps! :-)

  7. Shana says

    I am moving to another city and going to be opening my own practice. I know it takes about 90 days. Do I have to wait to move to apply or can I go ahead and get started on the process?

    • Anthony Centore says

      The question depends on a few factors, including licensure and practice address. Would you like to call us at 1-855-4-THRIVE? We could help you to review your options!

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