Q: I would like to ask you a question about how insurance credentialing has been provided on behalf of Therapists of XYZ.
I heard something that there is likelihood that the company doing insurance credentialing has been providing insurance credentialing for Joseph and Mary as for practitioners which are individual and not as a first insurance credentialing XYZ which has been credentialing them as a group with the carrier and consequently credentialing Mary and Joseph under the group paneling as clinicians.
Please are you able to confirm that Thriveworks has been looking for acquiring XYZ group insurance credentialing for the carriers which are not paneled with the agency yet? On the target list there are some carriers which are already paneled with XYZ, however there still are carriers which we have to approach. Due to this I need you to provide some clarification for me to know how to handle this matter.
A: Hello George, you asked me a really good question and I am able to give you an answer. Mary and Joseph were insurance credentialed both under your practice group and also independently.
The outcome of this is that Mary and Joseph are insurance credentialed to practice at practice of your group and also to charge under the tax- id number which is assigned for your practice. Right now, they are not authorized for practicing anywhere else, however if they want to change or add the tax- id number to their billing practice, they may have a foot in the door with other companies.
A group practice insurance credentialing issue is handled differently, according to various insurance companies. Some of them have completed the application for the group which they sent as a first, and it is before we are able to add providers to the practice group. (There are also the cases when at the same time they sent three applications where one is for Mary, second for Joseph and the third is for the group.)
Other insurance companies add to their system the group after we insurance credential first provider of practice. For instance: company send in Joseph´s application with tax ID number together with the information about group and then both the group and the Joseph are put into the insurance system of the company.
I am really glad you are concerned about Joseph and Mary´s “wrong” insurance credentialing. It is due to the fact that they are insurance credentialed independently in lieu of the company where getting credentialed and after that also being under them (what protects the company).
Five years ago, I also faced similar concernment when for my own practice I first began insurance credentialing providers. I can assure you that their insurance credentialing is the only right way of insurance credentialing which works for practices of groups.
I hope this was helpful for you!
Yours sincerely,
Anthony
Thriveworks Credentialing
1-855-4-THRIVE
I am an LPCA getting ready to start a private practice in KY. However, as an LPCA, I can not bill insurance – I can only do that once I achieve LPCC status – which I am in the process of working on.
I am planning ahead and thinking about employees that I can hire, but I want to make sure these employees can bill insurance for their services.
Can you tell me what other types of credentials that you may be aware of in Kentucky that are insurance billable – such as LCSWs and LPCCs. Or could you point me in the right direction so I can research the information myself?
Many thanks in advance for your help!
Kelly
Hi Kelly, there are many. Look for fully licensed clinical social workers, counseling (as you said, LPCCs), marriage and family therapists, psychologists, or psychiatrists. The key is that they are fully licensed, and not intern-level/intermediate-level licensees. I hope this helps!
Kelly,
Would be very interested in how you moved forward with your practice as an LPCA. Thanks, Shellie
Hi Anthony,
Your articles have been so helpful to me in my pursuit to start my own practice. I worked as an independent contractor for another practice previously and was listed on certain insurance panels, but under the practice’s Tax ID number. Is there a way for me to change that with the insurance company, so that it is my Tax ID they have as a provider, and no longer listed as a provider for this other group? Thanks!
Nancy,
Thanks for your comment! Has me team contacted you yet to help you?
–Anthony
Anthony I have a question. How are group practices and inpatient facitlites able to hire LPCA’s bill for there services if LPCA’s are not able to be licensed on insurance panels? Is it because they are add to the group’s insurance panel and not independent panels?
Anthony I have a question. How are group practices and facitlites able to hire LPCA’s and bill for their services if LPCA’s are not able to be licensed on insurance panels? Is it because they are able to add them to the group’s insurance panel and not insure them as independent panels?
I am currently credentialed at a group practice and wanting to see clients on my own one day a week at a different location. Will I need to reapply?
Mary,
It is likely that you will need to re-apply with most of them, however with some panels you might have a good head start.