What Insurance Panels Do I want to Join? 4 Important Questions

If you’re just beginning to think about accepting insurance, you might be wondering: “What insurance panels do I want to join, and which do I want to avoid?”

There are a few major things to consider.

1) How much does the insurance company pay for services?

2) How quickly does the insurance company pay / reimburse?

3) Will I get clients if I’m listed on the insurance panel?

4) What are the biggest insurance companies in my area?

Let’s address the first question in this article :-)

1) How much does the insurance company pay for services?

It’s no secret what insurance companies pay. Every insurance company posts their fee schedule publicly. While this might be hard to find online, a call to the insurance company (or a few calls) should get you someone in the provider relations department who will send you their most updated fee schedule.

First Note: Fee schedules vary depending on area. BCBS of Massachusetts doesn’t necessarily pay the same as BCBS of California.

Second Note: Some insurance companies will negotiate with you, if you think their rates are too low for the services you provide (and some won’t). For example, Aetna negotiates but Blue Cross doesn’t.

Third Note: Even if an insurance company reimburses less than you would like, it could still be a lucrative relationship if you can see those patients on days / times when you have trouble filling your schedule.

Fourth Note: Insurance companies tend to restrict service times. For example, a counselor who usually spends 60 minutes with each patient, might find that an insurance-paid service is for only 45 minutes. This means that, even if you are making less money per patient, you could be making more per hour (you will just see more clients in the same time period).

Fifth Note: Some of your services might not be cover by insurance. For these services, you can bill the client directly. This can help you improve your bottom/top line.

I hope you found this article helpful. We’ll be posting answers to the other 3 questions soon. Remember, if you ever need help with medical credentialing (i.e., getting on insurance panels), simply call us at 1-877-747-9682 x-2. We look forward to talking with you!

Comments

  1. Marc B. says

    Hello,

    I am a LMHC (New York) practicing in a state agency setting. I’m currently exploring private practice opportunities and am interested in learning about any efforts/success you may have had assisting New York based LMHC’s to get on panels. The credential remains fairly new in NY and appears not to be widely accepted, (compared to the LCSW, etc).

    Thanks,

    Marc

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