Get on Insurance Panels FAQ – What you need to know about credentialing
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.
Have more questions, check out our most frequently asked questions below.
FAQ:
Q: Why would someone want credentialing? A: Being credentialed with insurance panels means that you are able to see patients who have specific insurance plans and bill those insurance companies for the services you render. This can greatly increase the number of patients who can access your services.
Q: What is the process of getting credentialed with insurance companies?
Q: Do I get to choose the panels I want to be on?
A: Yes. When you sign up for credentialing with us, you get to choose exactly which panels you want, and don’t want, to be credentialed with.
Q: What if I don’t know which panels in my area are best for me?
A: We can help! One of our credentialing specialists will talk with you by phone and can help you to select the panels in your area that will be best fit for you and your practice.
Q: What are some of the more popular insurance companies?
A: The popularity of insurance companies varies depending on location. However, some of the most popular and largest insurance companies are Blue Cross, Blue Shield, Aetna, Cigna, Magellan, Tricare, United Healthcare, Humana, Coventry, Highmark, Health Net of California, Kaiser, Wellpoint, Wellcare, Regence Group, Value Options, Medicare, and many others.
Q: How long does the credentialing process take?
A: The credentialing process generally takes between 90-120 days. When you sign up for credentialing with us, we waste no time getting your applications completed and submitted to insurance companies. We then follow up regularly with insurance companies to make sure that your credentialing applications are processed and approved as soon as possible.
Q: How many hours of work does insurance credentialing take?
Q: Do you have experienced credentialing providers in my area?
A: You bet! We have credentialed literally thousands of providers across the United States, including providers as far off as Alaska and Hawaii. No matter where your practice is, we have the experience needed to get you credentialed.
Q: Do you have experienced credentialing providers in my specialty?
A: We have credentialed healthcare providers of more types than we can list: from chiropractors, to behavioral health providers, to surgeons. If you are eligible to be credentialed, we can get you credentialed!
Q: Am I guaranteed to get on the panels I choose?
A: If you are fully licensed, we should have no problem identifying plenty of insurance companies and third party payers for you to be credentialed with. In some areas, some panels can be very selective or closed. In these instances, we will talk with you about the likelihood of a successful credentialing process. We want you to get the most out of your credentialing investment!
Q: What if the insurance panel I want to be credentialed with is closed?
A: Finding a closed panel can be frustrating. However, sometimes when panels say they are closed, they are still accepting providers, but on a limited basis. In the case of a panel saying that they are closed, we can still submit an appeal to the insurance company on your behalf. During an appeal, we will try to connect with the insurance company representative assigned to your area. We will then stress important parts of your qualifications and clinical practice. For instance, perhaps you have a specialty that the insurance company desires, or you are practicing in a neighborhood that is underserved. We do have success with many of our appeals. However, if a company is saying that their panel is closed, it might not be possible to get on the panel at that time.
Q: What if all the insurance panels are closed?
Q: Can interns / limited-license providers be credentialed with insurance companies?
A: Sometimes, but it’s highly unlikely. We have had success credentialing such providers on a limited basis—generally in areas that are very underserved. In most cases, insurance companies are looking to network exclusively with fully licensed healthcare providers.
Q: Can an intern bill patients under a supervising provider?
Q: How long do I need to wait after getting licensed before I can get on insurance panels?
Q: What exactly is a panel?
A: Good question! When we use the term “panel,” we are using an abbreviation for insurance panel, which is the group of doctors who are networked with the insurance company and are able to provide services for patients that have that insurance. A panel could also be an EAP Panel, which is the same thing, but with an EAP (Employee Assistance Program).
Q: What is an NPI number (an NPI 1, and an NPI 2)?
Q: What is CAQH?
Q: Can I get credentialed with an EAP (Employee Assistance Program)?
A: Yes! Like insurance companies, EAPs are valuable third party payers to be credentialed with. The credentialing process is very similar to being credentialed with insurance companies. In fact, some of the major insurance companies also offer an EAP. Popular EAPs include: ComPsych, OptumHealth, Magellan, Horizon Health, Mines and Associates, ValueOptions, Cigna, and Harris-Rothenburg International.
Q: How much does credentialing cost?
Q: How can I track my insurance credentialing progress?
Q: Can an LMHC accept Medicare?
Q: What is the process for getting credentialed with Tri-care?
Q: Can providers with a disciplinary action on their record still be paneled?
Q: DIY Credentialing: the number one challenge:
Q: DIY Credentialing: the challenge of “missing” information:
Q: For Physicians: do I need to be “Board Certified” to get on insurance panels?
Q: Do you provide medical billing?
A: Thriveworks offers billing services to it franchisees. Learn more about the exciting benefits of opening a Thriveworks Counseling center in your area, here: Counseling Franchise.
Hello,
I’m interested in opening a practice in another state and am interested if I can start the application process to get on some of the panels in the new state before I actually move. I also would like to know if being on panels for some of the bigger companies in my current state, will help to get on a panel in another state?
Hello. Just a quick question…can LCDCs be accepted on insurance panels. I live in TX. Thanks.
I just found this article, so I hope this is still checked. I am currently living and am licensed in WI ( but not currently practicing). I am planning on moving to to a different state and my licenses have already been approved. Three questions: how do I complete my applications if I have two active licenses in different states? and I get a job with an agency and start my private practice on the side, how does that affect the application process? and. How are most insurance companies responding to online video counseling?