Many people ask us, “Should I Get on Insurance Panels as a Group or Independently?” Here is how we helped out one such client:
Q: I would like to ask you a question about how insurance credentialing has been provided on behalf of the Therapists at XYZ Medical Center (my company).
I heard that there is a likelihood that your company has been credentialing my therapists, Joseph and Mary, as independent practitioners and not exclusively as a group under XYZ Medical Center. Consequently, with the credentialing services provided, I understand, that Mary and Joseph can now practice as independent clinicians, outside of XYZ Medical Center. Is this correct?
A: Hello George, you asked me a really good question. Here’s the answer: Mary and Joseph were credentialed both under your practice (XYZ Medical Center) and also independently.
The outcome of this is that Mary and Joseph are credentialed to practice in your group and under your practice’s tax- id number. Right now, they are not authorized to practice anywhere else, or independently. However, if either of them ever wanted to change or add the tax-id number to their credentialing contracts, they may be able to do this (and maybe not, depending on the company).
A group practice insurance credentialing contract is handled in various ways, depending on the insurance company. Some companies issue group contracts only if your practice has a certain number of clinicians (10-20 often), and some just don’t issue group contracts at all (they credential everyone independently and add your tax-id number as the billable entity).
I can assure you that Mary and Joseph’s insurance credentialing is accurate, and they are credentialed the best way to work at XYZ Medical Center. Can I help with anything else? Do you have any additional questions that pertain to insurance credentialing? If you do, we’d love to answer them. We’d also love to take the burden off and complete the credentialing process for you. Our team of credentialing specialists have completed the proper training to get you on the insurance panels you so desire. Call 1-855-664-5154 to speak with one of these experts, whether you have additional questions or would like to talk with someone about getting started with our credentialing service.
Hello, I am just now beginning the process of researching applying for panes as an independent practitioner. I do have an office space available but I was wondering if I am required to apply for an LLC before I can complete the panel application process?
Thank you
Kelli
I have heard that there is two ways to bill for Physical Therapy for a private practice….1. To bill under the Physical Therapist 2. To bill under the group. Can you tell me what the benefits of billing under the group is vs billing under the individual Therapist. Also, what are the disadvantages?
Working with you is better than doing creds myself with insurance companies, HOW??
Your phone system did not initially work at all, just looped over and again.
When I got through, I was told none available theyd call me back.
Also the response above is marginally intelligible English.
Working with you is better than doing creds myself with insurance companies, HOW??
Hi Dan,
Thanks for your comment! You are completely right about the phones. It’s Columbus Day, so we gave our sales team a half day. This threw a small wrench into a phone forwarding–you should have reached out 24 hour answering service. We have fixed the problem, sorry for the hassle!
Dan, about the marginally intelligible english on the page. You were being kind at that! I just revised the page. You found a webpage in the deep of our website that we haven’t looked at in a long time, and never edited. Admittedly, we never thought anyone would find it. Anyway, the page as been revised, and should be somewhat intelligible.
Certainly we’re not putting our best foot forward here. If you’re interested in talking with us, give us a call. We’ll be back at our desks tomorrow and perhaps we can rebuild some credibility with you. Sincerely, Anthony (CEO).
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.
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?
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?
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
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