4 Reasons Why Insurance Credentialing Is Important

If you are in private practice, you’re a counselor, you’re working for a company, or you’re even a massage therapist, getting insurance credentialing is an important step to helping your practice succeed. If you try to defy this truth, you’ll quickly realize that doing so was a mistake. Imagine: a client walks into your practice and is interested in receiving your services. But then they find out you aren’t credentialed with any major insurance companies, including their own. Rather than saying, “Oh, that’s alright, I’ll just pay out of pocket!” they’ll likely walk right out and pay a visit to a healthcare provider who does accept their insurance. And it won’t be hard for them to find, possibly even right around the corner! If you need some further convincing, here are a few reasons why it’s important you get credentialed:

1. Insurance credentialing will give you leverage.

Many times, mental health professionals working for large therapy practices or hospitals assume that they do not need to get on insurance panels because their names are already listed with the insurance companies; however, that is not true.

When you are working for a large company or practice, there is the possibility to work under the contract the company has with the insurance company, meaning that you as an individual are not credentialed. Therefore in that case, if you decide to leave your job or start your own practice, you will be unable to work with the insurance of clients, despite having been able to accept insurance.

Insurance credentialing provides you both leverage and protection. Leverage in that you are not tied to one location; you can start your own private practice, and you can accept a wide range of clients. Protection, in that if you ever decide to leave your job, it protects you from losing compensation.

2. There are more HMOs than PPOs.

When a patient uses his/her insurance, he/she will require you to be paneled with his/her insurance company and to be in network. People with PPO plans can see psychiatrists, psychologist and counselors who do not belong to their network (these are, non-credentialed professionals with license), in some cases, but it costs the client more. Additionally, those with PPO plans could face considerable fees and penalties because they have chosen a provider who is out of network. But if a counselor has been credentialed by insurance companies, they will be able to accept more clients.

3. Universal Healthcare in the US means that everyone can see a therapist.

Many changes have been happening in the world of healthcare. One of the changes was the Affordable Health Care Act which was created to help USA citizens have health insurance. If you are not accepting insurance, you should. Many policies today allow your clients to use their insurance for visits.

4. Closing of Insurance Credentialing Panels

It should be noted that a lot of panels are closing at this time or are closed. This means that for new providers who are entering the field, you need to hurry to get on insurance panels before the panels close.

Getting credentialed can take between 90-120 days, so now is a great time to get started. For more information or to get started, call us at 1-855-664-5154 .