Will medical credentialing work when insurance panels are closed? (Updated)

Closed Panels in Medical Credentialing: A Dead End?

From big cities to small towns, we receive many calls from healthcare providers who have contacted insurance companies, only to hear that insurance panels in their area are closed. Is this a final dead end?

Not necessarily! In our experience, many insurance panels that position themselves as closed are simply more or less what we call “restricted.” What we mean by this is that providers can still get on with some persuasion. Sometimes this means writing a letter in appeal, or calling the insurance company representative a few more times to let them know how important getting paneled is to you (and their insured customers), or stressing areas of your medical practice that are of particular interest or value to the insurance company.

While our success at getting clients onto closed panels isn’t 100%, many of our providers are happily surprised when we’re able to get them credentialed with insurance companies their colleagues told them were “already closed.”

Employ Our Help

This is just one of many headaches that can arise with getting credentialed—one we can resolve or prevent. Our team is full of educated, trained, and experienced credentialing specialists who know just what to do when you run into matters of the like: we can help you with appeals for provider credentialing to get on closed panels. It involves…

  • reaching out to a specific contractor
  • reaching out to a representative for the county you are in
  • sending a letter that entails all of your unique specialties and information about your practice.

The contractor will then review the letter and application in the appeals process. If that fails, we do have the option of reapplying every 6-12 months. Panels usually do a review of their panels at the end and beginning of the year. UBH reviews their panels every 120 days.

In reality, not all of the panels are closed. Maybe BCBS and UBH were closed, but some of the smaller panels are open. While there are smaller amounts of people in the area with that insurance, there are fewer providers with the smaller insurance companies. That way, you end up being a big fish in a small pond.

There are ways around closed panels. If you are in our system long enough, more than likely, we will get you credentialed with the large private insurances. Insurance companies keep your records and applications on files, and when there is an opening, they turn to your application.

If you’ve had enough of fighting with insurance companies, and filling out provider applications, just to have those applications lost or rejected, give us a call at 1-855-664-5154. We are happy to tell you more about our services or to answer any questions you may have. Additionally, we have posted a handful of helpful videos on our FAQ credentialing page, for your convenience. So, give us a call, or consider surfing around our site to find the information you need!