Insurance Credentialing: What companies should I get credentialed with?

A question we are often asked is “What companies should I get credentialed with?”

It’s a good question, and an important one!

While our credentialing experts can help you choose valuable insurance companies specific to your practice area, below are some general (but still very useful) guidelines that apply to most healthcare providers, regardless of their location in the USA.

Major Insurance Companies

First, there are a number of major insurance companies that cover 10’s of millions of lives across the USA. These are generally a good choice to get credentialed with. These include: Blue Cross, Blue Shield, Aetna, Cigna, Tri-Care, Medicare, Value Options, Humana, United Health Care…and about 10 others.

The Long Tail

It’s common (and understandable) for health care providers to want to get on the insurance companies that are most represented in their area. This makes sense! If Blue Cross is the most popular insurance company, there are going to be a lot of potential Blue Cross clients. However, you don’t want to miss out on “the long tail.” That is, don’t automatically assume that insurance companies that have fewer patients in your area are not good choices. They may, in fact, be the best for building your practice! Let me explain:

Let’s say Blue Cross, being a major insurance provider in your area, covers 100 people.

Humana, Tri-Care, Aetna, and Value Options are smaller, each covering only 30 people.

While Blue Cross seems like the most desirable company, someone credentialed on Humana, Tri-Care, Aetna, and Value Options would actually build his/her practice faster (120 people total), than someone credentialed with just BCBS.

In addition, the insurance companies with fewer customers in your area, are likely to also have fewer providers available to see those patients. This means that you might just find yourself “a big fish in a small pond.”

Note: If you are in a city with a major university, you’re likely going to have clients (students) with insurance plans from all over the USA!

So which to choose?

If you’re doing credentialing on your own, your selection of insurance companies depends entirely on the time you have for medical credentialing, and your tolerance for frustration with the credentialing process. However, if you hire Thriveworks to do the credentialing for you, our rates are designed so that you (the healthcare provider) make your money back after just a couple appointments with your first client on any insurance company.

Put another way, our rates for medical credentialing are so affordable that if you need to turn just one client away because you’re not credentialed with a specific company, you have missed out on profit for your practice (and the chance to help a patient!).

Call us at 1-855-664-5154 to learn more (always a no pressure conversation!)


Your Friends at Thriveworks