Introduction
Congratulations on becoming a therapist! It is worth appreciating that you successfully made your dreams come true. Now you are an independent therapist with a practice of your own. But hold on, it is time to put up your feet. Now you have to explore diverse options to grow rich, and one of the best and foremost priorities is to access a reliable insurance panel. However, multiple options are available to approach and it might become comparatively difficult for you to figure out the best insurance panels for therapists. But you need not worry at all, we have got your back! Our extensively experienced professionals will take you on one fun-filled trip to help you find the most reliable panel for your practice. You will find out which panel is the best fit for your credentials, expertise, and the type of clients you are interested in working with. We will share with you the importance, benefits, and potential drawbacks of each insurance panel. Additionally, we will also let you know how much those panels typically reimburse and the important tips required to get on and off their lists. By the end of this whole process, you will be able to confidently build a thriving private practice with the support of a major insurance company.
In this blog, we will clarify all your confusion by clearly highlighting important queries such as what insurance panels are, what is panel coverage, what are the pros and cons for insurance paneled therapists, and how to get credentialed.
Understanding Insurance Panel
If you are a therapist and want to work with insurance companies, you must understand the procedure and technicalities involved in the insurance panel. Insurance panels are the networks of healthcare providers that insurance companies have contracted with to provide healthcare services to their members at pre-negotiated rates.
What uplifts your financial status is that once you join an insurance panel, a vast pool of potential clients begins to emerge, but at the same, it also has dark sides. Insurance companies reimburse at lower rates, which is a significant downside. Personally speaking, the benefits of becoming a member of the insurance panel outweigh the disadvantages, of course, compensation cannot be as high as privately paid clients, but it ensures a consistent stream of revenue for you.
There is a specific credentialing criterion that is essential for healthcare providers to qualify before becoming a member of the insurance panel.
Requirements To Join Insurance Panel?
The criteria require submitting the following documents:
- Certifications
- Licenses
- Minimum Experience
- Professional Liability Insurance
It may take three to six months to process the applications, and you must provide proof of education, insurance, licensure, and other documentation. Once you become a member of the insurance panel, then these companies will direct all its members to you for healthcare services, and handle billing, and claims processing.
The rates are set by the insurance company and are frequently non-negotiable.
It provides financial stability to healthcare providers to join the insurance panel. But its downside is that it involves lots of administrative hassles which often forces providers to limit the number of panels or choose to go off insurance panels in favor of privately paid clients.
The Best Insurance Panel for Therapists
It is essential for a therapist who is looking for avenues to grow his practice to sign up with insurance companies to ensure consistent revenue for the practice. At the same time, it is imperative to find the panel that sits perfect for your experience, credentials, client base, and treatment approaches. Conduct extensive research to find the insurance panel that reimburses the highest. And don’t hesitate to make the required changes that are necessary to best serve your clients. The most important strategy to ensure sustainable growth in your practice is to spend the most of your time focusing on what matters the most: the well-being of your client.
The Major Worth-Considering Insurance Players That Can offer The Highest:
Here we discuss some of the reliable and well-reputed insurance companies that you should take into consideration before joining an insurance plan.
Blue Cross Blue Shield (BCBS)
BCBS is one of the most incredible insurance providers. It opens a vast pool of potential clients for you when you become a participating provider. The application processing time can take a while, but its acceptance rates are higher for properly credentialed therapists.
Cigna
Cigna is an employee-focused organization, its members have a good average for mental healthcare services. Its application process is straightforward and rates are on the higher end of the spectrum. Its application process time is two months or more.
Aetna
Insurance paneling with Aetna brings lots of financial advantages as it has an extensive network and member base. Their reimbursement rates are fair and has an easy online application. Its approval time might take four to six weeks.
Medicare
You must enroll as a Medicare provider to serve as a Medicare members. This allows you to bill directly to Medicare for the healthcare services you provide. It involves lots of paperwork in the enrollment procedure but the reimbursement rates of Medicare are stable and the payment process is also reliable.
How Much Does Insurance Pay for Therapists?
As a qualified therapist, it is imperative to find ways to get paid for your services. Getting memberships of the insurance panel is essential for many therapists as it is the most feasible way to bill major insurance companies. However, it’s important to understand to know how much insurance companies will pay you for services you provide to their patients.
The amount insurance companies pay which are called reimbursement rates, varies from organization to organization based on:
The Insurance Company
Some companies such as Aetna and Blue Cross Blue Shield typically offer higher reimbursement rates than others. Government programs, Medicaid, and Medicare, usually pay on the lower end of the spectrum.
Your Experience and Credentials
Therapists with years of experience, licenses, and advanced degrees often qualify for higher rates. Such licensed psychologists may receive a higher rate than a counselor.
The Service You Provide
Reimbursement rates vary for individual therapy sessions, initial evaluations, group therapy, etc. The services involving specialized treatments tend to be reimbursed at a higher rate.
Graphic Location
Location is also one of the factors that has impacts on pricing such as affluent areas and large cities reflecting the overall cost of living in your area, charge high.
It might be anticipated that the insurance companies will pay therapists between $50 to $250 per hour for outpatient mental healthcare services. However, the rates for some panels might differ given the circumstances. The best strategy is to join two or three of the reliable insurance panels in your area and some smaller panels to get a good mix of referrals and pay. This is the best method as it keeps you providing an uninterrupted cash flow for your practice from more than one source.
How to Get Paneled with Insurance as a Therapist?
As a therapist, it is paramount to get insurance panels to build your practice. Getting on an insurance panel involves a written agreement between healthcare providers and insurance companies to provide services at an agreed-upon rate to the insurers. The best criteria to get on the panel is to fulfill the company’s requirement criteria and complete the credentialing process. Most of the time, it involves providing references, submitting an application, and undergoing a background check to verify your education and licenses.
Once you succeed in fulfilling the criteria and are approved as a certified therapist, the insurance company adds you to their provider’s list, making it easier for their members to find and choose you. After that, the company will directly pay you and set the rates for each service. When it comes to reliability factors, insurance panels are reliable sources and ensure steady streams of cash flow. That amount constantly keeps your cash flow moving. However, insurance paneling for therapists with insurance companies involves a lot of paperwork, and the reimbursement rates may be lower than your typical fee. Here are some of the important steps that help you get on insurance panels such as looking for major insurance companies in your area such as Aetna, Cigna, Blue Cross Blue Shield, and see what credentials they require. They often ask for a master’s degree, liability insurance, and a license.
You can also consult your colleagues for recommendations and references to include with your application to build your authority.
FAQs
How to get on insurance panels for therapists?
To get on insurance panels as a therapist, ensure you have a license, malpractice insurance, and an NPI number. Register with CAQH, choose insurance companies, and submit applications. Follow up regularly to check your application status. Once approved, sign the contract and start billing clients.
How long does it take to get credentialed with an insurance panel?
The credentialing process typically takes 60 to 120 days, but it can take longer depending on the insurance company. Delays may occur due to missing documents, high application volume, or additional verification steps.
Do I need to renew my credentialings with insurance companies?
Yes, most insurance companies require re-credentialing every 2 to 3 years to ensure your information is up to date. This process involves verifying your license, malpractice insurance, and any changes in your practice.
Can I apply to multiple insurance panels at once?
Yes, you can apply to several insurance panels simultaneously to expand your client base. This increases your chances of getting approved faster and allows you to accept a wider range of insurance plans.
What if my application is denied?
If your application is denied, you can appeal the decision, request reconsideration, or apply to other panels. It helps to ask for specific reasons for the denial and address any missing or incorrect information in your application.
