How to Get Your Practice onto an Insurance Panel?
The United States has a healthcare system that couldn’t function without insurance. While many people, both patients and providers, would say that the design is flawed, it’s the way the system has been run and will continue to run for the foreseeable future. That means that as a provider, you’ll have to deal with insurance companies, and whether you’re in private practice or work for a hospital, knowledge about the insurance aspect of patient care plans is beneficial. Part of being familiar with insurance is knowing about insurance panels.
What is the definition of an insurance panel?
An insurance panel is a group of healthcare providers that an insurance company has agreed to pay for services administered to their customers. This is also known as credentialing, and in order to get on an insurance panel, you need to go through a lengthy process.
Why an insurance panel matters to your practice.
There are several benefits to being on an insurance panel. It can boost the reputation of your practice, since getting credentialed is a process that involves scrutiny and verification of your licensure and your expertise as a provider. It’s a way that insurance companies verify that your practice is legitimate. Being on an insurance panel also makes it so that you can offer your services to more people who may need insurance to cover part of the expense of visiting your practice. The more insurance companies you work with, the more potential clients you have. Lastly, being on an insurance panel is a great way to get automatic referrals to your practice. Insurance companies have provider directories for their customers. By becoming an “in-network” provider with these insurance companies, you will be a part of this list. People looking for the services you offer will search in their insurance policy for providers available in their network, which will ultimately lead them to you.
Steps necessary to get onto an insurance panel.
- The first step to getting on an insurance panel is deciding who to work with. This is where networking can come in. Talk to peer practitioners in your field to see what insurance companies they work with, do some research as to which insurance providers are popular near your practice, the companies that work with your direct competition, and which ones might set your practice apart. You’ll also want to consider their reputation when it comes to reliable and timely payments, any other benefits they may offer your practice, and whether they are easy to work with.
- Before starting a credentialing application, you need to register with the Council for Affordable Quality Healthcare (CAQH). After completing the registration, CAQH will provide you with a unique provider number. Once you have this number, the credentialing process can begin.
- Next, gather some information regarding both your practice and your status as a provider. You will need your NPI (national provider identifier) number, your licensure information, taxonomy code, your resume, proof of malpractice insurance, proof of liability insurance if you’re renting your practice location, and any documentation of advanced training and credentialing paperwork.
- Once fill out the CAQH, you can make absolutely no mistakes on it. Check it over, check it again, and have someone you trust to proofread it. Retain a copy for your records before you submit it because you’ll need to reference it every four months. There are online options for completing the form in addition to the paper version.
- Once your CAQH and application are completed, submit them, and again, retain copies for your records. After this point, you can follow up with the insurance company to check on the status of your application, but most prefer you to wait at least over a month before reaching out. This creates a significant gap while you wait for approval, but you should try to check in at least once or twice to make sure they have received your information and are processing your application.
- Finally, once you are approved, make sure you are well-versed in the insurance provider’s contract requirements. Each company can be different, so your practice will need to have knowledge of the documentation, claim processing, fee scheduling, CPT codes, and appeals processes for each insurance company you are approved to work with.
How can I streamline my insurance credentialing process?
Just like insurance companies support multiple providers, a given provider can work with multiple different insurance companies, which only multiplies the time and effort put into applying to insurance panels. Thankfully, the CAQH is only something you have to do once, but each insurance company has its own application process that you will have to complete in order to be considered for their panel. This is valuable time you could be spending helping and treating your patients.
This is where expert credentialing solutions like those offered through ClinicMind come in. They act as a mediator, in a way, between your practice and the insurance companies you want to work with, to make sure you’re providing all of the necessary information the insurance company requires to process your application so that you don’t have to scramble your brain from trying to keep everything straight. ClinicMind collects the necessary information and documents from you and handles the rest of the process while providing weekly updates. They can even compare your credentials with different insurance company benefits to help you decide which insurance providers could be a good fit for your practice, while also alerting you to any missing information needed.
ClinicMind can help your practice quickly navigate credentialing.
The faster you’re credentialed, the faster your practice can start processing claims through insurance companies, and the faster you can ultimately be paid for services rendered. The efficiency of that process is well worth the return on investment of working with a company like ClinicMind to help take care of the hard parts for you.
