Insurance offers access to mental health care that many people might not otherwise be able to afford.
For therapists, accepting insurance as payment means joining an insurance panel. While there are many benefits to insurance panels—for both clinician and client—it can be a frustratingly complex process.
If you’re considering applying for an insurance panel, you might be confused about where to start. To help you understand the process, we’ve put together this guide to insurance panels for therapists.
What Are Insurance Panels For Therapists?
An insurance panel is a group of therapists who work with an insurance company to provide care to enrolled clients.
Joining an insurance panel requires a long process known as getting credentialed, and insurance providers will need you to prove your qualifications before you can join the panel.
The Pros And Cons Of Joining An Insurance Panel
Before you begin the long process of applying to an insurance panel, consider the benefits and the drawbacks.
Pro: Built-In Referrals
Built-in referrals are generally considered the main benefit to joining an insurance panel. The insurance panel is your referrer, and they are likely to have a wide reach.
Many clients will begin looking for a therapist through their insurance company, so they know they’re covered. Getting credentialed can help you reduce marketing costs, without losing business.
Pro: Access To Clients Who Might Not Pay For Therapy
For most, therapy is still considered a luxury, which means there are many people who will only consider going to therapy if they can reduce the cost with insurance.
By joining an insurance panel, you’ll have access to clients who might have otherwise avoided your service entirely.
Pro: An Indication Of Quality
Good therapists can work outside of insurance panels, but many clients see getting credentialed as a sign of quality. It can give you more legitimacy, and instill trust between you and the patient.
Con: Slower Payment
With self-pay clients, you’re likely to get paid almost instantly. At most, there might be a few days of waiting around for the bank to clear the payment. Things take longer with insurance panels.
For a start, you’ll have to apply for an insurance claim, which is a time consuming process. You’ll then have to wait for the money to come through. If the claim is denied, you might not get paid at all.
Con: Less Freedom
When you’re on an insurance panel, you have to follow the rules and regulations of the insurance company. The insurance panel will set your rates, so you’ll probably earn less per client.
Con: Reduced Privacy
While many clients prefer going through an insurance provider, others dislike the lack of privacy. Some clients will be unwilling to share mental health details with an insurance company.
How Do You Get On An Insurance Panel?
Getting on an insurance panel is known as “getting credentialed”, and it can be a time consuming process.
While the application won’t be exactly the same for every insurance provider, as a rule, getting credentialed requires filling in a lot of paperwork, and waiting to hear back from the company.
Find An Insurance Provider To Work With
The first step to joining an insurance panel is to find one you want to work with. Many of the drawbacks we’ve mentioned above—such as freedom and payment—vary depending on the insurance company.
Look through all your potential options, and pay attention to their reimbursement policy, the credentials they require, and their reputation. Ask colleagues for recommendations, and reach out to the companies themselves to learn more.
When you’ve chosen an insurance company (or companies), it’s time to start your application. Gather all the information you’re likely to need, before you begin your application.
Complete The CAQH
All insurance companies have their own application method, but nearly all require you to complete the CAQH. The CAQH, or Council for Affordable Quality Healthcare, is a non-profit coalition that insurance providers use for credentialing.
You will need to fill out a CAQH application, and if you’re successful, they’ll provide you with a CAQH number. Many insurance providers verify your data through the CAQH, so it’s a valuable resource if you’re applying to multiple panels.
You can print the CAQH application and fill it by hand, but it’s better to complete the forms online. It’s a more reliable method, and you’re less likely to make an error.
Before you submit the application, triple-check for any mistakes, as these can slow the process down.
Submit An Application
Now, you’re ready to submit your application. Keep a copy of everything you submit, as well as a record of when you made the application, and anyone you might have spoken with along the way.
Once you’ve made your application, be sure to follow up on it. Insurance panels will often receive large numbers of applications. If your application sits too long, it might expire, and you’ll have to start again.
Call to check that the insurer received your application, and check again every time you’ve submitted a document. Once your submission has been processed, call every few weeks to check on its progress.
It can take between 2 and 4 months for an application to be accepted or rejected, so be prepared for a wait.
If your application was rejected, you may be able to appeal. This can take another few months, but it’s worth doing.
Review The Contract
Once you’ve been approved, take a moment to read and review your contract before accepting. Familiarize yourself with the submission and appeals process, your fees, the current procedural terminology, and what the company will require from you.
Joining an insurance panel is an opportunity to consistently connect with clients, although the complexity of the billing process can have its downsides.
Therapists are able to join multiple insurance panels, and still work with self-pay clients, so there are many reasons to consider applying for an insurance panel.
Although the actual process of joining an insurance panel is long and complex, the eventual outcome is largely beneficial.