Mental Health Insurance Credentialing – The Process

Mental health Insurance Credentialing for psychologists and counselors have become extremely important today. Mental health specialists, just like other practitioners, need to go through an extensive credentialing process to validate their practice.

By forsaking credentialing, a practitioner compromises on a good number of clients covered under the federal insurance program. With a clamoring for more progressive ‘medicare for all idea floating in the United States political spectrum, credentialing has never been this urgent for mental health specialists.

Mental Health Insurance credentialing and billing for mental health professionals

Now, if we assume that a physician works on a $100/hr, pay, that’s approximately $20000/year in credentialing work per physician. This is excluding any paperwork; of course, you lose more money if you lose relevant documents.

In hindsight, you are spending way more than $20000/year. Credentialing services cost way less when outsourced to a third health insurance credentialing specialists like Denmaar.

Credentialing Cost Breakdown

Individual Practitioner Cost – 100-200$ per physician

CAQH Database

Initial Setup Cost can go up to $200-$500

Panel Application Cost

Practitioners should expect to pay $100 per panel

So, on average, the general cost of physician insurance credentialing services is somewhere between $2000-$3000/ year.

Most of the cost incurred in the process of Mental Health Insurance Credentialing services is because of its lengthy nature. You lose money if you lose your documents. You lose money, if you fail to follow-up with the insurance companies, resulting in the expiration of your application. The entire process has too many pot-holes for medical practices to crash and burn.

Hence, it is highly recommended to use the help of third-party experts like Denmaar for Mental Health Insurance panel credentialing.

Mental Health Insurance Credentialing Process

1.Getting Your Information in Order

As we mentioned before, credentialing requires a lot of information and documents from the
practitioner.

They are:

•  Licensure Information
•  NPI Number
•  Resume
•  Proof of Malpractice Insurance
•  Taxonomy Code
•   Proof of Liability Insurance from Landlord (Applicable on if you are renting)
•   Credentialing Paperwork

2. Fill Out Your CAQH

You will find many companies who use the Council of Affordable Quality Healthcare for the purpose of credentialing. Before filling out the CAQH form, you are required to hold an authentic resume with no gaps in employment. The application is supposed to be completed online via the CAQH hub.

The entire process can be extremely confusing to follow, but we at Denmaar assist you till the end.

3.Contact provider Relations

Once you have gone through the CAQH process, you are now afforded the liberty of choosing which insurance panel you want to be on. The insurance companies you choose may vary in the department of reimbursement rates, provider friendliness, payment speeds, etc.

Some companies may have their own sets of rules and requirements to apply. Now here you might face an issue of rejection, or not being accepted because the panel is full.

In such cases, you can do the following to build relationships with networks to gain access for future openings:

•  Evening and Weekend Availability
•  Experience with special populations
•  Crisis services
•  Handicap accessible facilities
•  Being located in an underserved area
•  Multilingual fluency
•  Having an in-network referral source.

4.Submit Application

Once you have taken care of the documentation and decided on which insurance panel to join, it’s time to submit the application and wait. The entire process of getting paneled is relatively swift, culminating within 9-10 hours.

All you have to do now is a follow-up. You have to keep tabs on the status of your application. Chances are it might expire while still in the process if taken too long, and you don’t want to start again. The insurance companies have to be notified every time you submit a document to ensure it has reached them.

5.Review after Approval

Once you have received approval, it is still not an appropriate time to celebrate. Do the following to be on the safer side.

•  Review your contract carefully before signing
•  Keep a file with the agreement and any addendums ready for future reference.
•  Learn more about the insurance provider’s portal on its official website.
•  Collect a list of phone numbers for the claims department, pre-authorization department and provider relations.

Once you have taken care of the above bucket list, you are ready to sign. To speed up the process, Denmaar’s will help you submit your claims electronically. This will help you save time, money, and paper.