Behavioral Healthcare Technology
DENmaar Guardian EHR/RCM Revolution

  Let’s discuss the Cigna Insurance Credentialing Process.

Cigna is a popular American health service organization based in suburban Bloomfield, Connecticut, and Philadelphia, Pennsylvania. Their insurance subsidiaries are major providers of mental, dental, accident, and life insurance to American citizens.

Cigna is known to provide Medicare and Medicaid programs to an individual in the U.S. and some international markets. Hence many physicians and medical practitioners want to become participants in the Cigna healthcare network. To become a participant, however, healthcare services need to apply for Cigna Insurance Provider Credentialing.

As we mentioned, Cigna has an extensive network of people who subscribe to their health insurance. If accepted as part of the network, a medical service provider naturally becomes an in-network provider and people with Cigna plan will be more inclined to use their particular medical service.

  The Process to Apply For Cigna Health Insurance Provider Credentialing 

The entire process of applying to get into any insurance provider network can be long and complicated. However, it is necessary to tap into those clients who have insurance, thus making the process mandatory to run a successful medical practice.

1. Pre Application

Before applying, Cigna requires practitioners to handover some necessary information to confirm that the applying practitioner is meeting basic guidelines of insurance credentialing with Cigna.

A Cigna health Insurance Credentialing representative is assigned to the practitioner who informs whether the applying party meets all the mandatory guidelines or not.

2. Submit Your Application

Once the practitioner is deemed compliant with Cigna’s guidelines, they send an e-mail with an application packet containing all the information needed to get started.

If the application information already exists on the CAQH aka Council for Affordable Quality Healthcare exists on the CAQH or One Healthport website, then Cigna Insurance Credentialing will with the applying parties permission, proceed to access it electronically.

The Following application information is required from the applying party, depending on:

•  State Medical or appropriate professional License
•  Drug Enforcement Agency Certificate (Mandatory)
•  Controlled Dangerous Substances Certificate (Mandatory)
•  Cigna participation in-hospital clinical privileges
•  letter of interest for insurance credentialing for Cigna
•  Board Certification Status
•  Professional and Educational Training
•  Work History
•  Malpractice Claims History
•  Adequate Malpractice Insurance
•  Prior Sanctioning Activities

3. Follow Up

Once Cigna receives the application packet, they will start the credentialing process. The entire process will take 45 to 60 days to complete.

During this time, the applying party will receive e-mails regarding:

•  Confirmation of Application received
•  Request any missing documentation or application information. If any fundamental document or information is found to be absent during the process, Cigna Insurance Credentialing will send a notification, notifying about the closure of that particular application.
•  Constant updates about the status of an application, including delays if any.

4. Cigna Approval

If Cigna approves a particular practitioner’s application, the practitioner becomes an in-network provider with Cigna. Cigna will update the provider information in their database within the next 10 business days.

Being a Cigna Insurance Credentialing in-network provider can be a very long and tedious process. The entire process requires at least 90 – 120 days to be completed and approved. There is a lot of paperwork, which makes the whole process quite frustrating for medical practitioners who want to accept clients with medical insurance. That is where the professional assistance of DENmaar comes into play.

With the help of our credentialing experts, we can walk you through the entire process by accomplishing tasks like updating credentialing with insurance Cigna, without any complications and hassle so that you can work on other core areas of your medical practice.

Error: Contact form not found.

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.

ABA insurance credentialing is one of the many crucial aspects required to run a behavioral therapy clinic. A successful medical practice has many moving parts that define its performance every day.  A healthcare organization must meet its credentialing requirements to provide services to their patients. If a medical practice fails, for whatever reason, to get credentialed with government medical agencies like Medicare, they cannot treat patients and collect payments from patients who are covered by the federal insurance program.

ABA Insurance Credentialing Therapy

Credentialing is the process of assessing the background and legitimacy of a medical practitioner and establishing the qualifications they require to become licensed professionals. As ABA therapists are practically board approved behavioral analysts, one cannot be an ABA therapist without meeting the credentialing requirements in their field of practice. With the help of ABA credentialing, behavioral therapy clinics are permitted to legally serve new patients and get paid by these patients for the services they perform.

Stop Losing Clients, Call us now on: 1-888-595-5101

Why Get ABA Insurance Credentialing

A Population Living With Autism Spectrum disorder

It is estimated that at least 3.5 million Americans today live with an autism spectrum disorder. The numbers signal the imminent demand for ABA therapists who have the skills and qualifications needed to provide medical attention to the ailing population.

Consistent Work

Probably one of its vital benefits is how it can get a medical practice onto an insurance panel, or better yet turn them into an in-network provider. This allows for dealing with billing codes, rates, and other reports and deliverables consistently. The overall uniformity this system offers can help healthcare enterprises make important decisions more effectively and efficiently.

Better Customer Support

As many insurance companies, today have their own team of autism specialists, in-network providers such as licensed ABA therapists have the chance to socialize and build valuable relationships within the organization that can help with faster claim resolution, or helps resolve queries regarding claim issues. This allows for pre-authorization, re-authorization, and claims information online. All of these factors ultimately enable clinics to provide better customer support to their customers.

Electronic Claims

Getting credentialed allows medical practices to send bills to insurance providers electronically. Electronic claims are a faster, more convenient way of receiving payments quickly than traditional paperwork. Unfortunately, this benefit cannot be enjoyed by medical practices that don’t possess the necessary credential requirements.

The Process of Getting Credentialed.

The ABA credentialing process is a tricky one. The whole process can take around 90 to 120 days to culminate. It is highly recommended that the credentialing process be started as soon as possible, especially for new medical practices. Because of its length of time, and complicated nature, it is highly advisable to seek the help of third-party support like denmaar who can get the job done for you.

The following is the process to get ABA Insurance Credentials

1.The first step towards getting credentialed requires medical firms to apply for an NPI aka National Provider Identifier. An online application requires the input of information like social security number, BCBA certificate number or BCaBA certificate number, Taxonomy code for behavioral analysts, and BA license number if applicable. The NPI is usually acquired within a day and is essential to receive reimbursements for ABA services with any carrier.

2.After the acquisition of NPI, the next step is to become a member of The Council for Affordable Healthcare. A medical practice can only become a part of CAQH. The medical practice needs an invitation from the insurance provider. Once the firm can log in to the CAQH system, they are required to submit a plethora of information such as employment history, references, resume, and W9, BCBA, or BCaBA certificates, educational history, information about medical practice.

3.After the application is completed, insurance companies will have access to the information provided. They will use the information to verify it with their agency.

ABA Insurance credentialing Medical practices need to be privy to all the plans and terms of coverage offered by insurance companies. It is also worth noting to get crucial information about a company’s ABA coverage. There is no point in the existence of a Behavioral therapy clinic without the necessary credentialing requirements. Credentialing is essential for medical practices to continue to accept new patients and receive payments to justify their services. The process to get credentialed can be tedious, a problem that can be alleviated by hiring third party professionals like denmaar who can do the heavy lifting for a medical practice.