Behavioral Healthcare Technology
DENmaar Guardian EHR/RCM Revolution

The following article will tell everything you need to know about successfully getting on an insurance panel as a mental health practitioner. 

This goes without saying but getting on an insurance panel is no easy task and can be incredibly frustrating, especially for mental health practitioners with already a lot on their plate. One way to make the credentialing process less overwhelming would involve being aware of certain fundamentals related to the arduous but necessary task.

That is exactly what we at DENmaar aim to do with the help of the below guide. So, without much further ado, let’s get started.

Finding Reputable Insurance Panels

By now you must be aware of all the health insurance companies active in your city and state. From large brands like Cigna to national entities like Medicare, it would be wise to keep a note of all these names before you start the credentialing process.

We would recommend making a spreadsheet that includes all of these companies. Moreover, expand your search by contacting your professional network. If you aren’t sure how many insurance companies are active in your state, then doing a quick Google search will provide the answers you need.

Make sure you note down the contact and address info of each of the insurance companies you find online. Save this information on your spreadsheet. Learn about the conditions regarding provider credentialing that apply to each specific company and make a note of them as well.

Learn About the Requirements of Insurance Companies. 

Insurance companies are constantly on the lookout for reliable practitioners for their panels. You must make a good case about your skills and strengths as a mental health practitioner in your application.

Below are a few things that insurance panels seek in their applicants.

1. Location

Insurance companies look favorably upon practitioners who are actively serving patients in an under-served location. Your chances of getting on an insurance panel skyrocket if you are operating a clinic or practice in an area where that isn’t adequately populated with healthcare providers like you offering their services.

2. Cultural Diversity

Do not forget to mention your ethnic background, especially if you belong to an atypical one. Also mention if you speak multiple languages. These defining characteristics will increase your chances of getting on an insurance panel.

3. Qualities and Specialty

Make sure to emphasize the training and educational qualifications you possess. Do not forget to mention your specialties, especially when you specialize in offering healthcare to kids, elders, and LGBT or minority members of society.

4. Crisis Therapy

Insurance Panels are likely to look favorably upon healthcare providers that respond to emergencies quickly.

The above factors make you stand-out, and as such, should be emphasized in your application to increase your chances of getting successfully credentialed. We recommend making a list of everything that makes you stand out among other mental health practitioners in your vicinity before undertaking the credentialing process.

Create a Good Resume and Letter of Intent

You need a good, comprehensive resume that highlights your skills and accomplishments. Follow the below pointers to create a compelling resume and letter of intent.

• •     Make sure your resume is short. One page is more than enough
• •     Focus on things that make you unique rather than mentioning things that anyone can do.
• •     Always use short sentences
• •     Form sentences in active voice
• •     Do not misrepresent your skills or lie. Also, do not undersell yourself.

The following format will make for an ideal resume:

• •     Contact information, License number with date of issue.
• •     Statement of intent
• •     Credentials, skills, specialties, educational qualifications
• •     Mention job experience. Include references to the organizations you’ve worked with, in the past.
• •     Include additional skills like the ability to speak multiple languages, etc.

The letter of intent is another thing you must be careful about when composing. You want to be distinguishable while portraying yourself in good light. The below format would make for an ideal letter of intent.

• •     Clearly state the name of the insurance panel you want to be on.
• •     Mention your credentials and educational qualifications
• •     Explain what makes you stand out among your peers. This could be language, culture, availability, etc.
• •     Mention if you have clients that are already on that panel and are being billed out of network.
• •     Close your letter by letting your intentions and desire to join the panel crystal clear.

Finally, Apply to the Insurance Panels

Now that you are prepared, it’s finally time to submit your application.

• •     Mail your resume along with the letter of intent to the appropriate application address.
• •     Note down the date on which you applied.
• •     Call the application office exactly one week after submission for confirmation. Note down the name of the representative that answered your call for follow-up and mention the date you called on.
• •     Confirm the next steps and also ask when you can follow up next.
• •     If for some reason your application is rejected. Do not be heartbroken and be ready to re-apply immediately.

Conclusion

Getting on an insurance panel is tough but not impossible. The above guide will considerably simplify the process for you. To make the process even more hassle-free, we recommend you give us at DENmaar a call. We are home to the credentialing experts and resources needed to help you get on an insurance panel effectively and efficiently.

You can explore our website or contact us now to learn more about how we can help with mental health insurance credentialing.

How to overcome the challenges that medical credentialing faces?

Medical credentialing is one of the most critical compliance issues in medical practice today. However, this is a time-consuming and complex process to do it properly. A poor medical credential can lead to registration problems and legal and financial complications. Do you know what weakens the medical credentialing process? Here are the top 4 most common medical credentialing challenges that every practitioner should be aware of and solutions to overcome those challenges in the credentialing process.

What is medical credentialing?

Medical credentialing is the process of verifying and evaluating the eligibility of a healthcare provider with educational qualifications, employment history, training experience, special resident certificates, licenses, and other eligibility details.

Challenges in Medical Credentialing

1. Lack of staff to verify credentials.

The medical credentialing process requires an expert team or organization to provide credentials to each healthcare provider providing services to patients. Do you know whose credentials should be checked? The list includes doctors, nurses, physicians, assistants, therapists, and every other provider. For each individual, their full educational qualifications, employment history, training certificates, residence, licenses, and any board-issued certificates in the provider’s specialization area should be carefully checked. So it will consume more teamwork to handle this big operation properly without any error.

Not allocating enough resources or staff to complete the medical credentialing process – is a common mistake due to some methods. This reduces revenue and creates work stress for the limited team available. In addition, when employees make mistakes with the application and the insurance provider does not accept the application, it delays the payment process.

What is the solution?

Outsourcing the medical credentialing process to the medical billing service providers will help you overcome this challenge easily because a reputable organization retains responsible and expert staff for the credentialing process. So the team will handle everything smoothly and on time without any errors, which will save valuable time and money.

2. Incomplete application of service provider

Provider registration applications are essential for completing the medical credentialing process. So it should be done correctly with all the necessary information. Unfortunately, some methods may fail to do so accurately without losing any data fields, resulting in payment delays and rejection of claims.

What is the solution?

Human errors are common when working on provider registration applications. To avoid this error, software based on advanced credentials will help you do it right. In addition, this automated process usually requires less administrative effort – it eliminates human errors, which saves you time, money, and resources.

3. Update the information

Access to applicant information is a significant challenge for healthcare organizations. An excellent medical credentialing process ensures that the healthcare provider is up to date with board certificates and licenses. All healthcare providers must regularly renew their licenses and credentials and keep them updated. About 85% of approval requests contain incorrect, missing, or outdated information. Even small changes, such as an address or phone number, must be re-authenticated in the CAQH database before the system can process the application.

What is the solution?

The doctor’s contact information and other relevant data are readily available to help you speed up the credentialing process. The re-credentialing process will also take a long time. The law will also reduce such recognition issues.

4. Deadline

The medical credentialing process plays an essential role in the revenue cycle of your healthcare organization. The end-to-end process will only take 90 days for the organization to review the application. However, when considering additional stakeholders such as insurance providers – the process can take up to six months – adding to your organization’s downtime.

What is the solution?

Give priority to safety, and spend as much time as possible. If it takes less time, you will be ahead of schedule.

DENmaar’s Medical Credential Services – The right choice to make your credentialing process more accessible.

What do we do?

• •     Collects and reviews all necessary documents to ensure completeness and accuracy before submitting payment
• •     Relieves staff and service providers from the time-consuming task of registering and re-credentialing with government and commercial paying agencies.
• •     Ensures timely approval to all service providers to avoid payment delay or loss of payment
• •     Liaises with thousands of payments across all states and manages all communications and follow-up through an application approval
• •     Works with our billing team to monitor any denials and communicate with fee payers for immediate resolution

Where to get the best credentialing service?

We, DENmaar, are the home for credentialing professionals to help you manage and navigate all the paperwork without any hassle. Since we take care of the entire credentialing process from start to finish, you will have time to focus on patient care.

Over the past two years, hospitals and health systems have quickly deployed several telemedicine systems to look after patients during the ongoing Covid-19 pandemic. But unfortunately, many of these systems were not planned in great detail or designed with a view to sustainability.

Nonetheless, telehealth has taken root, and now healthcare providers face the future with mixed care: personal care and virtual care. As a result, providers are starting to think more about their applications of telemedicine technology.

CIOs and other health IT leaders are thinking about implementing health systems across hospitals and enabling doctors to use technology in their current workflow. Moreover, many officials are considering expanding the scope of technology in the hospital to include all departments.

Hospital’s technological needs have changed rapidly during pandemics, and many patient-facing systems are rapidly operating to meet the demand for video visits. 

  Hospitals seek permanent designs that are part of their workflow. 

In the last few months, what happened across the country has been shocking and has led to telehealth’s emergence from most healthcare systems’ basements. The concept that was once considered a “pleasure” at the use-case level quickly became a “necessity” at the enterprise level throughout the patient’s journey.

Many realize that successful, integrated telehealth solutions are more than just doctors on-screen. Instead, when deployed comprehensively, they act as a digital front door to the health system, delivering clinical experiences and ultimately improving patient commitment.

Integrated care for the individual has been proven to prevent and reduce health risks, and you can use virtual care technology to improve care outside of a hospital setting.

Telehealth is no longer a separate component or competitive advantage for hospitals and health systems – it is a requirement and will provide financial benefits, improved reputation, and care.

  Embedding system-wide telehealth technology as part of their ongoing workflow

Streamlining technical and administrative processes related to providing virtual care through modern and unified platforms will simplify the workflow and improve the care experience.

Combining technology and administrative processes reduces the administrative burden on platform users and increases communication and collaboration in the team.

A single platform promotes fewer login, screen, and apps and extended capabilities such as viewing appointments, accessing current patient information, and combining chat and video appointments with colleagues.

It is imperative to access the curated data presented as actionable insights on the same platform- This enables better personal care throughout the patient’s most needed journey.

  Virtual access to patient’s room

How can CIOs and their team take advantage of this technology and expand it within the four walls of a hospital? For instance, in every department, or even on every TV screen in every patient’s room.

Equipping each patient’s room with telehealth capabilities and virtual access gives carers instant access to patients for various cases.

Virtual nursing units are an example of this idea. About two-thirds of nursing tasks, such as drug testing and some paperwork, are activities that do not need to be touched, and the caregiver does not need to be physically at the bedside.

By enabling each patient room in a virtual nursing unit with telehealth equipment, bedside nurses can focus on providing high-quality patient care by carrying the burden of non-functional care and administrative tasks. We have seen virtual nursing units that can discharge patients about 20% more than conventional nursing units within two hours of receiving a discharge order.

Furthermore, some of these units discharge patients 44% more in the afternoon than their traditional nursing counterparts. These metrics help increase productivity in opening rooms early to accommodate more patients and improve patient satisfaction.

It is also vital to note that patients often interact with people other than doctors and hospital caregivers. Virtual in-room care, often via a hospital room TV or another in-room device, can enable social workers or family members to communicate safely and efficiently with the patient while in the hospital.

  Where to get the best telehealth solution?

DENmaar’s telehealth solution provides a quick and secure way to start a telemedicine session with the ease of a phone call. Whether starting with an electronic medical records system or a provider application, a click of a button prompts a patient to start a session. 

DENmaar’s TeleHealth system is HIPAA compliant, providing a safe way for patients to quickly and safely provide treatment or prescribed services.

Telehealth, telemedicine, and telenursing are changing the world of healthcare forever as we know it. DENmaar is part of that change, and so can you. Call us today!