How to Get Contracted with Insurance Companies for Mental Health Providers

Insurance Credentialing for Mental Health Therapists

The following guide explains how to apply to insurance panels as a mental health practitioner and how to get contracted with behavioral health insurance companies.  Please contact us about your results using this guide!

Introduction

With a larger supply of therapists today than ever before, learning how to get on mental health insurance panels (behavioral health insurance credentialing) can be an arduous task.  By following the guidelines below, you will naturally increase your attractiveness and probability of being accepted.  So let’s begin!

(Alternatively, if you do want help, we provide a super competitive mental health provider credentialing service.  Happy to help you with all of the paperwork and tracking and annoyance.)

Find Reputable Insurance Panels

Many of us are already aware of the ‘major’ insurance companies within our state.  Some sort of Blue Cross and/or Blue Shield, Cigna, Magellan, UBH, UHC, Medicare, and Medicaid are large, national brands.

1) Create a list or spreadsheet of all insurance companies you know of within your state.

Don’t stop yourself here, however.  Contact your professional network and hop on your favorite search engine to find other possibilities.  A simple search of “list of insurance companies in California,” for instance, will yield surprisingly good results (change your search to your state, region, or city, of course!).

2) Add these other insurance companies to your list.

Next we’re going to go online and find website and contact information for these organizations.  Again, load up your favorite search engine and search for the org in question.  Save their website into your list or speadsheet.  While browsing within their website, look for “new providers” or “apply” links.

Advanced tactic!  Load up google.com and type in the following:  “site:cigna.com provider application”.  This search will only give you results from the cigna.com website with the words “provider application” on the page!  Simply change cigna.com to the name of the insurance website you’re inquiring with and try this search.

3) Write down the link to the application in your sheet! And finally, dive in to the application for specifics!

4) Write down notes, specific requirements, and contact information for your application.

For a customized list of insurance companies to work with, reach out about our credentialing service for mental health therapists and behavioral health providers.

What Insurance Panels Want & Need

Insurance companies of all shapes, sizes, and locations need to find reliable, effective practitioners for their panels.  To stand out among the crowd, you need to present your skills, strengths, and abilities in alignment with the needs of insurance companies.  Specifically:

  • Location.  Insurance companies need providers in under-serviced locations.  If you live in a geographical area without a large number of practicing providers, apply!  Consider opening an office in an under-served area close by, often with cheaper rent.  Consider sharing an office as well.
  • Cultural Diversity.  Do you speak multiple languages?  Are you from an atypical ethnic background (and understand specific issues arising from said background)?  Make sure to mention these defining characteristics.
  • Availability.  Can you work on the weekends?  In the evenings?
  • Specialties, Certifications, Education, Training.  Highlight the extra education you’ve gained to ensure panels know you provide specific modalities of service.  Use brand-name terms like CBT and Dual Diagnosis.  If you specialize with kids, the elderly, LGBT patients, or other minority groups, keep this in mind for your letter of intent.
  • Crisis Therapy.  Panels want to know they can refer a patient quickly.

These specific criteria help you stand out and fill in gaps in coverage for insurance panels.

1) Make a list of specific ways you stand out which you’ll use for drafting your resume.

Create a Resume & Letter of Intent

page1-593px-Resume.pdf

Resume

Let’s create or update your resume!  Like with any other resume, the standard things  you learned in college apply:

  • Keep it short.  Ideally it’s one page.
  • Don’t mention things everyone else can do.  Exclude your proficiency in Microsoft Word and Excel.  Said inversely: focus on your differentiating factors.
  • Use the active voice and always shorten sentences.
  • Use popular terms and modalities of practice that apply.
  • Do not lie about your qualifications but do not under-represent your skills and abilities.  Don’t sell yourself short!

A simple format for your resume:

  1. Personal Contact Information & License Number with Date Received
  2. Objective or Statement of Intent
  3. Summary of Credentials, Qualifications, Skills, and Specialties
  4. Your Job Experience — make sure to include groups & organizations & references with contact information
  5. Your Education — if you speak multiple languages, include this here

And as always, ask a peer to review your resume!  While scary, an extra set of eyes will help perform a gut-check to ensure you’re not over-representing or under-representing your service.

Letter of Intent

Like your resume, you want your letter of intent to be high-impact and differentiating.  This is where you will reference the specific ways you stand out.  Make it personal and make it specific. Here is a great format for your letter of intent:

  • State that you want to be on XYZ insurance companies panel!  This is obvious but extremely important.
  • Write about your educational experience and credentials.  Mention specific training and modalities of practice you can offer.
  • Explain major differentiating factors such as your availability, location, languages, and culture diversity.  Show that you can offer specific assets to the panel that many therapists cannot.
  • If you already have clients from that panel and bill out of network, let them know as well.
  • Close by restating your intention and desire to work on their panel.

(You can also outsource all of this!)

Apply to Insurance Panels

Now it’s time to bring it all together and apply!download

1) Take your Resume and Letter of Intent and submit them to the appropriate provider application address.

2) Write down the date you submitted your application in an application log spreadsheet.

3) One week later (5-8 business days), call the application office to confirm submission.  Make sure to add the name of the representative and date you called to your application log.

4) Ask about next steps and expected followup time.

Be Prepared to Re-Apply

Insurance panels are often “full”.  Appeal and reapply!  Create a templated appeal letter ready for this exact reason, rehashing the differentiating factors in your letter of intent.

FAQ

The panel says they are not accepting new providers at this time.

Many panels will have an abundance of ‘average’ providers.  Do not take this seriously!  Make sure your application is read thoroughly by asking a representative.  Explain you provide differentiating skills, availability, and location.  Call call call!  Ask to speak to a manager to plead your case.  Ask where to write in an appeal letter.  Don’t give up!

No, really, they are full!

So be it, but their capacity changes quarterly.  Make sure to apply every three months.  Use your application log and a calendar reminder and apply again.  Between applications, update your resume and cover letter.

What will a panel ask when I apply?

As we’ve mentioned before, panels are incentivized to bring on providers serving unpopular hours, under-represented locations, and cultural minorities.  They will also ask about your modalities of service and theoretical orientation.

Because insurance companies only want to serve clients for as short of a time as possible, it is good to have skills in short term modalities like CBT and crisis intervention.  Likewise, panels will ask about the number of your clients who visit you for an array of visits, from 5 to 10 to 20 plus sessions.  They want to get clients “fixed” as soon as possible and hope to see your services end within 20 sessions, often sooner.  This is simply a reality of the insurance business so take it as a given and act accordingly!

They’ll want to ask about your license, credentials, and any complaints.  Have a set of references with contact information available upon request.

Can I practice from a home office?

This can be a limiting factor in getting accepted to a panel and is not recommended.

How many hours should I spend on each panel application?

Up to 10 hours on average to prepare all your material.  Treat panel applications like a job application because that is exactly what it is!  Take it seriously, dedicate time and resources to your application, and always peer-review and ask for feedback.  Put in the effort as it’s required!  If you want help, we offer extremely competitive credentialing prices.

I’m an intern or not licensed, can I be accepted?

Almost 100% no, but you can contact an insurance company to try to authorize reimbursement for claims handling one of their clients.  This is difficult.

12 Comments

  1. miyume April 8, 2015 at 2:55 pm #

    This is great! Very helpful!

    Reply

    Avatar
    • Denny February 1, 2016 at 6:48 am #

      Thanks so much Miyume, glad we could help! 🙂

      Reply

      Denny
  2. Priscilla V Marotta,PhD May 15, 2016 at 3:44 pm #

    Impressive summary with excellent points. Will refer new therapists in our practice to this resource.

    Reply

    Avatar
    • Denny March 16, 2017 at 2:20 pm #

      Thank you so much Priscilla!

      Reply

      Denny
  3. Urvi July 18, 2016 at 11:52 am #

    I have a questions. Can an independent contractor be placed on group practice insurance panels for multiple practices or are you limited to just one group practice?

    Reply

    Avatar
    • Denny July 19, 2016 at 10:21 am #

      It’s a matter of being credentialed within the group / billing NPI. So if you are approved under that NPI you can bill. Call to verify rendering NPI and group / billing NPI. There’s no limit to working under just one group NPI.

      Reply

      Denny
  4. Alicia K Caldwell March 11, 2017 at 3:10 pm #

    What do you think about thriveworks or any other companies that you give money to in order for them to do the leg work to get on insurance panels? Thanks!

    Reply

    Avatar
    • Denny March 14, 2017 at 10:51 am #

      Hi Alicia.

      The problem with credentialing services in general, and I cannot speak to thriveworks, is that they cannot guarantee any outcomes on behalf of their providers. Some panels really are not going to accept someone if they aren’t far enough with their education, just accepted a lot of providers, etc. This is why we don’t offer the service. Please ask your peers about them!

      Reply

      Denny
  5. Austin May 9, 2017 at 6:24 am #

    I am thinking about setting up a practice, but was wondering if you can get on a panel without first paying rent somewhere to get the permanent address? It would be a lot of upfront expense if you are not able to bill for up to 3 months.

    Reply

    Avatar
    • Denny May 15, 2017 at 12:29 pm #

      You need to have a service address so unfortunately you will need to find a medium-term office.

      Reply

      Denny
  6. Mary larson October 24, 2017 at 7:44 am #

    Once you get on a. Insurname panel, how do you get the patients through the door?

    Reply

    Avatar
    • Denny June 20, 2018 at 11:43 am #

      One benefit of being contracted with mental health insurance companies is that they are in fact sending you clients! So this does become less of an issue when you get on their panels.

      Reply

      Denny

Leave a Reply