Credentialing

A Guide To Therapist Credentialing | Mental Health Credentialing

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December 17, 2021

The credentialing of therapists and mental health professionals can be time-consuming. However, its importance outweighs the difficulties associated with getting it done. 

It can take a lot of time and effort to sort through piles of paperwork, numerous complete forms, and fulfill various requirements for credentialing - especially If you don’t know what you are doing. 

However, with Float Care, you can focus entirely on providing quality care to your patients, while our automated credentialing process takes care of the details.

What is Therapist Credentialing?

Therapist credentialing is simply a process of background check conducted by the insurance company before entering into a contract with a mental healthcare provider.

Therapist credentialing, if done effectively, allows the mental health provider to partner up with insurance companies. 

Many clients pay for therapy through their insurance company. As a result, getting credentialed opens your doors to those types of patients as it is impossible to bill with insurance companies without credentialing.

Seeing the health benefits which most employees in the States have, the reason most of them would majorly work with in-network therapists ( therapists who have credentialed with their insurance company). In-network therapists can receive payments for their services from insurance companies.

The credentialing process can be tedious, long, and frustrating, but everything else becomes more manageable upon completion.

What is Involved in Therapist Credentialing?

Generally, credentialing is a long process that can take between a month and six months.

The insurance company will review professional history, work experience, and previous complaints filed against the provider during credentialing.

Additionally, the network will review licenses, degrees, work histories, and other evidence to ensure that the provider can provide mental health services.

Benefits Of Therapist Credentialing

Universal healthcare 

Through the Affordable Healthcare Act in the US, an environment has evolved where everyone can access a counselor.

Universal health care enables everyone to rely on insurance for any medical condition, including mental health issues. This means that therapists in-network with insurance companies can quickly reimburse for services rendered to their clients (enjoying the universal healthcare act). 

It also guarantees opportunities to work with many other clients in therapy as many of them will prefer working with a therapist they don't have to pay for directly.

Flexibility

Getting credentialed allows you to easily transition into your practice or a new location without losing access to the existing insurance panels supporting your services.

It also puts you in a position to negotiate a higher salary with your employer, seeing that you no longer need to be dependent on them for billing insurance.

Health Maintenance Organization (HMO) 

The time when therapists and mental healthcare providers majored in PPOs (preferred provider options) their patients are fast passing away. PPOs allowed mental healthcare professionals to work with clients without credentialing with insurance panels or accepting HMOs.

Due to reduced monthly premiums, most clients prefer to work with HMOs rather than PPOs. As a result, the use of PPOs is fast fading away as they are not financially feasible options anymore.

Even if you have a potential client who uses PPO, you will still incur a fee if you are out of their network.  

Therapist Credentialing Requirements

Getting credentialed as a therapist ideally takes some time after submitting the relevant documents. Float Care can ensure efficiency by automating the process. Meanwhile, you can file claims as an out-of-network provider.

Here are some things you need to put in place while undergoing the credentialing process.

  • Study the most used insurance companies in your area: This is an excellent place to start, and you can get started by checking in with your hospital and talking to who handles their medical billings.
  • Make sure you get the following required credentials before you start: Such as;

a.) An up-to-date full license

b.) Tax ID number

c.) A National Provider Identifier number (NPI Number)

d.) Proof of Liability Insurance

e.) At least three professional references

f.) An updated resume or CV showing employment history for at least five years

g.) Copy of graduate school transcript

  • Completing the Council for Affordable Quality Healthcare (CAQH) application process: CAQH Proview is the universal credentialing portal that almost all insurance companies use to authenticate their mental healthcare professionals. 

You are to upload every document needed to verify your credentials. Once registration is successful, you will receive a CAQH identifier number which is part of the requirements of insurance companies.

  •  Contacting Employee Assistance Programs (EAP's)
  • Contact each insurance group individually to complete the credentialing applications for them.

Do you need to get credentialed? Save time, and ensure efficiency with Float Care

Sign up today!

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