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Mental Health Credentialing – How to Navigate the Insurance Credentialing Process

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Mental Health Credentialing – How to Navigate the Insurance Credentialing Process

If you are a mental health professional looking to expand your practice, insurance credentialing may be on the table. This process allows for accepting insurance payments from clients – an excellent way to expand both client base and income. However, for new providers it can seem like an intimidating hurdle.

The Affordable Healthcare Act (ACA) ushers in a new era where almost everyone is using some form of health insurance to pay for services. As a result, more therapists are needing to become credentialed for their practice.

Accrediting for insurance panels is a time-consuming and complex process, but it’s essential if you want to provide quality services to your clients. Fortunately, there are resources available that will guide you through this journey.

1. Selecting the Appropriate Insurance Companies and Panels for Your Practice

The initial step to getting insurance credentialed is deciding which companies and panels are ideal for your practice. Not all insurers and panels offer identical benefits or payment structures, so it’s essential that you select those which will maximize your revenue potential while providing excellent patient experiences. It will save time in the long run by selecting these top options for your practice.

In order to be credentialed by an insurance company, it is necessary to guarantee your credentials are up to date. This can be accomplished by obtaining the relevant national provider identifier number or NPI number; many insurers require this and it’s often free to obtain.

To become credentialed with EmblemHealth, you must submit an application and all necessary verifications. After this has been received by the CRC (Credentialing Review Committee), they will assess your application according to EmblemHealth’s credentialing criteria. Ultimately, either they approve or deny your request; you will then be informed of their decision.

Once credentialed, you must reevaluate your credentials every three years to maintain eligibility. The CRC and credentialing department will conduct this reassessment, which includes verifying primary source verification of licensure and accreditation.

One of the best resources to navigate through the mental health insurance credentialing process is joining an online group. The Facebook page, Insurance Billing and Credentialing for Mental Health Clinicians, offers helpful information from other therapists who have gone through it before.

Another great resource for therapists is the Insurance Answers podcast, hosted by two therapists who share their insights on insurance credentialing. They offer tips on avoiding common errors and pitfalls in this arena.

Even though using insurance can be expensive and time-consuming, it can open the door to a vast pool of new clients. Furthermore, being on an insurance panel gives you access to built-in bases of clients who will likely remain loyal over time, thus increasing the profitability of your practice.

Sign up here to try or learn about sound therapy that lowers anxiety, insomnia, pain, insomnia, and tinnitus an average of 77%.


- Welcome, SoundTherapy.com lowers anxiety 86%, pain 77%, and boosts memory 11-29%. Click on the brain to sign up or share with buttons below to help others:
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