What is Medical Credentialing and Why is it Important?
Medical Credentialing is the process of becoming affiliated with insurance companies so that you (the medical provider) can accept third party reimbursement.
This is necessary for the success of a clinical practice, since it opens the doors for many individuals to take part in counseling. Unfortunately, medical credentialing can be an unwelcome distraction from providing quality care to patients–but it doesn’t need to be.
Patients Want to Use their Insurance
Just a few years ago, health experts considered medical credentialing to be optional for building a practice. Today, it has become more necessary than ever for providers to be networked with insurance companies. This is partially because more people in the U.S. have health insurance than ever before, but even more-so because patients desire (even demand) to use their health insurance when seeking healthcare services (rather than out-of-pocket payment).
Insurance Plans are Covering more Services than ever (Pre-existing conditions, Mental Health, etc.)
Medical credentialing is becoming more valuable as health insurance plans are becoming broader in regards to the scope of treatments they cover. These changes include mental health and behavioral health parity, as well as fewer restrictions on pre-existing conditions and the coverage of supplemental services. These services include physical therapy, massage therapy, acupuncture and others.
Insurance Panels are Getting Full and Closing
Unfortunately, insurance panels (for providers) are increasingly becoming full, which means the process of medical credentialing is becoming more challenging every day.
That being said, some panels that claim to be “closed” are really just being selective about which providers they are adding. Knowing how to position your practice and expertise can go a long way when it comes to getting into “closed” panels.
Help with Medical Credentialing
If you're looking for a medical credentialing service that can take the burden of credentialing off of your plate, consider Credentialing.com. We'd love to talk with you about our full-service medical credentialing offer that guarantees success.
Please feel free to call us at 1-855-4-THRIVE (or 617-379-3485).