Medical Credentialing Service - Get on Insurance Panels, Provider Enrollment
What is Medical Credentialing and Why is it Important?
Medical Credentialing is the process of becoming affiliated with insurance companies so that your patients or clients can use their insurance to pay for your services, and so you—the healthcare provider—can accept third party reimbursement. In today’s medical marketplace, being able to accept potential patients’ insurance plans is crucial for the success of healthcare practices big and small. Put simply, if potential patients can’t use their insurance plans at your practice—be it a family medical clinic, a counseling office, chiropractic, dental, an optometrist’s office, etc.—patients are likely to “vote with their feet” and find a competing provider who will.
Unfortunately, medical credentialing can be an unwelcome distraction from providing quality care to patients–but it doesn’t need to be. Thriveworks also offers Expert Medical Credentialing for Nurses, Doctors and Physicians. Find out more about Nurse Credentialing and Doctor/Physician Credentialing.
Patients Want to Use their Insurance
About twenty years ago, physicians and healthcare professionals alike still considered medical credentialing (getting in insurance networks) to be optional for building a medical practice. In contract, today it’s 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. And in many ways, those health insurance plans cover more than ever before. One can go to healthcare.gov to read that previously not covered pre-existing conditions are now, by law, necessarily covered. One can also see that insurance plans also have “mental health parity” which means insurance plans cover services provided by mental health counseling and psychiatric practices.
One notable way that insurance plans are more limited than in years past in the absence of “out-of-network” benefits. When one has out of network benefits one doesn’t need to choose a provider who is in network. Instead, the patient can select any qualified provider and later file for reimbursement to his/her insurance company. Today, in contrast to years past, very few insurance plans have out-of-network benefits, and then they do (again, very rare), there are significant financial penalties to the patient for choosing an out of network provider. Hence, patients look in network to find a provider—sometimes the first place they look for a doctor or healthcare provider near them is their insurance plans preferred provider list.
Insurance Plans: Covering more Services than Ever
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.
However, the cost of health insurance in the United States has increased accordingly. Persons invest heavily into their health insurance plans, and you better believe when they need healthcare services—be it general medical care, emergency medical care, dental, chiropractic, optometry, or mental health services, or anything—patients desire (even demand) to use their health insurance plans when seeking those healthcare services.
Insurance Panels: Getting Full and Closing
Unfortunately, as droves of healthcare professionals apply to join insurance networks, those networks are increasingly becoming full (and sometimes even closing), 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 highly 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 Getting on Insurance Panels
If you're looking for a medical credentialing service that can take the burden of getting on insurance panels off of your plate, consider us at Credentialing.com. We’ve helped thousands of providers and practices get credentialed and we'd love to talk with you about our trusted and effective credentialing service.
Please feel free to call us at: 1-855-664-5154.
Meet our Team
We Surveyed Practicing Medical Billers,
and asked them about Top Insurance Companies
Overall Rating: 5★★★★★ based on 35
Navigating the credentialing process is time consuming for a busy provider--especially one who is trying to bu...Read more
ild a practice. Thriveworks reduces the workload and stress for the practitioner by putting a system in place to diligently apply to insurance panels and follow-up with each step of the credentialing process. The virtual basecamp is a convenient way to monitor communication and progress.
I found working with Ashley at Thriveworks a pleasure. She made the credentialing process simple and easy. She...Read more
was quick to respond to any questions I had, and remembered to keep me on my pre-determined schedule to get her all my documentation. I'm now on two panels and the whole process felt effortless. I highly recommend Thriveworks!
Always warm, friendly, and effective whenever I reached out to them, the Thriveworks team took on the Goliath ...Read more
of getting me credentialed. I'm trained as a psychotherapist and didn't have the know-how or time to trudge through the mess. DO contact them and save yourself the stress. Best investment I made in years!
I did some of the paperwork for insurance credentialing in the past. I will never do that again! It is not a p...Read more
leasurable experience! I was so happy to find Thriveworks! They followed up with me and the insurance companies. No matter how long it took, they were professional and efficient and I was very satisfied with the results. I will always use Thriveworks!
Thriveworks came to my rescue and removed the anxiety and paperwork from the credentialing process. Now I hav...Read more
e an ally and resource that I can depend on anytime I have a question or need assistance." But that pales in comparison to what I feel about your services. I am sorry I could not be more eloquent. I tell all of my colleagues about Thriveworks - it is an investment well worth the results.
Opening a practice is very stressful and I wanted a credentialing company that could help take some of the hug...Read more
e paperwork burden off my shoulders. Thriveworks was the perfect choice! They were fast, efficient and professional answering all of my questions and making me feel confident and informed every step of the way. Thanks so much for all of your help!
Thriveworks credentialing process is stress and worry FREE!! Your credentialing is completed by very friendly ...Read more
and helpful staff that will answer all of your questions or concerns promptly. I Felicia Perry LPC would highly recommend them for all of your credentialing needs. Community Behavioral Center LLC enjoyed doing business with Thriveworks.
Credentialing through Thriveworks was a seamless, painless, and efficient process. As a sole practitioner with...Read more
zero time for credentialing, Thriveworks took the stress off, provided clear and timely updates, and allowed me to focus more on my practice and my clients. The time saved and the stress avoided are easily worth the investment. Thank you Thriveworks!
Thriveworks was instrumental in helping me start my private practice. They handled the entire process of apply...Read more
ing to be a provider on various insurance panels, and ultimately was accepted on each of these networks. Thriveworks made this experience seamless and hassle free, allowing me to focus my energies and attention in my work with clients. The staff was professional, knowledgeable, and responsive to my inquiries/requests. I plan on continuing to utilize Thriveworks as my practice grows. Thank you.