Receiving Your Credentials in Insurance

A few decades ago, it was considered that health care professionals did not need to be credentialed in insurance. However, with the increased security surrounding preferred provider networks, this optional step allows you to increase the number of patient caseloads dramatically, instead of just accepting private pay and HMO paid patients. But why was this not expected decades ago?

Years ago, patients did not expect every physician office to accept their insurance. They also didn’t expect all physicians to accept insurance plans. For example, mental health services were not typically covered on any insurance plan, even if the insurance plan covered out of network doctors. Some insurance companies did offer reimbursement services after the patient had already paid for the visit. Insurance has changed dramatically since then. It has become increasingly important for doctors to sign up with preferred provider networks because patients demand to have their choice of doctor and the health care field has become extremely competitive over the last few decades. Here are some reasons you should get your insurance credentials.

What Does Insurance Credentialing Mean?

Insurance credentialing is an important part of operating a medical office. It is the process of becoming affiliated with insurance companies and becoming approved to work with their payment processing and reimbursement system. It takes quite a bit of time to complete and can be a very distracting process. However, becoming approved for third-party reimbursement is necessary for today’s economy.

The Insurance Credentialing Process

While getting the insurance credentials for a medical office is necessary, it can be a pretty extensive process. Most of the applications are Over 30 pages long. And collecting the required data, and following up with the insurance companies, can be a very time-consuming task.

Companies that Specialize in Medical Insurance Credentialing

There are a lot of Credentialing Services that focus on managing the enrollment into various health insurance companies. They can be contracted with on a case by case basis. Or they can work with numerous insurance companies at one time to benefit a medical practice.

What Insurance Companies Should You Focus on First?

There are a lot of insurance companies out there and knowing which ones to sign up for first is key to building your practice. Forbes shows that the largest 5 insurance companies that medical practices should sign up for first include:

UnitedHealth Group

Anthem

Aetna

Cigna

Humana

Since the task of signing up with different insurance companies can be so time consuming and overwhelming, it is advised that medical practices start with the most popular insurance companies first, which are the five in the list above.

Where Should You Go from There?

After you have signed up with the top five insurance companies nationwide, you should take the time to sign up with smaller insurance companies to expand your patient reach. Not only will your community thank you, but the bottom line on your business will as well.