What You Need to Know About Insurance Credentialing for Therapists

This blog post was written by our sponsor, Headway, as part of a paid partnership with CEU Creations and CE4Less. While CEU Creations and CE4Less do not receive any commissions or fees from the sale of Headway’s services, we are sharing this content to provide helpful insights for mental health professionals. 

Learn the best ways to approach insurance credentialing for your practice — and how to avoid common pain points in the process.

Billing insurance as a therapist can be a great way to grow your client base and expand access to mental health care. But the process of getting credentialed with health plans — or joining an insurance plan’s network — can be time-consuming and even stressful.

Following the right steps to get credentialed — including taking time to learn about the process before you dive in — can help set you up for success, saving you time and unnecessary headaches.

In this article, learn more about how to get credentialed with insurance panels so you can grow your therapy practice. 

What is insurance credentialing for therapists, and why is it important? 

Insurance credentialing, sometimes referred to as “paneling” or becoming “in network,” is the process of joining an insurance plan’s network. When you’re in the network, the insurance company is more likely to refer its covered patients (“members”) to you, and you can bill the insurance payer for services you provide. This vetting process is important because health plans want to ensure you’re licensed and properly trained to provide behavioral health care to its members before referring them to you and paying you for your services. The credentialing process also allows you to learn important information about health plans, such as their fee schedule and customer support tools.

Common challenges of joining health panels

Joining health plans as an in network provider can be a challenging process, especially if you’re navigating it on your own (and juggling all the logistics with your existing client load). Every health plan has its own, unique requirements, so you’ll likely be tasked with collecting and submitting different personal and professional information. 

Once you’re in network, you’ll also be responsible for submitting claims, which involves compliance and documentation requirements that vary by health plan. It can be time-consuming (and sometimes frustrating) to manage different plans’ payment schedules and, if needed, track down late payments.

That said: Joining health plans can be one of the best ways to grow your practice while meeting important mental health needs in your community. When you’re in network, you’ll have access to a broader group of clients, and health plans and other medical providers may refer their members to you. Being in network can also reduce the financial burden for clients, making it easier for them to start and stay in therapy.

How to get credentialed as a therapist

Though every health plan is different and credentialing steps can vary from plan to plan, most credentialing applications for mental health providers involve the below steps. 

Complete a CAQH application 

If you’ve never applied to be credentialed with an insurance company, then your first step is to fill out a CAQH (Center for Affordable Quality Healthcare) application. Many health plans refer to CAQH as a database of provider information. It’s a service the insurers pay to access, so you as a provider won’t have to pay for registration. You’ll receive a unique CAQH ID once you register, which panels may ask you to include when you fill out applications. You only need to register for CAQH once, but you’ll be required to re-attest the application every 120 days to continue billing health plans.

Identify health plans to join 

The next step is to research major health plans in your geographic region and your specialty. Asking your professional network which insurance payers are most common can ensure you capture the most potential clients. You may also want to identify plans from major systems in the area, so primary care providers can easily refer their patients to you. 

But joining health plans is about more than simply adding more clients to your schedule. It’s also important to find out whether insurance payers are reliable. Do your research to learn about fee schedules and ask other providers if they’ve faced setbacks getting paid.

Solutions like Headway make the insurance credentialing process much simpler! Headway can help you find plans you’re eligible to join, submit credentialing applications on your behalf, inform you about specific documents you’ll need, and even check the status of your application for you. Learn more about Headway.

Contact plans you’re interested in 

Once you land on health plans you want to join, you’ll need to inquire about their specific credentialing requirements and request a credentialing application. Some insurance websites make it easier than others to learn about the application process. You often find this information by searching “[insurer name] join network” or “[insurer name] mental health credential.”

Gather the required documentation 

Next, compile the documentation required for your application. Again, every health plan is different in its requirements, but they typically request a therapist’s proof of licensure, malpractice insurance, and your DEA certificate if you’re a prescriber. Save time by finding your CV, license information, NPI number, and any additional training or certification documents.

Fill out and submit the application

Now, it’s time to fill out the insurance network’s application. You’ll likely need to provide personal and professional information, including your education and work history, a history of malpractice claims if applicable, and any other details requested by the specific plan you’re applying to. Double check all this information before you submit to avoid frustrating delays in your application.

Wait patiently and follow up as needed 

Finally, once you submit your application, it’s time to wait for the health plan to review it. Typically, therapists can’t treat clients under health plans until credentialing is fully approved and processed. As a best practice, try to keep a record of which applications you submitted, when you applied, and any conversations you have with the health plans you apply to. The credentialing process can take anywhere from 90 to 120 days, depending on the specific plan. If needed, you can follow up with the insurance plan you applied for to ensure your application was submitted successfully.

How Headway simplifies credentialing for providers

Credentialing, as essential as it is to bill health plans as a therapist, requires patience. Many providers find themselves stuck in administrative limbo, delaying their ability to see clients and get reimbursed. This process can feel even more frustrating if you’re juggling application requirements when applying to multiple health plans.

If you’d rather spend more time seeing clients than filling out forms and following up, you can skip many of the above steps as a Headway provider. Headway, a service that makes it easier for therapists, psychiatrists, and group practices to accept insurance, helps you get credentialed in multiple states in as few as 30 days. Rather than repeating the same process for different health plans, just complete the process once — Headway handles all the credentialing steps and negotiates on your behalf. Once you’re in network, Headway also manages claims submissions and payments, so you won’t have to chase down your reimbursement — and all of these services are at no cost to you.

Instead of spending time and energy on administrative tasks, you can focus on what’s most important: supporting your clients on their mental health journeys. Talk to a practice consultant.

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