Medical Credentialing

Not too long ago, potential clients/patients would sheepishly ask “do you accept my insurance?” Today, they demand it!

Medical Credentialing is the process of becoming networked with insurance companies so that you can accept your patients’ insurance.

In other words, Medical Credentialing is the process of becoming affiliated with insurance companies so that you (the medical provider) can accept third party reimbursement.

While important for the success of a clinical practice, medical credentialing is an unwelcome distraction for many health professionals working to provide quality care to their patients, but it doesn’t need to be!

Today’s Patients Want to Use their Insurance

Just a few years ago, health professionals considered medical credentialing “optional” for building a practice. Today, it has become more necessary than ever for providers to be networked with insurance companies.

In part, this is because more people in the U.S. have health insurance than ever before, and patients desire (even demand) to use their health insurance when seeking out health care services (in lieu of out-of-pocket payment).

Insurance Plans are Covering more Services (Pre-existing conditions, Mental Health, etc.)

In addition, medical credentialing is becoming more important as health insurance plans are becoming broader in regards to the scope of treatments that they cover. These changes include Mental Health / Behavioral Health parity, less restrictions on pre-existing conditions and the coverage of supplemental services, such as physical therapy, massage therapy, acupuncture and other holistic health services.

Insurance Panels are Getting Full and Closing!

Unfortunately, insurance panels (for providers) are becoming increasingly full — meaning the process of medical credentialing is becoming more difficult every day. As insurance companies close provider panels,  the barrier for physicians, counselors and health professionals becomes higher and more difficult to climb.

*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 one’s self and expertise can go a long way when it comes to getting into closed panels.*

Medical Credentialing Help!

If you’re looking for a medical credentialing service that can take the burden of credentialing off your plate, consider Thriveworks. We’d love to talk with you about our full-service medical credentialing that guarantees success.

Please feel free to call us at 1-855-4-THRIVE (1-855-484-7483)

Or you can read all about it our Medical Credentialing site.