|Posted by Stephanie Adams on June 17, 2011 at 11:09 AM|
I'm almost done with my internship. My clients are asking me when I can start using their insurance. What can I tell them?
For many interns, one of the most exciting things about being finished with their internship is being able to apply to be on insurance panels. But - surprise! - a lot of interns don't know how to do this. In fact, becoming an insurance provider is something I'm still learning myself. But I can tell you what I know so far, and hopefully that will be enough to get you started.
In order to start applying for insurance panels, you'll need to read the fine print. And then re-read it again. And then talk to a representative, and your supervisor, and the office manager of your group. Simply put, it takes a lot of time. But if you want to do this, just suck it up and put aside the hours. After you're done, at least you won't have to do it again...except, of course, to update your information.
There's going to be a few restrictions: check restrictions related to your particular licensure, (do they insure LPCs? LMFTs? LADCs?) type of service provided, and geographic area. Checking geography simply means if your area already has "enough" providers, you might not be allowed to apply to be a provider with that insurance company.
There's going to be some companies, especially government companies, that require certain paperwork and policies be in place to qualify for coverage. For example, you can't bill most (any?) insurance panels for no-shows. Some insurance companies try to prevent you from personally billing the client for no-shows either! Still more may not want to take you until you've had a certain number of years in practice. (Unfair!)
Once you decide with which groups you want, you will need something called an NPI number, which stands for National Provider Identification number. (Don't confuse this with a tax ID number, which is your SS# if you're self-employed/sole-propreitorship, or your employer's company tax ID number in most other cases.) You can apply for your NPI number at the National Plan and Provider Enumeration System (NPPES).
You'll need more information on hand to apply: Your liability insurance information, your counseling license number and expiration date, sometimes professional references, (contact information, not reference letters) school information and internship information. Oftentimes providers will request you first apply with a centralized credentialing agency, such as CAQH. This is a pain the first time, but then makes life easier because individual insurance companies can refer to that to verify your information, generally without additional action on your part.
Then, you wait. As of now, I have only been granted provider status at one major insurance company, and that took at least 6 weeks. I found out I was approved when a client called looking for me as a network provider, the letter notifying me of this fact didn't come until a few weeks after that. So if you have clients asking about timing, the safest answer is "a while."
You now know a little more about how to apply for insurance panels, but no doubt you've all heard of the controversy of whether or not to accept insurance period. On the one hand, it DOES compromise client privacy. On the other hand, unfortuantely many clients don't care and will not go to counseling if it is not covered by their insurance. It takes much longer to get reimbursed from insurance (and they will take any option not to reimburse) but you also get clients from their listing of in-network providers. It's a cost-benefit analysis, like so many other things. What aspect matters most to you?
What do you guys think? Are you planning on applying to be an insurance provider? Why or why not?