What is the credentialing process, when working with you?
Essentially, we manage all of the tedious, time-consuming work you don’t have time for.
We start by sending you a simple application we call the Master Survey. It asks you basic questions about what your education, expertise and license. This allows us to get to know you and so that we can identify the best way to get you on the panels you want.
Once this is done, we work with you to determine which insurance companies are a great match for your practice. We’ll provide a list of our best recommendations after researching the area you operate out of.
At that point, we handle the strenuous process of retrieving the credentialing applications, filling them out, submitting them and then following up continually to ensure that the insurance company approves the applications timely and efficiently.
We update you throughout this process via phone and an online dashboard that displays the status of your applications. We let you know immediately whenever we need additional information for your application, such as signatures.
How long does it take to get on an insurance panel?
On average, the credentialing process takes at least 3 to 4 months. That is why we highly recommend practices to begin the process as soon as possible in order to prevent losing clients who want to use their insurance. If you’re getting ready to start your practice, now is the perfect time to get started.
What if I don’t get on the panels I want?
Thanks to our experience in the industry, we’ve learned that it’s easy to figure out early on whether or not an insurance company is willing to approve your application and be in network with your practice. We use this information to determine which panels are worth the time necessary to apply for, making the chances of rejection pretty low.
It’s possible that your request for an application will be denied, but we can still appeal on your behalf to the insurance company. Otherwise, the best step is to move forward and focus on getting on other panels.
Is it possible to get on panels that are closed?
An important thing to know about closed panels is that they aren’t always literally closed. Often, insurance providers will say their panels are closed when they’re really just restricted. In that case, we’re able to appeal to the insurance companies and use the benefits
of your practice to persuade the insurance company to let you on their panel.
Here are some of the advantages you may offer that are alluring to insurance companies:
1) Your area is an underserved population
2) You offer appointments for weekends
3) You are affiliated with a credentialed practice that is referring clients to you
4) You have a colleague who prescribes medication and is willing to refer patients to you
5) You work with children
6) You have extended office hours Have a handicapped accessible office
7) You offer therapy in a second language
8) You are certified in a niche therapy
9) Your office is handicap accessible
10) You have some other benefit such as an appealing specialty or resource that is appealing to insurance companies
Unfortunately, there are times when panels are actually closed, and appeals won’t help. But our success rate has been quite impressive to our current and past clients who have managed to get on closed panels.
How much does this whole process cost?
We strive to make our rates affordable and manageable by providing packages based on how many panels you want to be on. Put another way, it only takes a handful of appointments with a new patient/client to make your money back. That is money you would have lost had you waited to finish the credentialing process.
Who are you? And how did you get into medical credentialing?
We are Thriveworks Medical Credentialing (Thrive Counseling LLC), and we started out as a counseling practice in Cambridge. We experienced firsthand how tumultuous the credentialing process is, so we developed our own service for helping other good practices get on insurance panels without all of the hassle we had to go through.
Our expertise and credentials have been quoted in multiple news publications, such as the Boston Globe, ABC News, Boston Business Journal and many more. Our company is also a member of the Better Business Bureau and we currently maintain the highest possible grade rating with the Boston Chapter BBB!
If you’re running a chiropractic practice, or are getting ready to strike out on your own, can you be credentialed?
Absolutely! We’ve worked with chiropractors, doctors, surgeons, etc…
Medicare is a really good insurance to accept, as it pays well, pays timely, and a lot of people have Medicare. However, the medical credentialing process is one of the trickiest.