How to credential with insurance companies outside of ALMA and Headway
and why you might want to!
Companies like ALMA, Headway, and Grow can serve as fantastic tools for individuals in private practice. The primary allure of platforms like these lies in their ability to simplify the process of therapist credentialing with insurance providers. Accepting insurance is a surefire method to expand a therapy practice. Nevertheless, the credentialing process can be tedious and painstaking. This is where services such as ALMA, Headway, and Grow come into play. However, there are instances when being paneled outside these companies may be advantageous. In this article, I will share ways to get credentialed independently and why it might be beneficial. Let's dive in.
WHY CREDENTIAL INDEPENDENTLY?
Supervisory Billing: Independent credentialing allows for supervisory billing and/or incident to billing, enabling an LCSW (or fully licensed provider) to supervise an LMSW (or provisionally licensed provider) while clients can still utilize their insurance. For more information, check out this video...
Flexibility: If you leave ALMA, Headway, or Grow, you lose your credentialing. Independent credentialing ensures you remain credentialed even if you leave these platforms, providing greater flexibility.
Long-Term Stability: There's no guarantee that platforms like ALMA, Headway, and Grow will be around indefinitely. As start-ups, they may face uncertainties. Being credentialed independently safeguards your credentialing in case these platforms cease operations, preventing disruptions to client care or practice shrinkage.
HOW TO GET PANELED INDEPENDENTLY
There are two main approaches, differing in cost and time investment.
DIY Credentialing: This is the cost-effective but time-consuming option. Navigate to insurers' websites, here is an example from CIGNA, and complete their applications. Additionally, fill out the CAQH profile, an application used by most insurance panels. You must then remain proactive by calling and emailing to ensure the application gets completed, the contract is negotiated, and signed.
Credentialing Company Assistance: Alternatively, you can hire a credentialing company to guide you through the process. Be cautious and choose a reputable one. I used GreenPoint Med. There are many great options out there, just be sure to read the reviews. While this option may be more expensive, it significantly reduces the time and effort on your part. Credentialing companies often excel in negotiating rates and may have valuable contacts with insurance companies, yielding long-term benefits.
FURTHER GUIDANCE
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Hi Matthew,
This might be pointing light to the obvious, but I am going to ask anyway. It has to to do with a non-licensed practitioner and credentialling. From what I've read and gleaned from my own research, one can not bill insurance without licensure, directly working with Aetna or other.
I kinda knew this, however my impression of your videos about Alma (including the fact that on their website, there is a questionaire asking what type of therapist or practioner you are; choice e) non-licensed, is an option they provide. I feel almost optimistic that there is some kind of exception here, or new development that allows non-licensed persons to accept insurance.
So I clicked on it. I got an email from them about all the states they operate in and mentioned something about if you are a Licensed therapist, in any of these states, book an appt.. So I emailed them asking them to define licensure and prerequisite to billing insurance.
Can you define a licensed therapist, and how does this relate to credentialling and can I bill insurance by getting on boarded by a group like Alma or even Headway? I have certifications but not a Masters degree or licensure in counseling. Ty - Andrew