Insurance credentialing & paneling guide for therapists (2024)

Insurance paneling is notoriously complicated. Rula makes it easy.

Key Takeaways

  • Insurance paneling (also called “credentialing” or becoming “in-network”) allows you to accept insurance payments from clients who are covered by certain health plans. This often makes it easier for clients to access care because it reduces the cost of therapy.
  • When you’re part of an insurance network, you’re listed as a preferred provider in that network’s directory. This makes it easier for potential clients to find you and can help you grow your private practice by providing a steady stream of new referrals.
  • Insurance paneling is often a lengthy process that can take up to six months if you handle it on your own. But in working with Rula, a behavioral health company that supports therapists in starting or growing their own private practice, therapists can be credentialed and start seeing clients within Rula’s network in as little as two weeks.

Insurance paneling, the process by which a therapist can join an insurance network, allows you to accept insurance payments from clients who are covered by that insurance network. This process reduces out-of-pocket expenses for clients and can help you expand your client base and revenue stream.

Collaborating with insurance companies is one way to expand your client population and grow your private practice. But if you’re like most therapists, you’d probably prefer to spend your time supporting clients instead of dealing with confusing insurance paperwork.

Fortunately, insurance paneling doesn’t have to be complicated. If you partner with an organization like Rula, you can get support through the credentialing process and build a thriving private practice while continuing to deliver excellent care to your clients.

Understanding insurance networks and insurance paneling

The terms “insurance paneling,” “insurance credentialing,” and “becoming in-network” all refer to the general process of qualifying a therapist to accept insurance payments. But before embarking on your insurance credentialing journey, it’s important to understand the ins and outs of how insurance plan networks work.

Simply put, an insurance plan network consists of a group of healthcare providers and facilities that agree to offer certain services at a discounted rate. People who have health insurance usually choose to see providers in their network since the cost is typically lower than out-of-network care. As you explore your options for joining insurance networks, keep in mind that some networks will align with your personal and professional goals better than others.

For example, networks often place limitations around the geographic area they cover, the types of therapeutic modalities you can offer, the types of mental health conditions you can treat, and reimbursem*nt rates for therapy and other mental health supports. So before attempting to join an insurance network, be sure to research the best options for you and ask your colleagues for recommendations.

The pros and cons of insurance paneling

As is the case with many aspects of running a private practice, there are some pros and cons to joining insurance panels. It’s important to consider whether going in-network makes sense for you, your clients, and your business goals. But if you work with Rula, you’ll enjoy the following practice-boosting benefits:

  • Increased referrals: Finding a therapist who accepts their insurance is a challenge for many clients. But in joining the Rula network, you‘ll be listed in our provider directory which will make it easy for new referrals to find you.
  • Consistent income: It can be hard to stabilize your income when the majority of your business comes from self-pay clients or fluctuating out-of-network reimbursem*nts. But in working Rula, you’ll receive your contracted rate for each client you see within two weeks of treating a client.
  • Better client retention: When you accept your clients’ insurance, it reduces the financial burden of going to therapy. This can make it easier for clients to fit mental health care into their budget and attend their sessions consistently.
  • End-to-end administrative support: Rula handles credentialing, insurance eligibility, verification of benefits, and all aspects of billing including claims submission and collecting copays and coinsurance from clients.

Many therapists say that accepting insurance has helped them build successful private practices. But other providers may not wish to join insurance networks because doing so can result in:

  • Lower session fees due to caps on reimbursem*nt
  • Limits on the types of mental health concerns they can treat and the treatment modalities they can offer clients
  • Client privacy concerns since some clients don’t want their mental health information shared with insurance companies

Streamlined insurance credentialing with Rula

At first glance it might seem like joining insurance network is a no-brainer. You’ll grow your private practice and help expand access to affordable mental health care along the way.

But if you work in the mental health field, you likely know firsthand just how frustrating the insurance credentialing process can be. Many therapists report spending months attempting to finalize this process on their own and some say they won’t even attempt it, opting to only take self-paying clients.

At Rula, we’re here to support therapists by taking cumbersome administrative tasks like insurance credentialing off their plates. Therapists who partner with Rula benefit from a streamlined credentialing process that makes it easy to start seeing clients with certain health plans in as little as two weeks

.

Here’s how it works:

  • Meet with a Rula Provider Specialist. The first step in becoming credentialed with the Rula network is meeting with one of our dedicated Provider Specialists to ask questions and learn about the benefits of joining our platform.
  • Submit application information. If it sounds like Rula is a good fit for you and your practice goals, we’ll move forward with credentialing. This starts with gathering some application information including your NPI number, license, malpractice insurance, resume, and three professional references.
  • Support with CAQH. From there, we’ll help you fill out the Council for Affordable Quality Healthcare (CAQH) application and complete any other necessary steps before submitting your application. If necessary, we’ll follow up on your behalf to ensure each aspect of your credentialing goes smoothly.
  • Start seeing clients. Once approved, Rula links therapists with all our contracted payors so you can start seeing clients within our network in just two weeks! Of course, you can always opt out of working with a certain payor if there’s a conflict of interest and we’ll continue to support you with all aspects of billing, insurance, and more.

Final thoughts

It’s frustrating but true, the timeline for insurance paneling for independent therapists is up to six long months. But at Rula, we’re here to streamline complicated administrative tasks like insurance credentialing so you can focus on supporting your clients and growing your practice.

To learn more about how our team of Provider Specialists can help you join our network and start seeing clients in as little as two weeks, schedule a meeting with our team.

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Insurance credentialing & paneling guide for therapists (2024)

FAQs

What is the difference between paneling and credentialing? ›

Credentialing and contracting are interlinked processes in establishing a healthcare provider's relationship with an insurance company. Credentialing and “paneling” are interchangeable.

Do insurance companies read therapist notes? ›

Progress notes can be released to a third party either without explicit consent from the client or after the client signs a generalized consent form. In fact, many insurance companies may ask to see progress notes to approve services and provide payments.

What does it mean to be paneled as a therapist? ›

Insurance paneling (also called “credentialing” or becoming “in-network”) allows you to accept insurance payments from clients who are covered by certain health plans. This often makes it easier for clients to access care because it reduces the cost of therapy.

What does paneled mean in insurance? ›

An insurance panel is a group of providers who work with an insurance company to provide patient care services specifically to clients who are enrolled with that insurance company.

What are three methods involved in credentialing? ›

Here are three types of credentialing services in the healthcare industry and how they can be beneficial:
  • Physician Credentialing. Physician credentialing verifies the qualifications and background of a healthcare provider applying for a new job or contract. ...
  • Credentialing Maintenance. ...
  • Provider Enrollment.
May 20, 2023

Why is paneling so expensive? ›

The price of wall paneling usually depends on the quality. The more thickness vinyl panels possess, the higher the price would be. When you compare the price of vinyl wall paneling with drywall, you will come to know that the cost of wall paneling is higher than the drywall.

Do I have a right to my therapists notes? ›

(Note that a therapist's personal, usually handwritten process notes are not considered to be part of your official record and your therapist is not required by HIPAA to let you see them. Still, many therapists are willing to share these notes with their clients upon request even though they legally don't have to.)

Can a therapist refuse to release notes? ›

Client Requests

It is vital to know that clients have the legal right to access their medical records, which include psychotherapy notes. However, if you believe releasing private or sensitive information may cause harm, you can deny the request. In such a case, you must provide a written explanation for the denial.

Can therapists keep personal notes? ›

Under HIPAA, psychotherapy providers don't have to keep notes. You can write them by hand on a notepad or type them on a computer — as long as you keep them separate from the patient's medical record or progress notes.

Can you overshare with a therapist? ›

However, as we've explored, there is a delicate balance between sharing and oversharing. Oversharing in therapy can potentially hinder our progress, disrupt the therapeutic alliance, and even impede our journey toward growth.

Can a therapist have countertransference? ›

In psychoanalytic theory, countertransference occurs when the therapist projects their own unresolved conflicts onto the client. This could be in response to something the client has unearthed. Although many now believe it to be inevitable, countertransference can be damaging if not appropriately managed.

What does it mean to be credentialed with insurance? ›

Medical insurance credentialing is a complex, time-consuming process that verifies healthcare providers are legitimate and qualified to receive reimbursem*nt for services rendered. All practices that wish to bill an insurance company, including hospitals, clinics, physicians, and therapists, need to be credentialed.

What does it mean to be paneled? ›

fitted or decorated with panels or wainscoting. synonyms: wainscoted. adorned, decorated.

What does paneled provider mean? ›

"Paneled Provider" means an individual who has been determined by the CCS program to meet the advanced education, training, and/or. experience requirements for his/her provider type in order to render services to a CCS applicant or client.

What is a closed panel in insurance? ›

Closed panel plan is a Plan that provides health care benefits primarily in the form of services through a panel of Providers that contract with or are employed by the Plan, and that excludes coverage for services provided by other Providers, except in cases of emergency or referral by a panel member.

What is credentialing in simple terms? ›

Credentialing is a vital process for healthcare institutions. In simple terms, it is the process of assessing a healthcare provider's academic qualifications and clinical practice history.

What is the purpose of a credentialing board? ›

The major purpose of the agency is to serve as a state standards board for educator preparation for the public schools of California, the licensing and credentialing of professional educators in the State, the enforcement of professional practices of educators, and the discipline of credential holders in the State of ...

What is paneling in healthcare? ›

Panel management is a technique that can help ensure you and your staff are being proactive with your patient population. Panel management, often referred to as population health management, involves all clinical staff in your independent practice, including medical assistants, health workers, and nurses.

What's the difference between credentialing and contracting? ›

Where credentialing is a comprehensive background check on the provider, contracting is the process of signing the contract to become a part of the insurer's network. The contract is signed by both the payer and the provider and all of the terms and conditions are listed.

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