Navigating insurance panels for therapists: How to start taking insurance

Getting paneled with insurance companies usually requires time, commitment, and organization. Many therapists avoid the process of accepting insurance out of concerns about making a mistake in the paneling application or not even knowing where to begin. However, there are steps you can take to ensure you submit the correct paperwork and reduce the chances of mistakes. 

Step one: Gathering your paperwork

The required documentation to apply for many insurance panels includes:

• An up-to-date license in the state you are practicing in
• Your tax ID number, employer identification number or EIN (optional for self-employed providers), and national provider identifier (NPI) number 
• Your practice address 
• Proof of liability insurance if you rent an office or space
• Any further education credits or advanced training certificates 
• Your resume 
• Your graduate school transcript
• A letter of intent
• Professional references
• A taxonomy code if you plan to bill with Medicaid or Medicare

How to create a letter of intent and resume

Insurance companies will want to see your professional resume when you apply. Keep the resume around one to two pages long, with your contact information and license number at the top. Focus on what makes you unique; you can add your relevant education, special courses, past positions in the field, and skills. 

On your resume, mention if you speak multiple languages, live in a rural community, have certification in a particular specialty, or offer crisis management services. Insurance companies may look for providers that offer unique services that clients struggle to find in certain areas. There may also be more spots on the panel if you live in a rural area.

In your letter of intent, let the insurance company know you’re interested in paneling with them. Tell them how you can benefit their company and which types of therapy you offer, in addition to any specialties or further education credits you possess. Try to keep the letter upbeat, professional, and compassionate. Ensure you edit the letter for grammar and spelling, and try to keep it around one page in length.

Step two: Searching for insurance companies

Before sending your applications in, outline a list of insurance companies you’d like to work with. You can determine the most popular options in your state by checking other therapists’ websites to see which companies they are paneled with. Medicaid, Medicare, Cigna, Blue Cross, and Blue Shield are standard insurance options; each has its own application.

Once you’ve found panels in your area, create a list or a spreadsheet to track them. Do an online search to find their provider panel application page and note the link or print the application to mail it to the company. 

It may also be advantageous to write down the mailing address for each company. Ensure you’ve noted the application mailing address, not the company’s main residential address.

Step three: Submitting your application

Once you have the application forms available for each panel you hope to apply to, print out the number of applications congruent with the number of companies you’re interested in. It may be beneficial to paperclip each stack of paperwork and look through each before filling out the application to ensure you’re not missing any forms. 

Put each application in an envelope and mail it to the insurance provider’s application address. Take photos of each envelope sent and mark down the date it was sent for your records to keep track of the progress. You may also be able to get a tracking number from your post office if you mail the applications with a postal worker’s assistance. 

After a week, you can call the insurance company to ensure they have received your application. Track this call and ask the agent the expected time until you receive a response from the company.

Note that this process may take a few weeks to several months. You may receive a faster response if you filled out your paperwork correctly, didn’t miss any forms, and have unique qualifications.

Step four: Applying for CAQH 

The Council for Affordable Quality Healthcare (CAQH) is an organization that connects insurance providers with medical providers like doctors, dentists, and therapists. This is another avenue to become credentialed with healthcare organizations. It helps companies ensure that the providers registered through the portal are licensed and have the credentials to offer insurance to clients. 

You may be required to update this registration every three months if any changes are made to your identification numbers, office location, or licensing. 

Step five: Addressing approval or rejection 

Rejections from insurance panels are standard. If you are rejected due to a full panel, there may be no spots for new therapists at this time. You can reapply or appeal your rejection to be reconsidered. However, panels may take several months to approve new providers. Consider reapplying every few months. If you believe you were rejected due to a lack of information, revise your resume and letter of intent. Including professional references and certificates from past career-relevant courses may be beneficial if you didn’t include them in your first application. 

In addition, calling the insurance company to talk to the application department can help you discuss your case if you believe there was a mistake. Calling can warrant a faster response than sending a letter or waiting for a response in the mail. 

Many panels are looking for therapists that offer “above average” services. Adding additional languages, cultural education, trauma-informed education, or unique skills may benefit your case. In addition, insurance providers might seek those with hours outside a standard business schedule or those with multiple long-term clients. 

If approved, ensure you read through the insurance contract from top to bottom before signing. Understanding the terms of your agreement before you start offering sessions can ensure you do not make errors in filing for payment. 

Step six: Accepting insurance 

Once you can accept insurance, talk to your existing clients interested in billing their insurance plan. You can also advertise your new insurance options on your website or online biography page. Once you have an agreement in place with a client, use the paperwork provided by the insurance panel to bill for services. The insurance company may have sent you a billing guide and information about which services they will cover and how much you can charge. 

On the billing form, you can be asked for a current procedural terminology code (CPT), which is a code used for billing based on the length of time for sessions or the type of sessions. For example, there are codes for 30-minute sessions, one-hour sessions, and testing services. You may also be required to add a diagnostic code from the DSM-5 for insurance to cover services. 

Once you have completed the claim, you will have a deadline through your insurance provider to file the claim. Some therapists hire billing specialists or bookkeepers to keep track of these records. It can be beneficial to file all your insurance claims within the shortest possible deadline so that you don’t miss any. 

After you have filed the claim, the insurance company may reimburse you for services within 30 days or the timeline outlined in your contract. Ensure you have filled out the forms correctly, or there may be delays in your payment. This process can involve verifying whether your insurance company requires a diagnosis to bill for services.  

Some clients may also be required to pay co-pays. Discuss your client’s insurance policy with them before treatment. If you’re not financially savvy and require support, you can contact a financial advisor for your practice.

Resources to aid in the process 

Taking insurance can be challenging, but you’re not alone in the process, and there are various tools available to you, including the following: 

• Insurance billing software: Many software companies offer therapist billing software that involves electronic claim filing, documentation, receipts, and pre-made templates to streamline the billing process.
• Note-taking software: Having organized notes can help providers keep all of their clients’ financial information safe and in one location.
• Policy creation tools: Therapists may be tasked with creating policies on billing, such as late fee policies, cancelation fees, and insurance guides for clients. Many tools and companies provide these templates for therapists to reduce the time it can take to create them.
• Electronic health record (EHR) software: An EHR program can help therapists keep client medical history in one location and often involves areas to take notes on referrals, releases, demographics, and session progress. It is an electronic version of a client chart, often used by medical professionals.