A Therapist’s Guide to Insurance Credentialing

Insurance credentialing is the process insurance companies use to review and verify a healthcare provider’s qualifications before the provider can be included in the insurance plan’s network. 

For therapists, getting credentialed is a key step toward being able to accept insurance for their services, which may help them serve a more diverse pool of clients and build a consistent caseload.

What is insurance credentialing?

For many therapists, being able to accept insurance for their services is an important part of growing their practice. 

However, accepting insurance is not as simple as just deciding to do so.

This is where insurance credentialing comes in: it’s one of the necessary steps therapists have to complete before they can start accepting insurance. 

Insurance credentialing is the process of verifying a healthcare provider’s qualifications and professional background before the provider can be included in the insurance company’s provider network. 

Beyond credentialing, the other parts of the process include contracting and enrollment. Here’s what each step entails:

• Credentialing: The insurance company verifies the therapist’s education, training, license, work history, and malpractice coverage. 
• Contracting: The insurance company and the therapist sign an agreement specifying the legal and payment terms of the contract. 
• Enrollment: The therapist is entered into the payer’s system so that insurance claims can be processed. 

The exact structure and breakdown of these steps can vary, and in some cases, they may overlap or merge depending on the insurance company.

Why therapists choose to become credentialed

For therapists who choose to become credentialed and contract with insurance companies, there can be a range of benefits, including: 

• Diverse pool of clients: Accepting insurance allows therapists to connect with a diverse pool of clients, including those who wouldn’t be able to afford therapy without insurance.
• Built-in referrals: Being an in-network provider with insurance companies and being listed in the insurer’s directory gives therapists built-in marketing and referrals.
• Multiple payment options for clients: Therapists who accept insurance can offer clients multiple ways to pay, as they can still accept cash-pay clients as well.
• Consistent caseload: Accepting insurance often helps therapists build up and maintain a consistent stream of clients more easily.

That said, deciding whether or not to accept insurance as a therapist is a professional question that’s not always straightforward. 

The credentialing, contracting, and enrollment processes can be complex and time-consuming, and some therapists may choose not to accept insurance for various reasons. A recent study found that, in the United States, about one-third of therapists working in independent practice do not accept insurance. 

How to get credentialed with insurance companies

If you decide that you do want to get credentialed with insurance companies as a therapist, how exactly does it work? 

The exact credentialing process can depend on the insurance company, but here’s a general breakdown of the typical steps involved:

• Register with CAQH (if applicable): Many major insurance companies use an online data source called the Council for Affordable Quality Healthcare (CAQH) to credential healthcare professionals. When you register with CAQH and complete your profile, various health plans can get your application information from there (when authorized). Be sure to keep your CAQH information up to date; professionals are typically required to re-attest their CAQH information every 120 days.
• Complete the insurer’s application: Each insurance company typically has its own application, which you have to fill out and submit if you want to join their network.
• Authorize the insurance company to review your credentialing information in CAQH: After registering with CAQH, make sure to authorize the insurance company you’re applying to so they can review your information.
• Provide any additional documentation and correct any errors: If any errors come up during the credentialing process, be sure to correct the information and update your application. And if the insurer needs any additional information, try to provide it as quickly as possible.
• Check your credentialing status: Depending on the insurance company, it may be helpful to follow up on your application to ensure they have everything they need. Some insurers specify how long to wait before following up, so be sure to follow each insurer’s guidelines.

How long does insurance credentialing take?

Insurance credentialing often takes around 90 to 120 days (about 3 to 4 months), but the timeline varies and depends on the insurance company and your application. 

Making sure that your application is complete and error-free can help speed up the process. For instance, some common issues that can lead to delays include: 

• Not authorizing the insurance company to view your CAQH profile
• Having incomplete or outdated information in your CAQH profile
• Having information in your application that doesn’t match what’s in your CAQH profile
• Attaching incorrect documents 
• Not providing your current professional liability insurance certificate 

BetterHelp insurance credentialing for therapists

The insurance credentialing process can be complex and intimidating, but you don’t have to handle it entirely on your own. If you become a therapist through BetterHelp, you’ll get support in navigating this process. 

Our credentialing and enrollment teams manage this entire process on your behalf using the details you provide. With a wide array of payer contracts, we are able to get you in network much quicker than if you were doing it all yourself. 

This support means you’ll have more time to focus on expanding your caseload and providing high-quality care to your clients, rather than wading through paperwork on your own.

BetterHelp accepts insurance through major providers including Aetna, Blue Cross Blue Shield, Cigna, and UnitedHealthcare, giving eligible members more ways to access convenient mental health care and helping providers serve a broader pool of potential clients without additional overhead or marketing costs.