A sure-fire way to increase your referral sources and expand your practice is to be accepted on a few insurance panels. But it ain’t easy! I defer to articles found quickly through a Google search (“insurance panels for mental health providers”) which spell out the steps concisely. Instead, I am going to give you the skinny on the ups and downs and the pros and cons of being on a panel. Insurance Panels: The Good, the Bad and a Plan.
First, the Bad:
If you are not fully licensed, you cannot be a provider on a panel. And while a counseling center can be a preferred provider group, you are not eligible until you are licensed and practicing independently. In addition, some insurance companies require clinicians to have several years of experience before they can apply.
The reimbursement amounts vary, but generally, they will be considerably less than the hourly rate you have set for yourself based on your market. Often, they are HALF of what your full-fee rate is.
There is an annoying amount of paperwork. First, to be accepted onto the panel, then to satisfy treatment plans, treatment updates and reimbursement protocols.
The time between initiating an application and being accredited is very long. Often the process takes months to complete. In addition, submitting a claim and getting paid is typically 4-8 weeks–that is, if you submitted the claims properly and it didn’t get kicked back to you.
You are contending with a restricted panel and they simply may not have openings in your area. Or you might need a specific skill (e.g. DBT, EMDR). Perhaps, this may require you to be invited onto the panel or have another clinician suggest you as an alternative for their coverage purposes, or a third party (maybe a employer company), requesting your name be added to the list.
Discouraged? Hold on. Here’s the Good:
With Mental Health Parity, there are opportunities opening on many panels. Here’s the trick. You must offer something that is unique–a niche, (frequent readers know I can’t help myself!) or fill a need. A colleague of mine specializes in grief counseling for children who have lost parents. She successfully landed on four panels after contacting several grief groups in the area, giving a short talk on complicated grief and then contacting the insurance panels of several interested clients who wanted individual therapy.
Employee Assistance Programs are often looking for reliable providers with open slots with quick access. I know personally, as a director of a program, that my go-to therapists who have reached out to me and developed a relationship, were my top-of-the-list referrals. In fact, several therapists who were panel free who requested me to advocate for them with the panel, are now happily accepting referrals from the program.
Primary care physicians are most often insurance based and are welcoming to a colleague that also takes insurance. It’s an easy referral and a great way to build a collegial relationship.
While the fees are lower, you do get paid a consistent hourly rate. There is no discussion, uneasiness or “may I have a reduced rate” complications.
Marketing to large companies that have many employees on their panels is often an easy pitch. They welcome someone who is able to provide care to their folks.
I prefer to look at Insurance panels as just another income stream for your practice. While you are defining your specialty, gaining experience, developing relationships and honing your craft you can also expand your client base. It takes time and organization. If you choose, you can hire an accrediting company to do the legwork. Keep in mind, that if you do decide to join a panel then you must take insurance reimbursement from any of your clients that are on those panels as part of your provider contract.
There is a compromise solution–as you build your practice, insurance panels can be a part of your initial plan. As you maintain and fill your practice, you can easily discard panels. In addition, many clients have HSA (Health Saving Accounts) deductibles. They can be thousands of dollars. Letting a client know that you will accept their HSA or FSA credit cards is really helpful. Or, working with the client and offering a certain amount of sessions for the deductible amount or sliding your fees to maximize the number of sessions is a way to accommodate the client and avoid joining insurance panels. Just be careful with sliding fee arrangements. You need to have a plan that applies to all clients in order to justify why one person got a discount and another did not, particularly if you are still on a few insurance panels. And, never make your sliding fee lower than the highest paying insurance company you are credentialed with–otherwise, they can argue that your fee is lower than the rate you agreed upon with them.
Regardless of how you decide to go forward, consider this possibility for your practice. They can be a valuable tool in the beginning stages of practice growth as well as a supplement to your existing income.