Therapists can refer clients to psychiatry on UpLift. Psychiatric providers are available to answer questions about medication, changing treatment plans, side effects, and more.
Through a collaborative approach, harm reduction works within the realities of our world and addresses those truths, rather than deny them.
Through a collaborative approach, harm reduction works within the realities of our world and addresses those truths, rather than deny them.
Through a collaborative approach, harm reduction works within the realities of our world and addresses those truths, rather than deny them.
Through a collaborative approach, harm reduction works within the realities of our world and addresses those truths, rather than deny them.
How to get credentialed with insurance panels
Learn what you need for the credentialing process so you can start accepting insurance from clients
4
min read
To accept insurance as a therapist, you’ll need to join an insurance panel. The process for getting paneled is called “credentialing,” and is similar to a background check.
While the process should be straightforward, it can be confusing and time-consuming navigating each insurance company’s process. Credentialing also doesn’t always end in success: Sometimes, payers can reject you but you can reapply.
Despite the challenges, getting on a panel has benefits. You can reach and support more clients, since many people rely on insurance in order to afford therapy.
We help mental health providers get paneled for free with major insurance payers in their area, but we’ll go over what you need to know if you want to do credentialing yourself.
Prepare your credential materials
- Current license in the state where you’re practicing
- NPI Number — Your National Provider Identifier number identifies you as a medical provider, per HIPAA provisions.
- Tax ID Number or Employer Identification Number
- Proof of liability/malpractice insurance
- Your graduate school transcript, for some panels
- An updated resume or CV, with at least 5 years of employment history
- At least 3 professional references
- Letter of intent (We’ll explain more about this further down.)
- Any special or advanced certifications or qualifications
Do your CAQH Proview application
If you don’t already have an account, you’ll need to register for CAQH. The Council for Affordable Quality Healthcare—or CAQH Proview—is a database that’s used by most insurance companies to verify credentials. Then you’ll receive your CAQH number, which you can give to companies when you apply.
We highly recommend doing the application electronically and not via paper. You can upload your documents for credentialing to CAQH. (There may be instances where you’ll need to fax information.) Be detailed in your history and use the MM/YYYY format for start and end dates on your resume or CV.
Don’t forget to maintain your profile. CAQH requires you to update your information 2 to 4 times a year, usually quarterly. CAQH will send you email reminders when it’s time to update your profile.
You can also find services—such as UpLift—that will help you fill out or update your CAQH when you’re looking to get paneled.
Choose the insurance panels you want to join
Each insurance company will have their own process that you’ll have to apply to individually. Do your research on the most common payers for clients in your area and that the clients you want to reach have.
Some other factors to consider would be:
- The difficulty of the panel’s process
- How long approval takes
- How well the insurance company supports providers
- How long the company takes to process claims
- Reimbursement rates for claims
- Other requirements that a panel may have
Write your letter of intent
Your letter makes the case for why you should be accepted into this panel. You’ll want to consider what you bring as a provider and if there are any gaps you fill.
State that you want to join the panel. Include any information about your training and expertise. You’ll want to think about the factors that differentiate you to show how you’d benefit the insurance panel. This can be many different things, from your specialties, modalities and approaches, location, cultural perspective, availability, languages, crisis services, or some other niche.
Submit your application, follow up, and wait
Take your research from deciding which insurance panels you want to join and submit your application. Each company will have a process on their website where you can apply.
After you’ve submitted your application, you can follow up to make sure that the insurance company received it and if you need to submit anything else. You can also ask about next steps. It can be helpful to note the representative you spoke with and the time, so you have a record.
What to do if you’re rejected by an insurance panel
Sometimes, an insurance panel is “closed,” meaning they aren’t accepting any new providers. If that’s the case, you can wait until it opens again.
If the panel you applied to isn’t closed but you were rejected, you can appeal the rejection. Contact the insurance company to make your case. Ask them where you can send an appeal letter, which will restate what you bring to the panel.
Insurance Answers podcast has great resources on navigating insurance, including an episode with information on getting on closed panels and rejection.
If you still cannot join after an appeal process, don’t be disheartened. You can re-apply to join the insurance panel in a few months.
Keep records once you’re accepted
Once you’ve been accepted by an insurance panel, feel free to celebrate but don’t forget to keep your documents.
Make sure to:
- Review your contract and reimbursement rates. (You can try to negotiate for higher, too. This might not be as effective when you’ve just joined but is possible as you gain more experience.)
- Understand your documentation requirements when submitting claims.
- Keep your information updated in each insurance company’s portal and in CAQH.
It can be helpful to know the credentialing process but don’t forget, there are also resources like UpLift that can do credentialing and CAQH updates for you for free.
Eliana Reyes is a content strategist and writer at UpLift.
Meredith McClarty
Our fact checking standards
Every UpLift article is created by our team or other qualified contributors, and reviewed for accuracy by clinicians.
Katie Coughlin, LCSW
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