Being a private practice owner can be as challenging as it is rewarding. On the one hand, you get to do what you are passionate about—helping people through the issues they are facing. On the other, you have to navigate the murky waters of billing and insurance.
As a private practice owner, you can get paid in one of two ways, private pay or insurance.
What Does It Mean To Be On A Panel?
Being on a panel with an insurance company means the same thing as being credentialed. In order to bill an insurance company, you have to be an approved therapist that is credentialed with them. It can be a pretty lengthy process to join a panel. Once you are on it, though, it doesn’t mean it’s going to go smoothly for you all the time. Billing insurance can be a frustrating experience. Not only do you have to know the codes that are applicable for your practice and sessions, but you need to know what codes each insurance will accept. While the CPT codes are standard across the medical field, not every insurance company will honor them.
Pros And Cons Of Being On An Insurance Panel
Just like basically everything else in life, there are pros and cons to being on an insurance panel. There are no right answers to whether or not you should get paneled. But, it is important to remember that it’s a requirement if you plan on billing for insurance.
Pros of being on an insurance panel
- The insurance companies you are credentialed with are your referrers. You don’t have to work extra hard to get the word out about your practice.
- A lot of clients do prefer to go through insurance. Even if their insurance won’t absorb the full cost, it still gives them some financial relief.
Cons of being on an insurance panel
- Dealing with a third party (the insurance company) often means there is a wait time before you get paid.
- There is a lot of paperwork that comes with being credentialed. This needs to be submitted to the insurance panel.
- Most insurance panels do not allow you to set your own rates. Each insurance company will set the rate that you are paid. It is definitely a disadvantage when you are on a panel.
Being Credentialed Is Similar To Being Licensed
Just like you need to be licensed in each state in order to see clients from them, you also need to be paneled for every insurance that you want to accept at your practice. Applying for multiple panels and playing the waiting game with all of them is one of the hardest parts.
Making Your Decision About Insurance Panels
This is one of those situations where there is no right answer. The right decision for one therapist will be completely different for another therapist. Are you overwhelmed with this decision? Let’s connect if you have any more questions. In addition to the website, I run a Facebook group called Insurance Billing for Telehealth Practitioners.
This group is exclusively for all therapists, not just the ones who only provide telehealth. Feel free to request to join the group. There will always be a group of people to whom you can ask questions about the pay rates, reimbursements, and accepted billing codes for insurance companies.