How to Find the Best Credentialing Services for Mental Health Providers?

Payer delays, denied applications, and poor follow-through can cost you major capital loss and delays, especially when you are running a mental health business. The method to avoid them is by becoming credentialed with various insurance companies. However, credentialing is also not as straightforward as one would believe. It entails licensing issues and accurate accreditations. Therefore, we use this blog to address aspects of finding the best credentialing services for mental health providers.

Ensure you seek the best credentialing services for your mental health business with Strategique Partners!

Why Should You Consider Credentialing as a Mental Health Service Provider?

When you start and run a mental health business, you need to take care of a lot of things. However, finance-related matters are the fuel of your business, which is why you need to put in every effort to ensure smooth income and expenditures. Insurance credentialing is the best way of doing it because of the following reasons:

1. More Reliance of Patients on Indirect Payments for Mental Health Services 

As the demand for mental health services has seen a general rise in recent years, the American client base of mental health services providers has relied more on indirect payments. This requires behavioral health businesses to credential with insurance companies to ensure they smoothly receive payments for their services. 

2. Higher Payer Scrutiny for Fraudulent or Non-compliant Providers

With the rising checks to verify providers, insurance companies are now making it difficult for businesses to remain off their panel lists. When a mental health business is in-network, it means it will receive favorable disbursement of its earned money, as there are minimal checks. Another benefit of being on an insurance company’s credentialed list is that many new patients choose service providers from the insurance network’s panel.

What Aspects Should You Try to Find While Selecting the Credentialing Services for Mental Health Service Providers?

Getting your mental health business credentialed is a task best performed under the supervision of expert credentialing companies. However, the problem that behavioral health businesses face here is the selection of a credentialing service platform. We will break down your needs in this regard into must-have features of the best credentialing services specific to mental health businesses:

1. Specialists in Behavioral Health Businesses, Rather Than Generalists

When looking for any kind of consultative services for a behavioral health business, you should always keep in mind that there are very unique aspects of this market. A generalist in this regard cannot be a solution. These aspects make the behavioral health market unique:

1. ASAM-level program requirements
2. State-by-state facility licensing
3. Clinical credentials for LMFT, LPC, LCSW, LCPC, psychologists
4. Requirements for NP and PMHNP prescribing
5. Telehealth-only provider guidelines
6. Medicare/Medicaid enrollment complexities

Therefore, you should select a credentialing expert only when they have experience with the above-mentioned unique aspects. 

2. Knowledge and Expertise in Credentialing Process from Start to End 

Another non-negotiable is knowledge of each and every aspect of the credentialing process of a mental health business, whether it is counseling centers, group practices, or telehealth therapy practices. The question here arises when the mental health business owner themselves are not knowledgeable about various processes. This is why we have provided the following checklist of the processes from start to end:

• CAQH setup & management
• Provider enrollment with commercial payers
• Medicare PECOS applications
• Medicaid enrollment per state
• Facility contracting (SUD, detox, residential, PHP/IOP)
• License verification
• NPI (Type 1 & Type 2) setup
• Revalidation & re-credentialing
• Follow-ups until approval

You can seek more help from our billing experts as well. 

3. Transparent Pricing

Credentialing is being employed as an antidote to the cash flow challenges in the mental health businesses. So, if the credentialing services cost you so much that it shakes your cash flow, it can never be a good choice. This is why competitive pricing with transparency is the ultimate feature you have to seek in your credentialing partner. The most common credentialing pricing is:

1. Flat fee per payer ($150–$500)
2. Monthly subscription ($200–$500 per provider)
3. Full facility credentialing packages ($3,000–$12,000 depending on size)

4. Mental Health Business-related Compliance-Driven Credentialing Support

Mental health regulatory compliance is interwoven with the credentialing process. You are required to fulfill all licensing and regulatory obligations to get credentialed. Therefore, in choosing the credentialing services, a business must also assess whether the partner is well-versed in the mental health business-related compliance or not, such as the following:

1. CARF
2. Joint Commission
3. SAMHSA guidelines
4. State licensing boards
5. Medicaid program integrity requirements
6. Facility-based credentialing standards

Is Strategique Partners a Good Choice for Credentialing Services for Mental Health Businesses?

Strategique Partners specializes only in behavioral health businesses, working closely with the mental health business market in the USA for many years. It has helped businesses open and then grow into very robust and sustainable ventures. Our company development experts have helped smaller health businesses grow and expand or consolidate fragmented businesses. In all this, billing and financing remain our prime focus as we see it as the first major objective of behavioral health businesses, the second being serving a good cause. This is because, without a robust revenue stream, a business fails to serve the cause. 

You can ensure good revenue streams for your mental health business through insurance credentialing with the help of Strategique Partners.

Commonly Asked Questions Regarding Credentialing Services for a Mental Health Business 

We enlist a few of the most asked questions by business owners regarding insurance credentialing of mental health businesses in the following lines:

How Long Does It Take To Get Credentialed With Insurance Companies?

The credentialing process generally takes a long time. You may have to wait 3 to 8 months to get credentialed for your behavioral health business. Therefore, it is advised to start the credentialing process fairly early. 

Can I See Patients While Waiting for Credentialing Approval?

Yes, it is possible to entertain clients and provide services without credentialing approval. You can get paid directly from clients. However, you can only see clients specifically, depending on insurance billing for payments, once you are credentialed with their insurance policy.

What Type of Liability Insurance Is Needed for Credentialing?

Liability insurance needed by credentialing companies varies by minimum coverage amount. However, it is usually general and professional liability coverage.

Are There Unique Credentialing Requirements for Telehealth Mental Health Businesses?

Credentialing requirements for telehealth mental health businesses are slightly more comprehensive. You often require multistate licensing and certifications. Furthermore, insurance providers have separate panels for telehealth service providers. This makes the credentialing process unique for telehealth mental health businesses.