As such, your state’s Medicaid policy is up to them.Įach state may have their own system that they have built that might be slow and require many enrollments as well, or they might contract out the insurance coverage to existing “commercial” insurance companies.Įxample: What you think is UHC is actually Medicaid via UHC and while you’re in-network with UHC, you’re out of network with their Medicaid network your claims get denied. Why is Medicaid Hard to Bill for Mental Health Providers?įor the same reason that Medicare is hard to bill, except that each state has their own contract instead of each region (see Medicare map). We take care of this enrollment process and secondary claims submission and follow-up for our providers at TheraThink. Most clients also have a secondary insurance company to bill alongside their Medicare coverage. Each system is clunky and the enrollments take quite some time. Medicare subcontracts out to many different subcontractors like Noridian or Palmetto or Novitas or NGS or WPS or FCSO.Įach contractor has their own electronic claims submission enrollment requirements, forms, and process. Why Is Medicare Hard to Bill for Mental Health Providers? It’s worth noting that none of these are impossible to bill but each company has particularities about their claims filing process, operational speed, and subcontracting policy, which can lead to a higher likelihood of problems and a longer claims and revenue cycle. Simplify Your Practice Tip: If you are busy enough, consider dropping new EAPs. Other EAP plans require their own unique form. Likewise, EAP sessions have far more hoops, billing nuance, and prior-to-session manual labor (authorizations) involved in billing. This can skew data downward in comparison to brands that to not facilitate a Medicaid plan in that State. Many Medicaid polices are subcontracted out to lower paying organizations. More Difficult to Bill Insurance Companies for Mental Health Providers: Each state runs their BCBS in their own way so ask colleagues as well. Inquire about your local BCBS within google by typing in “Blue Cross Blue Shield” + your state’s name. To sum things up, the Blue Cross and Blue Shield network across the United States is one of the highest reimbursing and most competitive plans to work with. The following links go to each company’s credentialing website: Most Competitive Insurance Companies for Mental Health Providers: Medicaid can be the trickiest of them all, not listed here. Not all companies are easy to work with even if they pay well. Tip: You will probably need to establish a separate legal business to work with these companies so expect to create an E-IN for your new practice to get paid the best rates. Investigate which companies are paying the most in your State by asking your colleagues. Top 4 Insurance Companies For Established & High License Level Providersīest suited for LCSWs, PsyD, PhD, and MDs: If you’re an LPC, LMFT, or newly licensed provider, you might find these companies are a good fit. There are many state-specific insurance companies that might be a great fit for your transition to a new practice but of these four, you should be able to work with two and get started asap! Insurance Contracts for Your New Private Practice Some companies, such as many of the BCBS plans, require you to establish a business, E-IN, and group NPI.įor mental health credentialing, we are quick to recommend Aetna, Cigna, and if your license allows it, Medicare (not eligible: LPC, LMFT). If you want to become in-network with higher paying, lower fuss plans, it is likely you’ll need a longer amount of experience and possibly a track record of working with that plan as a provider in a previous group or agency. In our experience, the higher the reimbursement rate, the higher your license level need be to become in-network with that company. Mental Health Credentialing Recommendations These are payment averages that do not represent the rates of any of the aforementioned insurance companies are a not a guarantee of any rate or payment amount. None of these values represent what you will be paid or are a guarantee of payment nor do the represent the rates each insurance company may or may not reimburse. Medicare Reimbursement Rates Ĭommercial Insurance Reimbursement for Mental Healthįind out which insurance companies pay mental health providers the best in our interactive charts below: Mental Health Insurance Reimbursement Ranges.Which Companies Are The Hardest to Bill.Highest Paying Insurance Companies for Mental Health. Credentialing Recommendations for New Practices & Established Practices.Mental Health Reimbursement Rates by Insurance Company įind out which mental health insurance companies pay you the most!
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |