CAQH, the Council for Affordable Quality Healthcare, is often needed in conjunction with an insurance company’s application to complete one’s medical credentialing (i.e., to get on insurance panels). Major insurance companies like BCBS and Aetna use CAQH as a part of their application process.

There are a few important things you need to know about your CAQH application.

1) You need to be Invited.

You can’t just go on to CAQH and upload your information, you need to be invited by an insurance company. This creates a near “Chicken or the egg” situation where you need to first submit an application to an insurance company. Then, call that company about 2 weeks later to see if they received the application you sent and have generated you a CAQH number. Only then can you can go to CAQH, complete the application, which is –you guessed it–sent to the insurance company, who needs it to complete your application.

2) Never opt to fill out your CAQH on paper.

CAQH offers medical providers the option to complete the application online, or on paper. Don’t choose the paper option. First, the application is 50 pages long and only prints correctly in color. But second, and most importantly, when you submit a paper application to CAQH they need to hire some data entry person to transfer all your information. I’d like to say that they do a poor job–but the truth is…it just never gets done. I’ve submitted several application to CAQH in paper before realizing they lose more of them then they input. When you call to ask what happend to your paper application, they simply recommend you complete your CAQH application online.

3) Your resume better be perfect

One of the trickiest parts of getting a CAQH application completed that cuts the mustard is to make sure your resume is perfect. This means 2 things in specific. First, your dates of employment and education need to be in Month/Year format (that is 11/2010). If you don’t post dates, they reject your application and won’t send it on to the insurance companies. Second, make sure there are zero gaps in your employment history. Seriously, not a day–they’ll ask for something to fill the gap (hassle!).

4) Don’t forget your re-attestation

Four times a year you’ll receive an email from CAQH, asking for you to “Re-attest” to the information in your profile. Not doing this can cause major problems with your ability to accept insurance, as the lapse in CAQH will be known by the insurance companies you are panelled with. Re-attestation only takes a few minutes (if you can remember your provider number and password), so log in and get it taken care of ASAP.

If you’re looking for help getting on insurance panels, MentalHealthCredentialing.com is available and can provide full-service medical credentialing. Call them toll-free at 1-877-747-9682 ext. 2

Medical Credentialing Service Helps Therapists get on Insurance Panels

As more Americans than ever are getting health care coverage, mental health professionals (including therapists in private practices) are finding that accepting insurance is an important part of their career success.

Unfortunately, the process of getting on insurance panels is known to be one wrought with bureaucracy and ambiguity—and many medical professionals are reluctant to begin the provider application process.

Today, a new service specializing in mental health credentialing is offering to take on the medical credentialing hassle on behalf of mental health providers. Dr. Anthony Centore, founder of the service, comments, “Many counselors and behavioral health professionals have heard ‘horror stories’ from their colleagues related to getting on insurance panels. We realized that we could help counselors by completing the credentialing process for them.”

Customers of the service fill out one data collection form, and provide a list of insurance companies’ panels they with to join. The medical credentialing service takes it from there—filing provider applications and following up with insurance companies—contacting the mental health professional to provide updates, and for the occasional request for additional information.

The service helps clinicians in the continental U.S., and is based in Cambridge, MA. For more information, visit www.MentalHealthCredentialing.com, or call 1-877- 747-9682, ext. 2.

To learn more about credentialing for behavioral health providers, read the article “Why It’s Important to Get on Insurance Panels.”

Let us know how it goes.

Catherine Auman, MFT is a Los Angeles psychotherapist and managed care enthusiast.  She talked to WTCI via email about why.

What’s your background? What do you do now?

I’ve been working in our field for over 25 years in virtually all aspects of behavioral heath: private practice, psychiatric hospitals, chemical dependency treatment centers, residential treatment, and consulting nationally with mental health facilities. I guess what’s most relevant for this interview is that I worked for two years inside managed care companies, seeing them from the inside out.

I’m now in full time private practice that I built using the managed care strategies that I teach others in my seminars.

All the managed care options can seem overwhelming.  How do you advise people to get started?

The first thing is to learn more about managed care and challenging the misconceptions they’ve heard on the street. Most of these things, like the rumor that managed care companies are hard to work with or that there’s a lot of paperwork, are completely untrue.

What mistakes do people tend to make as they try to get on panels?

People often don’t know how to appear attractive to managed care panels in their applications. It’s not enough to just go to school and get licensed. To make themselves more attractive to panels, it helps to become “managed care friendly.” Neither of the managed care companies I worked for ever mentioned trying to save money or to shorten lengths of stay – both always instructed us to do what was right clinically. They don’t particularly like to work with clinicians who are hostile, or don’t understand how they work. I teach all about this in my workshop.

Some companies have a reputation of being hard to get paid by.  Do you have suggested list of good-to-work-with insurance companies?

It’s really not true that it’s hard to get paid by managed care companies if you do your homework up front. I teach people “how to get paid every time” in my workshops. That said, I’d have to give the “easiest to work with” award to United Behavioral Health (UBH). Most of the time it’s so simple: bill online and a check arrives in the mail.  Love that!

Any final words of wisdom for people trying to get happily to work via panels?

I love managed care – I wouldn’t have a full time practice without it. There’s a steady stream of referrals, an average of two new clients a week, checks keep arriving in the mail from what I bill. Most of what you’ve heard about working with managed care is a lie – there’s very little paperwork, the companies are easy to work with if you know how, and the clients are high functioning. What’s wrong with that?

Find Catherine Auman online at catherineauman.com.

Pre-launch next step: malpractice insurance.

For social workers, a liability deal through the NASW here.

The AAMFT links to CPH and Associates.

For psychologists, Google likes the American Psychological Association Insurance Trust.

Doesn’t matter where you go for insurance, just go. Things happen.