The pros and cons of starting a private practice
Owning your own practice can be rewarding, but it’s important to consider the benefits and drawbacks.
The journey of getting credentialed as a provider doesn’t have to be overwhelming, especially if you follow a few important steps.
Before you can begin billing insurance companies for your work, you’ll need to prove you’re qualified and compliant with important licensing and regulatory requirements. The process of getting credentialed with insurance payers can be time-consuming and often confusing — but it’s an important part of establishing yourself as an in-network mental health provider in private practice.
That said: The journey of getting credentialed doesn’t have to be overwhelming, especially if you follow a few important steps. Below, learn more about the process of provider credentialing in mental health care, and how you can ensure a smooth credentialing process as a therapist.
Provider credentialing in mental health care refers to the process of verifying a mental health provider’s qualifications, professional history, and compliance with licensing and regulatory requirements.
While the process takes time, it’s important. It ensures providers meet important standards of care and are eligible to deliver services within a healthcare network or receive reimbursement from insurance payers.
The goal of provider credentialing is to ensure you’re qualified to provide mental health services according to an insurance payer’s standards. The process of credentialing can vary depending on the insurance company, but it commonly includes a detailed application that outlines your educational background, professional licenses, certifications, and specialties.
You’ll also be asked to list your clinical experience and past employment, along with any disciplinary actions or malpractice claims against you. Lastly, you’ll need to provide proof of all these items, including proof of licenses, board certifications, and continuing education.
Regular re-credentialing (typically every 2-3 years) ensures the provider maintains compliance with professional and legal standards.
The provider credentialing process in mental healthcare typically takes anywhere from two to four months. That said, the amount of time can vary depending on several factors, such as the complexity of the provider’s background and the insurance company handling the credentialing.
When you join an insurance payer panel, you’ll need to complete several steps, including credentialing and enrollment.
As we covered already, credentialing confirms a provider meets professional and ethical standards. The next step in the process, enrollment, refers to the process of registration with payers. Once you’ve enrolled with a payer, you can submit claims and receive payment for the services you provide.
Credentialing can be a lengthy process, but a few steps can help ensure a smooth process. Be sure to provide accurate information in your application and have the required documentation prepared in advance.
CAQH, or the Council for Affordable Quality Healthcare, is a non-profit organization with the goal of streamlining the business of healthcare. Insurance plans use the information providers submit to CAQH to credential clinicians. The goal is to ensure all providers have the education, training, and experience to provide quality care to clients.
Mental healthcare providers can submit, maintain, and share information about their education and practice using an online database called CAQH ProView.
As an extension of your practice, Headway leverages the information you submit to CAQH to get you credentialed with all available plans at once, and with fewer errors and delays.
At Headway, we directly integrate CAQH into our onboarding process, using CAQH to pre-populate our intake form, so you can get started seeing clients through Headway as soon as possible. Our form also immediately flags any required information that might be missing from your CAQH account. Rather than being delayed by weeks, you can quickly adjust your intake form and move forward doing the work that matters most to you.
Owning your own practice can be rewarding, but it’s important to consider the benefits and drawbacks.
Insurance verification can help ensure the process of providing your therapeutic services is as smooth as possible.
While some deductions seem obvious, you may be missing important ones.