Credentialing Headaches? Why a Consultant Might Be Your Lifesaver

Credentialing is crucial for behavioral health providers who want to be in-network with insurance companies. It’s also tedious and time-consuming, demanding a detailed understanding of requirements that constantly change.

One way to manage this is to invest in a full-time staff member whose sole job is to focus on credentialing.

A more efficient and cost-effective option may be to utilize the expertise of a behavioral health credentialing consultant.

What is Behavioral Health Credentialing?

Credentialing is a formalized way of confirming that your behavioral health organization meets or exceeds industry-wide standards for quality patient care.

In an ideal world, this would be a seamless process that involves submitting some basic information in one location. Unfortunately, things aren’t quite as simple or straightforward.

“Credentialing has a lot of moving parts,” said Michelle Levy, Director of Credentialing Services with GreenpointMed, a SimiTree Company. “It requires a considerable amount of time management, project management, and follow-up.”

Some (but by no means all) of these moving parts involve:

  • Creating and maintaining a CAQH profile (Council for Affordable Quality Healthcare)
  • Documenting that your organization meets standards set by the National Committee for Quality Assurance (NCQA)
  • Acquiring an employee identification number (EIN)
  • Enrolling in the electronic funds transfer (EFT) system
  • Managing an account with the National Plan & Provider Enumeration System (NPPES)
  • Obtaining and recertifying an Electronic Transmitter Identification Number (ETIN)

A few parts of the credentialing process are one-time tasks. But most require ongoing management to ensure that your organization remains in good standing. Missing a deadline or not providing the proper documentation can have a disastrous impact on your organization.

Why Lean on Expert Behavioral Health Credentialing Consultants?

In addition to forming the basis of your organization’s relationships with payers, credentialing also plays a key role in establishing your legitimacy in the eyes of prospective patients and referring professionals.

Here are a few reasons why turning to credentialing experts may be the right choice for you:

  • You can focus on your patients – The team you partner with can focus solely on credentialing, allowing you to turn your attention to providing the best care possible.
  • You can lean on their experience – Credentialing consultants will have experience with all aspects of the process. If a contingency arises, they will be prepared to deal with it immediately and effectively.
  • You won’t have gaps in service – Having a full team to support your credentialing efforts means you never have to worry about gaps in service because one person went on vacation or took the day off.
  • You can have peace of mind – Knowing that the team you’ve partnered with has your credentialing needs under control eliminates unnecessary distractions and provides peace of mind.

“Clients shouldn’t have to worry about the details of the credentialing process,” Levy said. “We take on that responsibility, so they can focus on what’s most important to them: Caring for their patients.”

How SimiTree Behavioral Health Can Help

Ready to take the hassle out of behavioral health credentialing? Partner with our expert credentialing consultants and ensure seamless compliance with industry standards.

Reach out to us today with the contact form below or call us at 866.839.5471 to discuss managing your credentialing needs. Your peace of mind starts here.