Launching Your Healthcare Practice?
Here's How To Nail Your Insurance Choices!
Are you ready to elevate your practice to new heights? This guide details the essential steps to ensure you’re choosing the best insurance networks for your practice.
If you haven’t read part 1 of the payor selection guide, check it out here: How to Choose What Payors to Contract Your Practice With (Part 1)
Now let’s get into part 2 of the essential steps to choosing your payors!
Step 3: Choose Insurance Networks
Research Insurance Companies
Investigate local insurance companies to understand their rates, claim submission processes, and payment timelines. Consult other healthcare providers and use online resources to gather insights.(1)
Evaluate Requirements
Different insurance companies have varying credentialing and paneling requirements. Some may offer group contracts, while others may only allow individual contracts. For example:
United Healthcare: Allows group contracts with five or more clinicians.
Magellan: Allows group contracts with just one clinician.
Cigna: Does not allow group contracts.
Prepare Documentation
Ensure you have all necessary documents, including professional licenses, educational certificates, work history, and specialty certifications.(2)
Submit Applications
Use platforms like CAQH ProView to streamline the credentialing process. Complete all required fields accurately and follow up regularly on the status of your applications.(3)
Negotiate Rates
Group practices often have more leverage to negotiate higher reimbursement rates. This can be a significant advantage in ensuring financial viability.
Step 4: Adapt To Regulatory Changes
Telehealth Regulations
With the rise of telehealth, ensure compliance with any additional credentialing requirements related to telehealth services. Understand interstate practice regulations and ensure adherence to telehealth standards.(2)
Policy Shifts
Stay updated on healthcare policy changes that could impact your practice. Regulatory shifts, such as changes in Medicare payment reforms and ACA subsidy expirations, can significantly affect your operations.(3)
Step 5: Market Your Practice
Branding and Patient Acquisition
Define your practice’s identity and messaging. Use SEO, local advertising, and community outreach to attract new patients.
Patient Retention
Enhance patient satisfaction through personalized care, proactive communication, and loyalty programs. Engaged patients are more likely to stay with your practice and refer others.
Choosing the right insurance carriers is a critical step in ensuring the success of your new practice. By conducting thorough market research, developing a solid business plan, and carefully evaluating potential insurance partners, you can set your practice on a path to success. Remember, the key is to stay informed, be strategic, and always prioritize the needs of your patients.
