WSPA member Tyson Bailey featured in the most recent APAPO Practice Update
Monday, October 24, 2016
Posted by: Sierra VanderHoogt
Running start … to a great career: Insurers
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This is a column geared toward early career psychologists working in practice settings. "Running start … to a great career" features topics typically not covered in graduate school and includes tips and advice from psychologists.
By Rebecca A. Clay
For some psychologists, taking insurance isn’t worth the hassle of burdensome paperwork and declining reimbursement rates.
But unless you practice in a wealthy neighborhood, out-of-pocket payments may limit access to care, says psychologist Angela Londoño-McConnell, PhD, president of AK Counseling and Consulting in Athens, Georgia. “Not everybody can afford therapy without the help of insurance coverage,” she says.
Londoño-McConnell and others suggest the following tips for working with insurers:
- Prepare to wait. Just because you’re licensed doesn’t mean you can join insurance panels right away, says Londoño-McConnell. Some insurers require you to have been licensed for two years, she says. Even for payers without that requirement, it can still take months to get on a panel. Some panels may already have all the mental health practitioners they need.
- Identify the major players. Consult with experienced psychologists about which insurance companies the major employers in your area use, says Kevin D. Arnold, PhD, who directs the Center for Cognitive and Behavioral Therapy of Greater Columbus in Ohio. While antitrust laws prohibit discussion of reimbursement rates, he says, check companies’ reputations by asking about how easy it is to get on a panel or whether the companies pay on time.
- Save time by using online tools. In the old days, says Londoño-McConnell, psychologists had to go through the time-consuming process of applying to insurers individually. Now they can use a free credentialing database called CAQH ProView™. “It’s like a universal application,” says Londoño-McConnell. States may have a similar service, such as Washington’s OneHealthPort.
- Negotiate if possible. When it comes to reimbursement rates, “it’s really a take it or leave it situation unless you have a big enough group to come to the negotiating table,” says Tyson Bailey, PhD, a partner in Spectrum Psychological Associates in Lynnwood, Washington. “An insurer is going to fight harder to keep a big, multidisciplinary group than a smaller practice,” he says. But there may be exceptions, adds Londoño-McConnell. If you have a high-demand specialty, you’re bilingual or it’s an underserved area, she says, it may be worth trying.
- Befriend provider relations staff. “Think of insurance carriers as your partners, not your enemies,” says Arnold. The first step is to get to know the provider relations person at each company, who can not only answer questions about applying or anything else but can discuss what else you could do to help patients.
- Streamline billing. Practice management software makes it possible for psychologists to handle their own billing; others prefer to outsource billing or have a staffer dedicated to submitting claims and following up. “If I have to sit on the phone for 45 minutes, it’s taking away money from the practice,” says Bailey. Whichever route you go, be sure to check for reimbursement errors, which Londoño-McConnell says are surprisingly common.
- Seek expert help. You might want a lawyer to review contracts, says Bailey. Your state psychological association and the APA Practice Organization can also help solve problems and educate you about applicable laws.