Dietitian’s Guide To Credentialing With Insurance Companies
Learn how to credential with insurance companies as a dietitian, and get more resources for nutrition professionals at Healthie.
When launching your nutrition business, one of the first, and most important decisions to consider is whether you will accept insurance or remain self-pay only. It can be intimidating to commit to one of these financial structures, and many dietitians feel overwhelmed and underprepared when considering credentialing with insurance. Nutrition programs in general lack providing new RDs with the technical know-how to launch a business and properly understand how insurance credentialing, contracting and billing work.
Getting credentialed can be a long process – taking a few months even at a time. In this article, we help you understand which insurance payers to become an in-network provider with to best support and grow your private practice, and how to take the first step with insurance credentialing.
Which Insurance Companies Should You Credential With?
First, the answer is not universal. There is not a definite list of insurance companies that will be the best support every private practice. It will all depend on your target clientele, your region, and the goals of your practice. Instead, we’re going to develop some strategies to find which insurance companies will best support your practice’s goals.
Think quality and not quantity.
While it might sound like a great idea to become an in-network provider with every insurance company you know of, credentialing can be a long and at times frustrating process. Focus on just a few at a time, no more than 3-4 insurance payers. This will keep you from getting overwhelmed and you’ll be able to keep track of where you are in the process with each company. If you’re just starting out with insurance billing, starting with just a few quality insurance payers will also allow you to adjust to the influx of new clients — and to efficiently learn the insurance billing process.
Before you get started, consider reaching out to some of your current clients that you are comfortable with and talk to them about what you are planning. They may be happy to share what insurance companies they are currently with to give you a few examples of companies to become an in-network provider with. Another set of people who may be able to recommend which insurance companies will best support your practice are referral partners such as physicians who have given you referrals in the past. They will most likely know which insurance companies are the most popular and used by your target clients. It never hurts to check out the websites of other dietitians or nutrition professionals in the area. A little market research! See who other industry professionals have become an in-network provider with. They may be a good reference point for your own business.
Before moving on to complete applications and begin the credentialing process, check first to see which of those companies currently have open panels and are looking to take on new in-network providers. Also, make sure that nutritional counseling is something that the insurance company covers. Medicaid for example does not credential dietitians in every state, so even if you went through the application process, you may be unable to be reimbursed by Medicaid. Often you can check this somewhat quickly with a google search on their policies surrounding nutritional care or a quick phone call.
Starting the Insurance Credentialing Process: Your CAQH Profile
Once you’ve gathered up a few names of companies, you’re ready to start working on your C. All insurance payers will need access to your CAQH profile to verify your information, so be sure to set your permissions to allow Medicare to view your profile. This is free to do, but will take approximately 2 hours if you have all of the required information on-hand. Be sure to keep this information on hand, as you’ll likely need some of it for the next step, such as copies of your credentials, and detailed work history information.
Pro Tip: Most providers have an individual NPI number which they include in their CAQH profile and insurance applications. If you have your business set up as an LLC, or have intentions of expanding your practice in the future, you may want to consider obtaining a second NPI for your business. This allows dietitians to credential their practices with Medicare (and other insurance payers) under their secondary/group NPI number and add themselves as an individual within the practice — ultimately allowing for other providers to become credentialed under their business umbrella in the future.
However, if you choose, you can certainly credential and bill under your individual NPI number.
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