insurance

It has been a year and a half of running my private practice and I'm finally starting to get the hang of this insurance thing. I am a member of CAQH (Council for Affordable Health Care), which holds a large database insurance companies use to enroll clinicians onto their panels. I can now submit electronic claims online. I understand what a CPT code is. I know the code when services are rendered in my office, etc, etc... As a client, there is no need to know what the heck I'm talking about. All you need to know is I can now accept some insurance. I am currently in network with Blue Shield, Aetna and I'm in the pipeline for United Behavioral Health (UBH) and PacifiCare. Their representative said I'd be accepted in their networks by the end of June 2008. I recently applied to Blue Cross, and Value Options. (Unfortunately, Health Net is not accepting new clinicians at this time)

I was very fortunate that I had a thriving practice early on without being on any insurance panels. In fact, my office landlord said she went through over five renters that failed to start a practice, and she was surprised to see me with several clients so quickly. I acquired clients through previous professional relationships, through word of mouth referrals and some through Internet marketing. I could have continued in this direction, without insurance.

Many clinicians choose not to deal with insurance at all. I can see why, what a headache it all can be. In addition, it is very intimidating. Plus, many plans will provide out-of-network reimbursement so the clinician does not have to concerned with submitting claims. I thought about taking that route, especially since dealing with forms and big companies is by far not a strength of mine. However, I decided to take on the challenge. The main reason is I do not want people to spend hundreds of dollars on services that could be provided through their benefits. My goal is to provide excellent services, help people get better, meanwhile not place too much of a financial strain on my clients. Plus, if I did not accept insurance, I'd miss out on working with certain populations I enjoy, such as Stanford students. I value my services and need to cover overhead costs as well, so hopefully I can get even more insurance companies to pay me to work with you!