Becoming a Network Provider:
Selling Yourself to Insurance Companies
By Barbara Griswold, LMFT
(updated October 3, 2023, updates in red)
When I joined my first insurance plan over 33 years ago, it seemed the only condition for joining was a pulse. Many panels required little more than an application and resume. Those days are gone. In many areas of the country, insurance plans have hundreds more applications than they need, so they are often closed to new providers.
Why don’t insurance plans want to have more people in their network? Well, it is expensive to maintain a large provider network — to check all provider references and application information, to do all the data entry, to constantly update their database with latest malpractice and license, to recredential every few years, and to answer all provider calls and emails. So it is in the plan’s best interest financially to maintain the fewest number of providers. However, they are also required to maintain a minimum number of providers with a variety of specialties to serve their members in any area.
So, let’s say you want to join a provider panel. Where do you start?
- Must you wait two years? It’s true that many plans say they won’t accept you until you have been licensed two (or more) years. However, don’t let this stop you from applying. Many plans don’t have this restriction. And a plan may land a new employer account and need to add providers quickly and unexpectedly, may dig into their rejected application file, and send you an invitation to join. Also, exceptions may be made if you have a needed skill, specialty, language fluency, location, etc.
- Get a list of insurance plans. If you are a California provider, I can provide an address list of 60 insurance plans and EAP plans that operate in California, in mailing label format — go to my online store to purchase. In other states, your state professional organization or state Department of Insurance may be able to provide you with such a list, or have one on their website.
- Develop a letter of interest and resume that is specifically targeted to insurance plans, that highlights the kind of experience and specialties you have that a plan would be looking for. (For help creating a dynamic targeted letter of interest that will make plans take a second look at you, plus an application strategy, schedule a consultation with me. As part of that consultation, I’ll give you a sample letter of interest you can use as a model).
- Use your time effectively. If you have phone numbers, you can call each plan, or visit their Web site to see if they accept online applications. However, these approaches aren’t usually too fruitful — often you will just be told they are not accepting applications. If you want to limit the time you spend on this project, do a blanket mailing, submitting your letter of interest by mail to all plans on your list, even if you haven’t heard of them, and even if they say they are full. In other words, spread the net wide instead of only reaching out to the one or two plans you want to be on. If you are sent an application, you can ask any questions you may have at that time.
- If turned down, reapply every six months. Eventually, through attrition or an increase in the plan’s membership, we can hope there will be openings on the panel, and your efforts may pay off.
- Keep a log with dates of actions you took, phone calls made, addresses you sent mail to, phone numbers and names of people you spoke with, and their advice.
- If you get frustrated, remember why you are doing this. Insurance referrals can account for thousands of dollars of income to your practice, and help keep your practice full.
For more advice about what plans are looking for, what to highlight in your cover letter, how to answer application questions, and all other questions about insurance, click here to purchase my insurance manual, Navigating the Insurance Maze, or schedule a consultation.
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Barbara Griswold, LMFT, is the author of Navigating the Insurance Maze: The Therapist’s Complete Guide to Working with Insurance – And Whether You Should. To purchase the book or other resources for therapists, click here. Contact Barbara at email@example.com to get answers to your insurance questions.
Copyright 2008-, Barbara Griswold, LMFT. No part may be reproduced without written permission of the author.