Becoming a Network Provider:
Selling Yourself to Insurance Companies
By Barbara Griswold, LMFT
(updated May 8, 2019)
When I joined my first insurance plan over 25 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 more 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 re credential every few years, and to answer all provider 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. A plan may land a new employer account and need to add providers quickly and unexpectedly, and may dig into their application file. 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, contact me — I am able to provide you with an address list of almost 60 insurance plans and EAP plans, in mailing label format. Your professional organization or state Department of Insurance may be able to provide you with such a list.
- 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 resume and interest letter that will make plans take a second look at you, plus an application strategy, contact me and I’ll send you information on my package to help you join insurance plans).
- Use your time effectively. While you can call each plan, or visit their Web site to see if they accept online applications, 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 resume and 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 you are told the network is closed, or get no response, call the plan and try to sell yourself. See if you can find out what needs they have in your area that might make them consider/reconsider your application (subletting a second office for a few hours each week in an underserved area? Leading a group? Getting training in CISD?)
- 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 will 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 firstname.lastname@example.org to get answers to your insurance questions.
Copyright 2008-, Barbara Griswold, LMFT. No part may be reproduced without written permission of the author.