INSURANCE CREDENTIALING FAQ FOR THERAPISTS
The questions you have about credentialing.
And the ones you didn't know to ask.
If you're trying to get credentialed with insurance companies, there's a good chance you've opened approximately 47 browser tabs and somehow ended up with more questions than you started with.
I get it. Between CAQH, NPI numbers, insurance panel applications, and all the follow-up, there's a lot to figure out.
I'm Fariha Newaz, LCPC, a therapist with more than five years of insurance credentialing experience. I started Off Your Plate Practice Support to help therapists, counselors, and group practice owners navigate this part of running a practice.
Here are some of the questions I hear most often.
INSURANCE CREDENTIALING BASICS
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Insurance credentialing is how insurance companies verify your professional qualifications before allowing you to participate in their provider networks.
For therapists, this generally involves submitting information about your license, education, professional experience, malpractice coverage, and practice details. The insurance company reviews that information as part of its credentialing process.
There's also provider enrollment and contracting, which are related but distinct steps. Depending on the insurance company, you may need to complete all three before you can see clients as an in-network provider.
It's a lot of administrative work, which is exactly why credentialing services for therapists exist.
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The exact process depends on the insurance network, your license, and where you practice, but it generally involves:
Getting your individual NPI and any organizational NPI your practice requires.
Setting up or updating your CAQH profile when the insurer uses it.
Identifying which insurance networks you're eligible to join.
Completing provider enrollment and credentialing applications.
Responding to requests for additional information.
Completing any required contracting and confirming your effective date.
You can absolutely work through these steps yourself. But if you'd rather have someone manage the paperwork, I offer insurance credentialing assistance for therapists and mental health practices.
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These terms get used interchangeably, but they aren't quite the same thing.
Credentialing is the process of verifying your professional qualifications.
Paneling or provider enrollment generally refers to applying to participate in an insurance company's provider network.
Contracting involves the agreement between you or your practice and the insurance company, including the terms of network participation.
You may need to complete multiple steps before you're officially in-network. Being credentialed doesn't automatically mean you're ready to bill an insurance company.
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Yes! There are credentialing specialists and practice support services that help therapists manage insurance applications, CAQH profiles, provider enrollment, and follow-up.
That's what I do through Off Your Plate Practice Support.
I work directly with therapists and group practice owners who want help navigating the administrative side of insurance credentialing. Whether you're starting from scratch or need help with applications you've already begun, we can talk through what makes sense for your practice.
CAQH & NPI QUESTIONS
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CAQH is an organization that provides a platform many insurance companies use to collect and access provider credentialing information.
If you're a therapist applying to insurance networks, you'll often be asked to create a CAQH profile, complete your professional information, upload supporting documents, and authorize participating insurance companies to access your information.
Not every insurance company uses the same process, but CAQH is a common part of credentialing for mental health providers.
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Yes. You can hire a credentialing specialist to assist with CAQH profile setup, updates, and re-attestation.
I offer standalone CAQH setup for therapists who need help getting their information organized and completing their profiles.
You remain responsible for reviewing and confirming the accuracy of your professional information and any required attestations.
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An NPI, or National Provider Identifier, is a unique identification number used for covered healthcare providers in administrative and billing transactions.
Therapists generally use a Type 1 NPI for their individual provider identity. An eligible group practice or organization may also need a Type 2 NPI.
The type of NPI your practice needs depends on how it's structured.
I offer NPI application assistance if you're getting started and need help navigating that process.
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Not necessarily!
Your individual Type 1 NPI generally stays with you throughout your career, even when you change employers or open a private practice.
However, you may need to update your information or obtain a Type 2 organizational NPI, depending on how your business is structured.
If you're unsure where to begin, we can review your situation and identify the appropriate next steps.
INSURANCE PANELS & APPLICATIONS
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Yes. I provide credentialing and provider enrollment assistance for networks including Aetna, Cigna, Blue Cross Blue Shield (BCBS), and Optum/UnitedHealthcare.
Each insurance company has its own application requirements, eligibility criteria, and network participation policies.
I'll help you prepare and submit the appropriate applications, track their progress, and follow up as needed.
Final approval and network participation decisions are made by the insurance companies.
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It depends on the insurance company, the network, your professional credentials, and whether your application is complete.
Some applications move more quickly than others. Delays can happen when an insurance company requests additional documentation, needs to verify information, or has limited availability in its provider network.
I can't control how quickly an insurance company processes an application, but I can help make sure the paperwork is organized, follow up on outstanding items, and keep you updated.
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Not necessarily, and this is an important one.
Submitting an application doesn't automatically make you an in-network provider.
Before seeing clients under an insurance contract, you'll want to confirm that all required credentialing, enrollment, and contracting steps are complete, and that you have the appropriate effective date.
Insurance companies may have different policies about when services become eligible for in-network reimbursement.
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First, you'll want to find out where it is in the process.
An application may be pending because it's still under review, additional information is needed, or the insurance company hasn't completed its internal steps.
I help therapists track credentialing applications, follow up with insurance companies, and respond to outstanding requests.
Sometimes the most frustrating part is simply not knowing who to contact. You don't have to figure that out alone.
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That's completely fine.
You don't have to start over just because you're bringing in someone to help.
We can look at what you've already submitted, which insurance panels you're working with, and what still needs attention.
SOLO & GROUP PRACTICE CREDENTIALING
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Yes! I work with therapists and counselors who are opening their own practices, preparing to accept insurance, or joining additional provider networks.
That can include CAQH setup, NPI assistance, insurance panel enrollment applications, and follow-up.
My solo credentialing package is designed for individual providers who want more comprehensive support.
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Yes. I also provide credentialing assistance for group practices.
If you're hiring clinicians, expanding your team, or managing multiple provider applications, I can help organize the enrollment information and coordinate the administrative steps.
Group practice credentialing can involve both individual provider requirements and organizational enrollment details, depending on the insurance company.
Contact me to discuss your practice and the number of clinicians who need support.
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Sometimes, but the process depends on the insurance company and the terms of the group's existing participation agreement.
A clinician may need to complete individual credentialing or enrollment steps before being linked to a group practice's contract.
I can help with provider applications, enrollment coordination, and roster maintenance as your practice grows.
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Yes.
Once you're credentialed, there's still information to keep up to date. CAQH re-attestation, recredentialing reminders, expiring documents, and provider rosters can all require ongoing attention.
I offer maintenance services for therapists and mental health practices that want help staying organized after initial enrollment.
WORKING WITH OFF YOUR PLATE
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Credentialing costs depend on the services you need and how many insurance networks you're applying to.
At Off Your Plate Practice Support, my current listed pricing includes:
Solo credentialing package: $1,500, including CAQH and NPI assistance and applications for up to five insurance networks.
CAQH profile setup: $200.
NPI application assistance: $225.
Individual insurance panel enrollment: $250 per panel.
Credentialing consultation: $200 for 60 minutes.
Ongoing maintenance and group practice pricing are also available.
You can find the full details on the homepage or contact me to talk through what your practice needs.
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Because I understand the practice side of the process, too.
I'm Fariha Newaz, LCPC, and I've spent more than five years working in insurance credentialing.
I understand why getting onto insurance panels matters, how much administrative work goes into running a practice, and how frustrating it can be when an application seems to go nowhere.
And when you work with Off Your Plate, you're working directly with me.
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No. Insurance companies make their own decisions about credentialing, enrollment, and network participation.
My services cover the administrative work involved in preparing applications, submitting information, tracking progress, and following up.
I can't guarantee approval or a particular timeline, but I can help you manage the process.
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Easy. Send me a message and tell me a little about your practice.
You can share which insurance networks you're interested in, whether you're a solo provider or group practice, and what you've already completed.
And if you're not entirely sure what you need? That's okay, too.
We'll start with what you've got.
READY WHEN YOU ARE.
Let's get this off your plate.
Tell me a little about your practice, what you're working on, and where you could use some help. We'll take it from there.