Psychiatry Private Practice owners how many insurance carriers do you accept?

[NPDude362]

I was wondering how many insurance providers a practice accepts on average or how many insurance carriers it would take to fill a patient roster. I have tried to search for this information but cannot find it. I was provided the following rates by a consulting agency that handles credentialing services for new practices. I know its not in the upper range as I don't even know how you would manage relationships with 25 insurance payers. 10 sounds reasonable, is that accurate?




"CREDENTIALING/CONTRACTING:
For a new practice, or a practice that is not currently networked with insurance carriers, we do combine the credentialing with the contracting as one package with a little variation. All packages include a start to finish process where we plan to credential the practice and at least 1 provider and will see the process through to obtaining and executing your network contract. This process is an average of 45-90 days for most government plans and 120-180 days to complete for most commercial payers although some may be completed a little faster and others may take a little longer. Obviously we have no control over closed networks.

• Credentialing and contracting of the practice and credentialing 1 provider with up to 25 insurance payers is $5,000, additional providers can be added for $2,400.
• Credentialing and contracting of the practice and credentialing 1 provider with 20 insurance payers is $4,200, additional providers can be added for $2,200.
• Credentialing and contracting of the practice and credentialing 1 provider with 15 insurance payers is $3,400, additional providers can be added for $2,000.
• Credentialing and contracting of the practice and credentialing 1 provider with 10 insurance payers is $2,500, additional providers can be added for $1,800.
• Credentialing and contracting of the practice and credentialing 1 provider with 5 payers is $2,000, additional providers can be added for $1,500.
• Additional payers can be added for $300-500 per payer
• In the event a collaborating physician is required to process a providers credentialing, the cost will be $200 per application or the cost of the additional provider, whichever is less.
• Continued maintenance may begin once the initial credentialing and contracting is completed and is about $60 per month per provider and can be customized to suit your practice needs, but most commonly includes:"

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[clausewitz2]

I was wondering how many insurance providers a practice accepts on average or how many insurance carriers it would take to fill a patient roster. I have tried to search for this information but cannot find it. I was provided the following rates by a consulting agency that handles credentialing services for new practices. I know its not in the upper range as I don't even know how you would manage relationships with 25 insurance payers. 10 sounds reasonable, is that accurate?




"CREDENTIALING/CONTRACTING:
For a new practice, or a practice that is not currently networked with insurance carriers, we do combine the credentialing with the contracting as one package with a little variation. All packages include a start to finish process where we plan to credential the practice and at least 1 provider and will see the process through to obtaining and executing your network contract. This process is an average of 45-90 days for most government plans and 120-180 days to complete for most commercial payers although some may be completed a little faster and others may take a little longer. Obviously we have no control over closed networks.

• Credentialing and contracting of the practice and credentialing 1 provider with up to 25 insurance payers is $5,000, additional providers can be added for $2,400.
• Credentialing and contracting of the practice and credentialing 1 provider with 20 insurance payers is $4,200, additional providers can be added for $2,200.
• Credentialing and contracting of the practice and credentialing 1 provider with 15 insurance payers is $3,400, additional providers can be added for $2,000.
• Credentialing and contracting of the practice and credentialing 1 provider with 10 insurance payers is $2,500, additional providers can be added for $1,800.
• Credentialing and contracting of the practice and credentialing 1 provider with 5 payers is $2,000, additional providers can be added for $1,500.
• Additional payers can be added for $300-500 per payer
• In the event a collaborating physician is required to process a providers credentialing, the cost will be $200 per application or the cost of the additional provider, whichever is less.
• Continued maintenance may begin once the initial credentialing and contracting is completed and is about $60 per month per provider and can be customized to suit your practice needs, but most commonly includes:"

Going to be extremely market dependent. I accept exactly one insurance. I filled in under a year and it would have been faster if I hadn't throttled intakes to one per day 6 months in

 

[TexasPhysician]

0

 

[dl2dp2]

0

~50% of psychiatrists take no insurance. This number is also slowly growing.

If you take insurance, you will also need billers that can handle 25 insurances. There are specific electronic infrastructures that handle this--think hospital-based practices that take most insurances. This definitely will add to your overhead, which is why it's rare for solo/small group psychiatrist practices to take insurances at all. In larger group/hospital-based systems, credentialing/paneling is a detail that's shielded from you as an employee.

 

[watto]

zed

 

[romanticscience]

2

 

[medium rare]

Zero

 

[Sushirolls]

Don't use those services. They are over priced.
You can complete them better and faster yourself. They will only fill out 70% and then pester you with additional details or questions or forms that must be completed by you, negating the fees you pay them.
Many of the insurances might not be in your area.
Simply look at the websites of other PCP or Psychiatry practices and you'll quickly see who is really in that area.
Does it really make sense to take an insurance for patients you'll see only 2-3 in a year potentially?
These services will also screw up the data entry - which means work for you down stream to correct and figure out when your claims are repeatedly being denied.

I opted for one of these services because I was originally doing inpatient, and wanted to capture every potential dollar. Wished I hadn't.

Now I'm only doing outpatient and only scaling back on how many I'm paneled with.

A recent doc took my advice to do it themselves, and had a much more seamless entry into their private practice.

At least 6, still medicare technically too for #7

 

[Username2015]

Zero. A psychiatrist I know who works for an insurance company also recommended taking zero.

 

[rjs2131]

Going to be extremely market dependent. I accept exactly one insurance. I filled in under a year and it would have been faster if I hadn't throttled intakes to one per day 6 months in

That’s great to hear. How many intakes/week were you doing initially? I’m accepting a few insurances and hoping to be full by the 6 month mark, but trying to gauge if I’m busy enough.

 

[clausewitz2]

That’s great to hear. How many intakes/week were you doing initially? I’m accepting a few insurances and hoping to be full by the 6 month mark, but trying to gauge if I’m busy enough.

I think at the point at which business was picking up the fastest I was doing 6-8 intakes per week. I only was able to keep that up for a couple months but thankfully didn't really have to. I also was spending two days a week at side gigs, so I needed a bit less to fill than someone trying to knock out 40 clinical hours per week might.

 

[Bartelby]

For those taking one insurance policy (or a small handful), how much of your panel is from that insurance and how much is cash pay?

 

[dl2dp2]

For those taking one insurance policy (or a small handful), how much of your panel is from that insurance and how much is cash pay?

I used to take insurance, and maybe my experience is generalizable. When you take insurance you try to negotiate with insurance to bring up the rates but in general, insurance doesn't want to do that. So you end up prioritizing cash intakes. As time goes on the rate difference between cash and insurance increases, so you end up with more and more cash, which makes you raise rates more often on cash. This then makes you prioritize cash even more. Eventually, you prioritize cash so much so that you decide to drop insurance and refer out.

 

[Sushirolls]

I have less than 5 cash pay, out of ~140 or so patients as of today.

I partly still take insurance and deal with headache of it, because I'm in an area where right now, a big chunk of **some** of the insurance companies pay in a way I can effectively make more than what I could doing cash. This even accounts for the increased office overhead of staff, billing, etc. But the inflection point for hourly rate is some where around 15-20 clinical hours per week, I can't remember, and lots of variables impact that calculated rate.

So in summary, taking insurance, but being open to cash pay patients is best for my office.

But if the local companies start dropping their rates, then this will quickly skew to what others elsewhere in the country experience, where cash pay is the only way to go. For instance insurance company X, people move into the local area expecting to pay cash but are surprised I take it, because else where this company is not friendly to Psychiatry.

 

[usoggyojimbo]

I partly still take insurance and deal with headache of it, because I'm in an area where right now, a big chunk of **some** of the insurance companies pay in a way I can effectively make more than what I could doing cash. This even accounts for the increased office overhead of staff, billing, etc. But the inflection point for hourly rate is some where around 15-20 clinical hours per week, I can't remember, and lots of variables impact that calculated rate.

So in summary, taking insurance, but being open to cash pay patients is best for my office.

For a person wanting to explore starting a private practice, is there anyway for someone to know this beforehand? I know you can look up Medicare reimbursement by area, but my understanding is that private insurance companies are less forthcoming with their negotiated rates.

 

[Sushirolls]

Some will provide a fee schedule up front, and you'll see it before you sign.

Others say the "usual and customary" blah, blah and you don't see it until after. Can always turn around drop them next day I suppose?

Or get a non specific snap shot by viewing who in a local area is in network. The independent smaller practices will have shed the less favorable. So in summary if you consistently see insurance XYZ with all the small private practices, chance are there is a reason why. The companies that are only in network for a smaller percentage of the practices, those are likely to be the ones to avoid.

Try to schedule a meeting to talk with another Psychiatrist in the area?

Just jump in, and learn for yourself?

 

[usoggyojimbo]

Thank you for the quick reply! I'm still a resident, so pretty far out from eventually starting a practice, but it is something I fantasize about. When fantasizing and over-analyzing, I wonder if I would want to start a cash only or insurance based practice. I think the answer would depend on the rates I could get.

I do think talking to more psychiatrists in the area is something that I'll plan to do, especially as a resident.

 

[clausewitz2]

Or get a non specific snap shot by viewing who in a local area is in network. The independent smaller practices will have shed the less favorable. So in summary if you consistently see insurance XYZ with all the small private practices, chance are there is a reason why. The companies that are only in network for a smaller percentage of the practices, those are likely to be the ones to avoid.

Try to schedule a meeting to talk with another Psychiatrist in the area?

Just jump in, and learn for yourself?

Very much this. If all the fancy-looking private folks that advertise their cash rates take the same one or two insurances, chances are those insurances are probably pretty lucrative.