November 19, 2021

Credentialing FAQ: Everything You Need to Know

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Let’s face it: getting credentialed with even just one insurance plan can be a bit of a headache. 

At SonderMind, we make it simple to get credentialed with multiple insurances with our integrated billing and credentialing support. We’ll get you in-network with insurance plans and EAPs — and we’ll handle your billing, too.

Read through these frequently asked questions to learn more about how the credentialing process works at SonderMind. 

What is credentialing? 

Credentialing is a detailed process in which a provider’s qualifications and career history are reviewed, including their education, training, internships, licenses, and specialty certificates.

Credentialing must be completed upon the hire or enrollment of a new provider and regularly afterward to abide by the standards set forth by regulatory and accreditation organizations such as the National Committee for Quality Assurance (NCQA) and The Joint Commission (TJC). 

Accurate credentials ensure that you can be in-network with applicable insurance plans, as well as employee assistance programs (EAPs).

What networks can I be credentialed with through SonderMind? 

SonderMind works with many major insurance networks. Plan accessibility varies by state and licensure. You can see a list of the states we operate in (and the networks we partner with) here.

How long does the credentialing process take? 

Credentialing with SonderMind is a two-step process. Your application will first be reviewed and approved to join the SonderMind Provider Network. This approval means that you are now a SonderMind provider and you will receive an email stating your ability to begin seeing clients through SonderMind. 

Upon your approval into the SonderMind Provider Network, you will begin the second credentialing process which involves ensuring your in-networks status with our payors. Upon SonderMind approval, you will automatically receive your credentials with our delegated networks in your state. The SonderMind credentialing team will send your application for participation for the remaining insurance contracts available in your state within one week of approval to join SonderMind. 

It can take up to 120 business days to be fully credentialed in these additional plans as each has its own timeline and process. If you are a SonderMind provider, log in to the Provider Community to see an estimate of network timelines

Is there anything I can do to speed up the credentialing process? 

The best way to ensure a speedy credentialing process is to be responsive to any credentialing-related requests. Make sure your CAQH is also up to date with references who have current contact information and that all of your documents are current (not expired).

What does it mean if an insurance network requests access to my CAQH profile?

After submitting your application for participation, some insurance networks will request access to view your CAQH profile to validate the accuracy of your application. An insurance network requesting access to view your CAQH does not mean you have been credentialed with them yet. You will still need to wait for the processing time frame until you receive your approval email. 

How will I know when I am credentialed with an insurance company?

When you have been credentialed with an insurance company, you will receive an email notification from our credentialing department. The email will inform you of the name of the insurance company, your effective date, and which license type and state you’re credentialed in. This is especially helpful when you have multiple licenses.

What if I am already individually credentialed with one of the networks SonderMind is credentialing me with?

If you are individually credentialed with an insurance network, this may speed up the credentialing process. 

Until you get the email from SonderMind that you have been approved by that specific insurance through us, any billing will need to be done through your individual contract outside your SonderMind Portal. Once approved, you can move any clients over and start billing through SonderMind. 

SonderMind’s credentialing with these payors will not impact your individual contracts in any way.

If I am credentialed individually outside of SonderMind, do I have to bill through SonderMind?

If you have your own contract with an insurance network and have a client who contacted you individually, you can choose to bill them separately or through SonderMind. Client matches sent to you directly from SonderMind are required to be billed through SonderMind. 

Can I get credentialed with SonderMind even if I am credentialed or a part of another group practice?

Yes, credentialing with SonderMind will not affect any other credentials you may have. When you are credentialed with SonderMind, you will be listed under our TaxID and group NPI information. For credentialing with a separate group practice or an individual contract, you will be listed under that contract’s specific information.  When we work with you to complete your CAQH application, this will be addressed to ensure there are no issues.

What if I change my practice location?

It is important to follow the appropriate steps to request a location change and update your CAQH profile to avoid claim denials. Our credentialing team can help you with this process.

Do I have to be credentialed with all the insurance companies in my state that SonderMind is in-network with?

Yes, you agree to be credentialed with all of your eligible insurance partners by joining our network.

How can I see which insurances I have been credentialed with through SonderMind?

You'll find this information in your provider portal. If you are a multi-licensed provider, you will only see networks for your primary state.

  • In the portal, click on your name, then click "Profile"
  • Next, click "Credentials" at the top of your Profile page
  • You'll find any insurance networks you have been credentialed with here. Approved credentials will state "Credentialed" under the column labeled credentialing status. Credentials that are still in the application process will have a blank credentialing status.

What claims standards do I need to meet as a SonderMind provider?

Maintaining the Centers for Medicare and Medicaid Services (CMS) requirements for notes within each claim ensures coverage for clients. We provide downloadable templates for intake assessment, treatment plan, progress notes, and discharge summary for you to use that meet CMS requirements. 

If you are a SonderMind provider:

  • Learn more about claim standards and access our free, downloadable templates here.
  • Learn more about credentialing in the Provider Community here

Get access to more resources

SonderMind’s evidence-based approach to care gives you the additional tools you need to provide the best possible support to even more people in need. When you join SonderMind, you have access to free resources, plus free or discounted CEs, case consultation, and an exclusive online forum for SonderMind therapists. See all continuing education and training opportunities available to SonderMind providers here

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