Insurance contracting is slow, paperwork-heavy, and different for every payer. We run the whole process — credentialing, applications, and payer approvals — so you can serve clients while we manage the red tape.
What is insurance contracting? It's the process of getting your treatment facility into an insurance payer's network so you can bill that insurer and get reimbursed. It involves credentialing your organization and providers, submitting each payer's application, and negotiating a participating-provider agreement.
These two get used interchangeably, but they're distinct steps. Credentialing is the payer verifying your qualifications, licenses, and accreditation. Contracting is the agreement that sets your reimbursement terms and brings you in-network. Credentialing almost always has to be completed before a contract is finalized — and a single missing document can reset the clock.
| What it does | Brings your facility in-network so you can bill insurers and get reimbursed |
|---|---|
| Credentialing | Payer verification of licenses, accreditation, and provider qualifications |
| Contracting | The participating-provider agreement and reimbursement terms |
| Typical timeline | Several months per payer — each insurer has its own process |
| Prerequisites | Proper licensing and usually accreditation in place first |
We identify which payers matter for your market and level of care, and the order that gets you to revenue fastest.
We assemble and submit the verification each payer requires — accurately, so it doesn't bounce back and restart the clock.
We manage applications across payers, respond to requests, and pursue participating-provider agreements on your behalf.
We follow every application through to in-network status, then keep your credentialing current so contracts don't lapse.
It's getting your facility into an insurance payer's network so you can bill that insurer and be reimbursed. It involves credentialing the organization and providers, submitting payer applications, and negotiating a participating-provider agreement.
Credentialing is the payer verifying your qualifications, licenses, and accreditation. Contracting is the agreement that sets reimbursement terms and brings you in-network. Credentialing usually must finish before a contract is finalized.
Commonly several months per payer, because each insurer has its own application, verification, and approval process. Starting early, submitting complete applications, and following up consistently shorten the timeline.
Usually yes. Most payers require Joint Commission or comparable accreditation and proper state licensing before they'll credential and contract with you.
How to get in-network and reimbursed.
The full sequence from level of care to opening.
Launch an intensive outpatient program.
Every month out-of-network is revenue you're not capturing. Let's get your contracts moving.