How do you get on insurance panels to accept reimbursement?

Question

I am a geriatric care manager and want to position myself to be able to accept long-term care insurance and eventually Medicare. How do I find out how to get contracted as a vendor to receive referrals from Long-term care insurance?

Answer 1

Provider eligibility requirements may be set by the insurance company, an insurance regulatory board, state law and/or maybe Federal law.

I'm not familiar with the term "insurance panel," but if you are providing care that is paid for by LTC insurance or Medicare, you or your establishment would be considered a provider. I'm just not clear from what you wrote whether you're some kind of nurse, nursing agency or nursing home.

Call up some of the LTC insurance carriers and just ask what the requirements are for the service you provide (nursing, care facility, etc.). For example, a long-term care facility may need to be licensed through the state. You may find contact info here: http://www.longtermcarelink.net/a7insura...

This link may help you connect with LTC associations local to you. http://www.longtermcareprovider.com/

To research state requirements and procedures online, google "long term care" and the name of your state. Here's one example: http://www.ins.state.pa.us/ins/site/defa...

I believe the state websites will have have the info you need on how to becme able to get Medicare reimbursements.

Answer 2

If you're talking about becoming a participating provider with insurers, you would contact the insurer's contracting department, which handles the rate negotiations and credentialing.

Keep in mind that its possible that the long-term care insurers may want you to be participating with Medicare first.  (I don't know for sure if LTC insurers have that requirement, but its something you might want to ask about.)