You’re finally ready to get contracted with insurance companies and you’ve reached out to Healthy Bytes for help. You’ve identified your top insurance companies to start with and can’t wait to start expanding your business.
Then, you find out a company's panel is closed. Don't worry! You do have options and Healthy Bytes can help.
What it means when a panel is closed
When an insurance company's panel is closed, that particular company has temporarily stopped accepting new dietitians into its network in a certain area (bummer, we know). Although the reasons can vary, it's most commonly a result of the insurance company feeling they have adequate coverage for a given county.
Unfortunately, there is no standard criteria insurance companies follow when opening or closing a panel, but there are steps we can take on your behalf if we find one is closed.
Option 1: Wait for the panel to open
Panels are generally closed temporarily, so our rule of thumb is to check back every three to six months. Healthy Bytes tracks this information and will do this for you when we work together to get you contracted. Follow-up does pay off, as we've seen panel status change frequently.
You may not have to wait idly in the interim, though. Some insurance companies allow you to submit an appeal when a panel is closed.
Option 2: Appeal
Appealing a closed panel is not a guarantee you'll be accepted as an in-network provider, but including specific, detailed information in an appeal can improve your chances. Appeals are viewed more favorably if they provide the following information:
A list of patients you've had to turn away due to your out-of-network status, with requested appointment dates.
A detailed explanation of your services and proximity of the closest dietitian with similar services. Generally, insurance companies will consider an appeal when there are no other qualified dietitians within a 30-35 mile radius.
A list of physicians who are not able to refer patients to you due to your out-of-network status.
Option 3: File claims out-of-network
Lastly, you can choose to be contracted as an out-of-network provider. Some insurance companies will reimburse out-of-network providers. Your reimbursement from insurance will be dependent on how each patient’s individual plan handles out-of-network providers. Healthy Bytes can help with this step by providing eligibility estimates.