A lot of small practices and solo practitioners send a letter of interest to an insurance carrier in hopes of getting paneled with them, as a credentialed in-network provider. In a lot of ways, a letter of Interest is very similar to a cover letter though there are some significant differences.
With a cover letter like you might write when applying for a new job, you’re really only sending a small amount of information. Usually, a resume or an attached C/V. Though with a letter of interest a bevy of credentialing usually needs to be sent with specific requirements in mind.
Of course, a lot of insurance payers and public health institutions have their own requirements on what should be sent. Not to mention making sure that all information is applicable to your state regulations
With a letter of interest, you are essentially making an appeal to be welcomed as an in-network provider with just that specific insurance company. So, not only do you need to make sure you are sending them 100% of the information they require, but you also need to write a letter of Interest to make a compelling appeal to be paneled with. While also making it clear that if you are approved and credentialed with them that the new arrangement will at least be mutually beneficial in the long term.
How to Wire an Effective Letter of Interest.
Right off the bat, any letter of Interest has to be written compellingly. Remember that you want it to become a powerful tool that persuades the insurance carrier or public health institution to offer you access to their network. This is best done by strategically addressing a few key components.
Include Accurate Identifying Information
You the provider need to make sure that all pertinent information also exactly matches the enrollment application. This includes your Name, your NPI number, your Tax ID, the CAQH Number, as well as any special services that are provided by your practice.
Include Any/All Special Attributes
It’s also critically important to include any unique attributes associated with you as a solo provider and/or your practice. This must include defining features such as whether your business is family-owned or corporation. You should also note if you are a minority-owned or women-owned small business. While these might seem like small details on the business landscape, they are exactly the sort of defining attributes that can enhance the appeal of your letter of interest.
Note All Unique Services Offered
If you or your practice offers a specialty service that your competitor doesn’t or one that isn’t available in your geographic region, you should also note it in your letter of Interest. Insurance carriers are keen to make the most out of critical niches and recognize the value of providers who go the extra mile to be trained and/or certified to provide them to those in need.
Include Accurate Geographical Location(s)
Your practice’s geographical location is more than just an address. Your letter of interest should also state whether you will be offering services in a rural or urban area, as well as any other critical demographic information that makes your practice best suited to meet the needs of your region.
Include In-Depth Patient Demographics
Defining the demographics of patients your practice caters to regularly. It often helps to group your patient’s groups by criteria such as age, income group, gender, etc.
Note All Your Referring Services
Being available for a referral from other providers in your geographic region also makes your letter of interest more appealing to insurance carriers and public health institutions. This might include services such as providing durable medical requirements, offering home health alternatives, and even referrals for hospice care.
Indicate Your Competitive Rates
Pitting your rates against those of your competitors can also be a factor that makes insurance carriers consider you for paneling over other similar providers in your geographical region. If possible try to note if the competitors provide a rate slightly less than the competition. This bit of information can make you more appealing than the insurance company.
Provide Any Information on Test Programs
A lot of insurance carriers already have crowded network panels. So, unless you entice them with something such as willingness to be part of test or trial programs, they might not panel you for fear of overloading their own existing network demands.
The Size & Scope of Your Practice
If you have a large clinic that you are opening your doors to for a new community or you are a solo practitioner hanging up your own shingle to offer a new specialty service, you want to make sure to note that in your letter of interest. If they don’t have a practice of your scale on their current panel, it can be the factor that gets you approved in the end.
Not your Medical Billing Practices
A lot of insurance payers have their own preferred method of claim submission and reimbursement. If you are using state-of-the-art online digital portals or a third-party medical billing agency to handle your claims submissions, it can give you a leg up over other prospective practices who use mail-in or clearinghouses to submit their claims.
Using a third-party medical billing service like Operant Billing Solutions, also incentivizes the insurance payer to approve you for their in-network panel. As it gives them the confidence to know your claims will likely be more accurate than other panel applicants.
This is especially notable if you are a very small practice of a solo practitioner, where error rates in claim submissions tend to be the highest. When you partner with an expert third-party medical billing service, you’re ultimately saving the insurance carrier time with the accuracy of the claims they receive from your practice in the future.
Documents to Include with Your Letter of Interest
While different insurance carriers, states, and health institutions have their own specific requirements, pretty much all of them will require the following documents be included with any letter of interest that’s worthy of their consideration. This includes:
- IRS Form W9
- Applicable Licensure
- Marketing material or brochure
- Top billing codes or desired rates.
- Sample claim forms
- Invoice on products.
Throughout the process of composing your letter of Interest, make sure to put in the due diligence to find out the name and address of critical decision-makers who will weigh in on your final approval. Try to address them directly, while still communicating formally.
