How to Accept Health Insurance

by Francine Richards; Updated September 26, 2017

As a health care provider, it is your decision whether to accept health insurance. The advantages to accepting health insurance include patients who are more likely to see a doctor that accepts their insurance, referrals from the insurance company, easy handling of claims submission and quick claims reimbursement. The cons are that you must accept the payment rate dictated by the insurance company for your services and you cannot bill the patient for the difference.

Step 1

Contact major health insurance companies in your area to inquire about joining their provider networks.Most carriers will have this information on their websites. Each company may have a different, but similar, process. If you want to accept Medicare, visit the Centers for Medicare and Medicaid website and follow enrollment directions. For Medicaid, go to your state’s insurance department website for information.

Step 2

Complete the provider network application. This will include filling out paperwork, submitting proof of licensure and professional liability insurance. The insurance company will review your application by committee, verify your information, history and credentials and prepare a contract for your signature.

Step 3

Sign a contract with the health insurance company that states that you agree to accept the network reimbursement rates and follow protocol pertaining to patient care and claims submission. The health insurance company will provide written notification when you are formally accepted into the network.

Step 4

Check the insurer's website to make sure that you show up on the health insurance online provider directory. Many members go to the insurer’s website to complete a search for doctors. You want to show up in its search that you are accepting new patients.

Step 5

Hang a sign at the reception desk in your office that lets patients know which health insurance plans you accept. Some insurers may send you a sticker or sign to place at the window.

About the Author

Francine Richards is a licensed multi-state insurance agent with years of human resources and insurance industry experience. Her work has appeared on Blue Cross Blue Shield websites and newsletters, the Houston Chronicle and The Nest. Richards holds a Bachelor of Arts in communications from the University of Maryland.