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Navigating the Blue Cross Credentialing Maze

Embarking on the credentialing journey with Blue Cross and Blue Shield of North Carolina was both a pivotal and challenging chapter in my entrepreneurial endeavor. The story begins when I met with a former employer to explore the prospect of joining their group practice. The allure of $175 reimbursement per session was enticing, promising a financial foundation for my budding private practice. Excitement brimmed as I envisioned learning the ropes from an experienced mentor.

Amidst this anticipation, life took an unexpected turn – my baby arrived the day after the completion of the articles of incorporation by the Secretary of State. Navigating the intricate landscape of credentialing took a backseat to the demands of motherhood, and I enjoyed a well-deserved two months of maternity leave.

The credentialing process kicked into gear in late July when my former employer's team started assembling the necessary information for my CAQH profile. Little did I know the complexities that awaited me – the requirement for current malpractice insurance for both my license and NPI, both individually and for the group practice. Armed with newfound knowledge, I swiftly applied and submitted the requisite information, eager to accelerate the credentialing timeline.

However, each update in the process seemed to unfold in slow motion, elongating the waiting period. By the end of August, the financial strain prompted a tough decision. I opted to launch my practice with Alma, recognizing the imminent need for revenue. Looking back, I wish I had laid the foundation for a referral network before my baby's arrival. The realization struck: building connections and referrals should have started long before the official business kick-off.

Armed with hindsight, my entrepreneurial mission evolved. I aspired to guide new clinicians on the path to expedited success, leveraging the experiences and lessons learned during this transformative period. Departing from my former employer's practice marked a turning point – I committed to navigating the credentialing process independently. There was no outsourcing to a credentialing company; I chose to forgo the expense and instead embrace the opportunity to master the process firsthand.

In my role as the CEO of my own venture, the decision aligned with my commitment to self-guidance and continuous learning.

Steering the ship toward greater achievements necessitated understanding the intricacies of credentialing, even if it meant a steeper learning curve.

In the course of my entrepreneurial journey, I came to a profound realization: one reason for the shortage of therapy coverage is the shortage of well-paid therapists. Expanding my practice to include other therapists allows me to become a mentor and grow the field of mental health. Accessing Blue Cross's network strategically positions me to reach more North Carolina citizens, creating a ripple effect for healthier mental health practices across the state. The credentialing process, though challenging, has become a vital step in my mission to contribute to a tipping point for improved mental health in North Carolina.

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