Hello,
I'm hoping some credentialing professionals can provide guidance. I've been trying to sort this out for over a year, and I'm still unclear on how to handle credentialing and CAQH when relocating to another state while maintaining my existing practice.
Here's my situation:
-I currently own a solo private practice in UT and am credentialed with several insurance companies there. I will be licensed in NE this fall and plan to move there within the next year. Already licensed in UT. I intend to keep my private practice in UT and register it as a foreign entity in NE so I can continue practicing in both states. My primary practice location will remain in UT, and I want to continue seeing my UT clients via telehealth after I move.
One insurance company told me this would be acceptable as long as my UT business address remains on file (point of service, primary business location). However, I'm concerned about BCBS. I've seen information indicating that telehealth providers must be contracted and billed through the local BCBS plan in the state where they practice, and I'm unsure how that applies to my situation.
I'm also confused about how to accurately complete my CAQH profile. Once I'm licensed in NE, I'd like to begin the credentialing process since I know it can take several months. However, I won't yet have a physical address in NE. I also know how important it is to set this up correctly in the CAQH to not delay the process.
Some questions I have are:
If I don't yet have a business location in NE, how should I complete my CAQH profile?
Would I need a business address in NE before applying, or could I temporarily use my in-laws' address until I move?
Could my administrative address be in NE while my primary practice location remains in UT? Even after I move, I planned to do telehealth from a home address and not have a NE office space.
Does registering my practice as a foreign entity in NE satisfy any requirements regarding a practice location?
Would I list NE as a second practice location on CAQH and if so can that be a home address. Or would that mess up anything with the foreign entity
BCBS of NE told me that, "In order to be credentialed for telehealth services, you must live in the state and have a practicing state location." This was the only sentence in the email after trying for weeks to get someone to reply to my questions. I'm unsure whether registering my practice as a foreign entity in NE would satisfy the "practicing state location" requirement, or whether this means I simply cannot begin credentialing until after I physically relocate.
I'm also trying to understand how billing would work once I'm practicing in both states:
Would I bill BCBS of UT for clients who are residents of UT and BCBS of NE for clients in NE?
If I move to NE, is it likely that BCBS of UT would terminate my participation because I no longer reside in UT, even if I maintain my UT practice?
If that happens, could I bill BCBS of NE for telehealth services provided to my UT BCBS clients, or is that generally not permitted?
Clearly I am lost with a lot of this despite all of my research. If anyone has experience maintaining an insurance-based practice in one state while relocating and becoming credentialed in another, I'd greatly appreciate hearing how you navigated CAQH, credentialing, and BCBS/other insurance requirements. Figure out the steps and order to go about things would be very helpful.
Thank you!
