Credentialing question

csperoni

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It's usually helpful if you post the question. Even someone without a lot of credentialing experience may have gone through your specific scenario and provide assistance.
 

Blackhorse

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We have a medical group with 2 PCPs. One MD is in California and the other PCP is in Virginia. When we applied for NPI for this group, we use a Tennessee address. These 2 PCPs will only do telehealth for California and Virginia patients. My question is: when we apply for credentialing with carriers, can we use either California or Virginia address, or we have to use the Tennessee's address?
 

csperoni

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Sorry I asked! 🤣
No experience credentialing only for telehealth with 2 providers in 2 different states and a business address in a 3rd state.
I will say however that most insurance credentialing allows for a "practice" address (which would be your CA or VA) and a separate payment or administrative address (which could be your TN if desired).
Sometimes an insurance will incorrectly mail a notice to the practice that should have gone to administrative address, but I would estimate 98% of stuff goes to the right location.
I know telehealth has drastically changed over the past 20 months, but I wasn't even aware an insurance would contract with a provider only for telehealth (unless it's through a 3rd party that insurance has an exclusive contract with to provide telehealth). I would assume each insurance company has their own policy about this (just like how everyone has their own policy about how telehealth is billed).
Good luck & maybe if anyone has experience similar to your situation, they will chime in!
 

Blackhorse

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Sorry I asked! 🤣
No experience credentialing only for telehealth with 2 providers in 2 different states and a business address in a 3rd state.
I will say however that most insurance credentialing allows for a "practice" address (which would be your CA or VA) and a separate payment or administrative address (which could be your TN if desired).
Sometimes an insurance will incorrectly mail a notice to the practice that should have gone to administrative address, but I would estimate 98% of stuff goes to the right location.
I know telehealth has drastically changed over the past 20 months, but I wasn't even aware an insurance would contract with a provider only for telehealth (unless it's through a 3rd party that insurance has an exclusive contract with to provide telehealth). I would assume each insurance company has their own policy about this (just like how everyone has their own policy about how telehealth is billed).
Good luck & maybe if anyone has experience similar to your situation, they will chime in!
Thank you for your reply. Maybe we just don't get the group credentialed. We can bill use those 2 PCP's individual NPI, they are already credentialed with almost every carrier.
 
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