Question about insurance companies across state lines

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Psychguy1990

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I am a CAP fellow that is about to graduate. I plan to start a small cash based private practice after graduation on the side.

To have some income I would like to have an employed job in the beginning to supplement my income and give me benefits.
I was recently offered a telemedicine job in a different state (state B)than the one that I am living and going to be doing my cash based practice (state A). This practice does not take Medicare or Medicaid but they do accept private insurance. I will not be seeing patients with the aforementioned practice in the place that I am physically living (state A).

My understanding is that some insurance companies such as BCBS require that you get credentialed in each state that you are going to work in separately where as some insurance companies (cigna?) credential you for the whole US when you do any state. Is this accurate?

I am asking because I would like to take this job but do not want it to impact my patients ability to see out of network reimbursement for some insurance companies

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This is only in context to your query of private commercial insurance.
You will be just fine. No worries.

State B / private practice will have your claims being sent off with your NPI-I, their NPI-II and their Tax ID number. Their Tax ID# and their Type II NPI is what their contract is based on. NOT your type 1 NPI.

All private insurance will consider you out of network (OON) with your private practice. If anyone - you or patient - tried to submit a claim to the insurance companies, it would be the practice address at location A and only your type I NPI, which will not sync up with the above.

To further allay your concerns... I have same type II NPI, and tax ID number. Moved my practice from State Blue, to State Red, and insurance companies would not pay me in network (IN) until they updated their contract/directory with new address! Some even required a whole new contract... taking months.
 
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