Telehealth Credentialing

The rule that drives everything: license where the patient sits

A provider has to be licensed in the state where the patient is physically located at the time of the visit. Not where you are. Where they are. This holds for Medicare, for state Medicaid, and for every commercial payer. So a virtual practice seeing patients in twelve states needs to be properly licensed and enrolled across all twelve. Get this wrong and the visit is not billable, and in some states not even legal.

That is the whole challenge in one sentence. The rest is how you solve it without applying to thirty boards one at a time.

Compact license or license by license?

There are two ways to reach a new state. Apply for a full individual license, board by board. Or, if your profession and both states qualify, use a licensure compact for an expedited path. Compacts are faster, but they do not cover everyone. Here is the honest comparison.

A compact license still is not payer enrollment

This is the part that surprises people, so read it twice. A compact license lets you practice in a state. It does not enroll you with that state's payers. Licensing and payer enrollment are two separate jobs, and you need both before a claim pays.

So even after a clean IMLC or PSYPACT path, you still enroll with Medicare, with that state's Medicaid program, and with each commercial plan you want to be in network with. We run both halves so nothing falls through the gap between them. Start with medical licensing and NPI registration for the license side, and provider credentialing for the verification and enrollment side.

phone

Payer enrollment, state by state

Licensing gets you in the door. Enrollment gets you paid. For a multi state telehealth group, that means:

Credentialing by proxy for facility telehealth

If your clinicians serve hospitals or other facilities, there is a shortcut built for exactly this. Credentialing by proxy lets the originating site, the facility receiving the service, rely on the privileging done by the distant site, the entity providing it, instead of fully re credentialing each provider. It needs a written agreement, and the distant site has to be a Medicare participating hospital or telemedicine entity, or accredited by the Joint Commission. For facility based telehealth it is a real time saver, and we set up the agreements and the proxy file.

What we run for telehealth groups, at scale

The reason groups outsource this is volume. Twenty clinicians across fifteen states is three hundred licensing and enrollment tracks, each with its own deadline. We map every provider against every target state, run the right compact or individual license for each, build and attest CAQH, file Medicare, Medicaid and commercial enrollment per state, coordinate primary source verification, chase the follow ups, and report where each track stands. You hand us the roster, the states and the payers. We run the maze. If your roster includes psychologists or therapists doing telepsychology, see mental health credentialing, and for the wider picture start at our medical credentialing services or browse credentialing by specialty.

specific proof points — providers credentialed, states covered, years in business.

Frequently asked questions