The Hidden Benefits of Regular Payer Contract Reviews

[@mohammadqabir5272]

Very informative. I heard there is a website or application where we can find the current reimbursement per CPT code from insurance companies, and this can be looked up by NPI. Im not talking about the fee schedule.

[@navigatingthebusinessofmed8251]

Hi there and thank you for watching. If there is something like this then I would love to know about it! I only know about the Medicare Physician Fee Schedule and Medicaid state fee schedules that are available to the public. I don’t even know any insurances that you can log-in to their portal to see your individual agreed upon fee schedule so please let me know if/when you find this!

[@stev5vasanth]

Could you please provide an explanation of cross-state and compact licensing for out-of-state providers offering telehealth and telemedicine services to out-of-state patients? Additionally, how can the telehealth-only credentialing process be initiated for out-of-state providers, and what mandatory documents are required to start the telehealth credentialing process? Thank you !!

[@navigatingthebusinessofmed8251]

Hi there. This is a very complex set of questions because every state has different requirements for out of state and telehealth providers. These were triggered due to the pandemic. Most states require the provider to be licensed, but some have an option if it is for telehealth only. We are anticipating Medicare making changes to the telehealth requirements soon that will go into effect 1/1/25. I’m advising everyone to be mindful of this and try to wait on any telehealth-dependent decisions until these are released here in the next few months because states and insurances will change their policies based on these requirements. Behavioral health is the only specialty right now where permanent telehealth guidelines have been established and everyone else is waiting to see what changes will come. Thank you for watching!