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In-Network status following to new office in new state?

September 13, 2016
 
Question:

Hi Jennifer,

Hope you're well.
I have a quick question about insurance.

I am contracted with a bunch of insurances in NY where, as you know, I practice.

I am thinking of opening an office in Connecticut. I would like it to be a no insurance accepted office.

I heard there is no reciprocity between NY and Connecticut regarding health insurance and that I can do this. 

Any idea if this is correct?

Thanks, Dr. A


Answer: 

Generally speaking, insurance credentialing is state by state - so when you move to a new state you would have to apply for credentialing and in-network status in the new state.  So, the answer to the question would be, yes, you can practice out of network in the new state. Of course with many questions there is not necessarily a definitive yes or no answer, and also there may be some gray in the middle.  While insurance is regulated on a state by state basis, there may be certain contractual relationships you enter in to with a payor that would restrict or create a relationship across state lines to be wary of.  

Be sure to review all existing contracts (or send over for review) you are a party to before making the move and assuming your in-network relations do not follow.  




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