Telehealth

Telehealth is reshaping how healthcare is delivered—and how providers and organizations are credentialed. If your practice offers virtual care, understanding the unique requirements for telehealth credentialing is essential for compliance, payer enrollment, and uninterrupted patient access.

What Is Telehealth Credentialing?

Telehealth credentialing is the process of verifying a provider’s qualifications, licenses, and compliance to deliver care remotely. This process includes additional considerations beyond traditional, in-person credentialing, such as technology standards, multi-state licensure, and payer-specific requirements.

Why Is Telehealth Credentialing Different?

• Multi-State Practice: Telehealth often means serving patients in multiple states, each with its own licensing rules and regulations.

• Technology Compliance: Providers must use secure, HIPAA-compliant platforms and document their use.

• Payer Variability: Medicare, Medicaid, and commercial insurers may have different credentialing and enrollment requirements for telehealth services.

• Credentialing by Proxy: Hospitals and health systems may use delegated credentialing processes for remote providers, which differ from standard credentialing.

Key Topics in Telehealth Credentialing

• Licensing and Multi-State Practice: Understanding state licensure requirements and interstate compacts for telehealth providers.

• Credentialing by Proxy: How hospitals and health systems can delegate credentialing for remote providers.

• Payer Enrollment for Telehealth: Navigating the unique requirements of Medicare, Medicaid, and commercial payers for telehealth services.

• Technology and Security Compliance: Ensuring your telehealth platforms and practices meet HIPAA and payer standards.

• Ongoing Maintenance and Recredentialing: Keeping credentials, technology, and compliance documentation up to date as regulations and payer requirements evolve.

Why Is This Important?

• Compliance: Proper telehealth credentialing is required to participate in insurance networks and receive reimbursement for virtual care.

• Patient Access: Credentialed telehealth providers can reach more patients, including those in underserved or remote areas.

• Risk Management: Following credentialing best practices reduces the risk of claim denials, audits, and regulatory penalties.