Let’s Address Addresses: How Your Location Affects Credentialing

Why Your Location Matters for Credentialing

At pie, we’ve encountered numerous providers launching their own practices who are surprised to learn that insurance payors require a physical practice address—even for telehealth-only services. Many assume they can simply use their home address or an alternative location, but these choices come with potential drawbacks.

If you're just getting started, you might be wondering:

• What address should I list if I only provide telehealth services?
• Can I use my home address?
• What if I plan to lease an office later but don’t have one yet?
• Do some payors require a site visit before approval?

If you're already credentialed but moving locations or opening an additional office, you may be asking:

• How does moving affect my credentialing with payors?
• Do I need to update my NPI and credentialing applications?
• How do I ensure claims and payments aren’t interrupted?

Understanding these requirements is crucial to avoid delays in credentialing approvals, payment disruptions, and exclusion from provider directories, which can make it difficult for patients to find you. This article breaks down what payors require, the best solutions for new practices, and what to do if you’re moving or expanding.

Do Insurance Payors Require a Physical Address?

Yes, most insurance payors require a physical business location when enrolling in their networks. This applies to all providers, including those offering 100 percent virtual telehealth services.

Why Do Payors Require an Address?

Even if you never see patients in person, payors require a physical location for:

• Administrative purposes – Ensuring their records are complete.
• Network directory listings – Some payors won’t list you in their provider directory without an address.
• Site visits – Some payors conduct inspections for fraud prevention and compliance.

Failing to provide a valid, acceptable address can result in delayed credentialing or even application rejection.

What Address Should Telehealth-Only Providers Use?

If you don’t have a physical office, you still have several options to meet credentialing requirements.

1. Your Home Address (But Be Aware of the Risks)

• Pros: Accepted by many payors for administrative purposes.
• Cons: It may be listed publicly in provider directories.

At pie, we’ve worked with providers who opted to use their home address for credentialing. While this can expedite the process, some were later concerned about privacy when their personal address appeared in public directories. If privacy isn’t a concern, using your home address may be the fastest way to get credentialed. However, check with the payor first to ensure they allow home addresses for telehealth-only providers.

2. A Shared or Subleased Office Space

• Pros: Meets payor requirements, gives you flexibility to see in-person patients if needed.
• Cons: Adds leasing costs, and you’ll need permission from the office owner.

Many providers rent space from an existing medical office or use a co-working space that allows healthcare professionals. This provides a professional address for credentialing while keeping costs low. One provider we worked with assumed they could use their church address for credentialing, but the payor rejected it because it wasn’t a valid healthcare location.

3. Virtual Office Services (Check Before You Use One!)

• Pros: Provides a business address for paperwork and mail handling.
• Cons: Some payors do not accept virtual addresses for credentialing.

Services like Regus or iPostal1 offer professional business addresses, but some payors flag these as invalid. Always confirm with the insurance company before listing a virtual office address.

4. A Future Office Address (If You Have a Lease Agreement)

• Pros: Ideal for providers planning to open a physical location but not operating yet.
• Cons: You must have proof of lease to submit with your application.

If you’re in the process of securing an office, some payors will accept a lease agreement as proof of location. This allows you to complete credentialing before you move in.

What If You’re Moving or Adding an Office?

If you’re already credentialed and are moving your practice or opening an additional location, it’s critical to update your credentialing information to avoid disruptions in reimbursements.

Steps to Take When Changing Your Practice Location

1. Update Your NPI Information – Your NPPES profile must reflect your current office location. If you’re keeping your old office and adding a new one, make sure both are listed correctly.
2. Notify Your Payors Immediately – Some insurance companies require pre-approval for a location change, while others allow you to submit an address update after the move.
3. Ensure Your Address Matches on All Documents – Your W-9, CP-575, and credentialing application must reflect the correct practice address.
4. Confirm If a Site Visit Is Required – Some payors conduct inspections for new locations, even if you were already credentialed at a previous address.

Common Pitfalls of Moving Without Updating Credentialing

• Delayed payments – If your payor hasn’t processed your address update, they may suspend payments.
• Claims rejections – If your address no longer matches their records, claims may be denied.
• Removal from provider directories – Some payors require a verified office address to keep you listed.

If you’re moving or expanding, contact each payor ahead of time to ensure a smooth transition and avoid reimbursement delays.

Do Payors Conduct Site Visits?

Yes, some payors require site visits before approving credentialing applications. This is more common for Medicare, Medicaid, and certain commercial payors.

When Do Payors Require a Site Visit?

• If you bill Medicare or Medicaid – Site visits are part of fraud prevention efforts and can happen at enrollment, revalidation, or if you update your location.
• If you are a new provider or group enrolling for the first time – Payors want to confirm that your practice location is legitimate.
• If there are red flags in your application – An address linked to multiple providers or an unexpected location (such as a home office) may trigger an inspection.

What to Expect During a Medicare or Medicaid Site Visit

• Unannounced Inspections: Medicare and Medicaid site visits are conducted by National Site Visit Contractors (NSVCs) and happen without prior notice during standard business hours.
• Verification of Business Operations: Inspectors confirm that your location is operational and matches the information in your enrollment records.
• Photographic Evidence: Inspectors take photos of your office, signage, and work areas.
• Home-Based Offices & Telehealth Locations: If your practice is registered at a residential address, the site visit will still occur at that location to verify legitimacy.
• Consequences of Failing a Site Visit: If your location cannot be verified or if the inspector finds discrepancies, your Medicare or Medicaid billing privileges may be revoked.

Signed, Sealed, Credentialed

If you’re setting up a new practice—or moving to a new location—your office address isn’t just a minor detail. It’s a big deal for credentialing. Some providers are caught off guard when they realize a home address might be public, or that payors don’t accept virtual offices. Others don’t expect a site visit but find out the hard way that Medicare or Medicaid wants to check in.

Here’s what to remember:

• Your practice location matters. Insurance payors almost always require a physical business address, even if you’re 100% telehealth.
• Not all addresses are accepted. A church, a P.O. box, or a virtual office might not meet credentialing requirements.
• Some payors will show up. Medicare and Medicaid can require site visits, and if they can’t find your office—or if it looks like a mailbox instead of a practice—you could be denied.
• Moving? Update everything. Your NPI, credentialing paperwork, and payor records all need to match, or you risk delayed payments and claims rejections.
• Telehealth adds another layer. Where you’re physically located when providing services—and where your patients are—affects licensing and credentialing rules.

The bottom line? Don’t let something as simple as an address slow you down. If you’re not sure what to list on your applications—or you want to avoid headaches with site visits and approvals—we can help.