Why Does Opting Out of Insurance Now Require Me to Opt In?

It started with what seemed like a fairly mundane administrative request.

I have never participated directly with insurance companies. I built my private practice outside of insurance from the beginning. My clients pay me directly for their care, and some choose to use their out-of-network benefits and submit documentation to their insurance company for possible reimbursement.

Until recently, that meant I didn't need to be credentialed with an insurance company. I didn't need a CAQH account. I wasn't part of an insurance network.

Then Blue Cross Blue Shield asked me to register as an out-of-network provider.

Wait.

What?