Good morning Danyle,
When I worked for Change Healthcare, I had a couple clients that used national telerad companies (OnRad and Direct). Their telerad rosters were 30+ physicians each so it was a daunting task to manage. I managed that process for a couple years, so I'm very familiar with telerad enrollments.
In my experience, only Medicare and Railroad Medicare care about the reading physician's address. All other payers, including Medicaid, use the TC address as the practice address.
I requested that the telerad companies give me as much notice as possible when their physicians moved. Frankly though, they often don't find out until the doctor has already moved.
I have a couple suggestions:
1. Use PECOS for all of the enrollments. Don't use paper forms. PECOS is significantly faster, and it prevents data entry errors. All of the major telerad companies have access to each of their physician's PECOS portals to e-sign the 855r applications. You shouldn't need to do any 855i's since the physicians should already be enrolled in their home states. You will need to do 855B's for your group to enroll your group in each state with the physicians' home addresses as the practice locations. Your group's Authorized Officials will need to know their PECOS logins to sign the applications.
I always used the group's name as the location name. As the address line 2, I used "Dr Jones's Home Office". That way I could easily identify which practice location belonged to each physician. Also, if any mail was sent to the physician's house, it would have our group's name on it instead of the individual physician's name on it.
2. CMS/Medicare publishes a zip code to locality spreadsheet. This will be your best friend to manage the process. Keep your own spreadsheet with physician info, physician address, state, carrier, locality, Medicare group PTAN, Medicare DR PTAN, and EDI status for that group's PTAN.
Download both of these files:
3. After receiving PTAN approvals from Medicare, double check that you received the expected outcome. I caught many, many errors where the Medicare analyst assigned a physician's PTAN to the wrong group PTAN. Particularly in California where there are 32 different localities.
4. Every new locality will have a unique group PTAN which also means a new EDI enrollment after the group's PTAN has been approved.
Good luck!
Janene W. Markuske (she/her)Executive Director
IntelliRad Imaging, LLC
3661 S. Miami Ave
Suite 1001
Miami, FL 33133
Office: 305-712-7229, ext 5
Cell: 727-244-7542
This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution, or copying of this message is strictly prohibited. If you receive this message in error or are not the named recipient(s), please notify the sender by return email and delete this message.