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  • 1.  Billing EIN numbers

    Posted 03-13-2018 22:52
    ​I am hoping to learn the most effective method found by other groups for billing in multiple states.  In order to ensure "in-state" billing, do large billing companies have a central corporation with a single EIN, with multiple subsidiaries and separate EINs and different state addresses under it?  We are fighting an out of state issue which requires precertification for even plain films due to the fact that our EIN is associated with a different state.  We have tried everything except this.  What do other companies do to make this process the most efficient possible?

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    Kelli Besh
    CEO
    Tennessee Interventional & Imaging Assoc.
    Chattanooga TN
    (423) 778-7234
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  • 2.  RE: Billing EIN numbers

    Posted 03-14-2018 09:08
    Registering as a business in the other state and receiving a State EIN from them was the solution that worked for us when I managed revenue cycle for a Dermatology / Plastic Surgery practice.

    Good luck!!

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    Tim Hollingsworth
    Business Manager
    Central Illinois Radiological Associates
    East Peoria, IL
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    Original Message


  • 3.  RE: Billing EIN numbers

    Posted 03-14-2018 10:01
    I have never had any problem billing for services in multiple states with a single EIN.

    I can't think of a reason why there would be special precert requirements based on the state where your entity is based. 

    It sounds like maybe they are deeming you out of network.  Are you enrolled with the health plan in the state where you provide services?  Sometimes, the same national health plan has different subsidiary/operating entities based on geography, and you need to be enrolled with each subsidiary based on the location of service on your claim.

    I certainly would avoid setting up different EIN's if at all possible.  That would be a nightmare.


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    David Smith FACMPE
    Executive Director
    United Imaging Consultants
    Mission KS
    (785) 393-8387
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    Original Message


  • 4.  RE: Billing EIN numbers

    Posted 03-14-2018 11:28
    Kelli - I have clients that bill under separate tax IDs depending on the State due to State Department of Corporations Law.  If the State is a Corporate Practice of Medicine State - your TIN must comply with State regulations in order to bill Medicaid and/or Medicaid Advantage Plans.   For example - in California - you can not bill MediCal unless you are a physician corporation - EINs and LLC are not permitted.   We also have Medicaid Advantage Plans that do indeed require auths for every single imaging study as part of their UR programs.   The purpose of this seems to be to capture the part of their population that is capitated and direct them to the correct facility.  Our imaging center clients that operate in this environment require the patient to bring the auth with them at the time of exam or they call the health plan upon patient presentation to obtain the auth.   If you are in a hospital environment - this can be more difficult if not impossible.  In those cases - we have armed the physicians with data about non-payment of claims under this scenario to discuss the possibility of stipends to cover the costs for the studies.   

    Deborah MacFarlane
    949.378.8308





    Original Message


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