Practice Management

 View Only
  • 1.  Final Reads

    Posted 06-28-2022 09:14

     

    Hello:

     

    We are a small hospital based group. We currently utilize teleradiology services for overnight hours. We have always done prelims and our inhouse billing service bills for the final reads from our physicians. The group is looking at going to finals reads. I am looking for some guidance on how other groups handle the billing specifically small groups. From the information I have found I have been told we would credential all teleradiology providers through our payers and bill. I am concerned with the volume of physicians, their turn over rate and then having to bill the correct MAC where the physician is sitting. For groups that are doing final finds do you have a specific person that is in charge of just credentialing? Do you experience payment issues since the physicians is reading for many sites?  I have no experience in this space and looking for any guidance that anyone is willing to share. I'm happy to connect offline.

     

    Thank you!  

    Danyle Conner

    Four Corners Radiology Associate's, P.C.

    304 N Behrend Ave. Farmington, NM 87401

    O:505-325-1572 F:505-327-4887

    Fcra85@hotmail.com        

     



  • 2.  RE: Final Reads

    Posted 06-28-2022 10:26
    Hi Danyle,

    You are correct that you must bill the final reads under the reading Radiologist.  We have found that most of the payers allow us to credential the readers locally, while only enrolling the group in the various state Medicare MACs with the reassignment from the Radiologists.

    We have had some luck requiring that the teleradiology company limit the number of readers to a specific subset.  This may mean that you will need to credential 20 or 30 readers rather than potentially hundreds of them.  Even with limiting the number it is a revolving door as we find that most nighthawks change companies quite often.

    To answer your specific question we have a credentialing department, and don't experience many payment issues other than those related to keeping everyone credentialed.

    Feel free to reach out to me if you have any questions.

    ------------------------------
    Cindy Pittmon RCC, CHBME, FRBMA
    Founder, President, CEO
    Acclaim Radiology Management
    Longview TX
    (903) 663-4800
    ------------------------------



  • 3.  RE: Final Reads

    Posted 06-28-2022 14:12
    I just saw a good article on this topic. https://info.hapusa.com/blog-0/teleradiology






  • 4.  RE: Final Reads

    Posted 07-05-2022 10:33
    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

    Fax: 305-397-1139


    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.