Volume 6 - April 20, 2020
Provider Enrollment Updates:
While many of our clients already have active payer enrollment efforts underway, we continue to receive questions regarding the process changes during this emergency declaration. Therefore, we felt it would be helpful to provide the CMS guidelines along with several supporting resource links. There have been temporary waivers put in place that support expedited provider enrollment with Medicare, many state Medicaid programs, and commercial payers. V2V Management Solutions supports many of our clients with a full provider enrollment and credentialing service team. We have asked our in house Provider Enrollment Team Lead, Kristyn Dice, to share her insights on how to manage this process in hopes this brings clarity for those of you currently navigating these challenges.
For more information on Kristyn Dice visit our website: https://v2vms.com/who-we-are/krystin-dice/
By Kristyn Dice, Transformationist
V2V Provider Enrollment Team Lead
CMS has established toll-free hotlines at each of the Medicare Administrative Contractors (MACs) to allow physicians, non-physician practitioners and Part A certified providers and suppliers establishing isolation facilities to initiate temporary Medicare billing privileges. Physicians and non-physician practitioners may also contact the hotline to report a change in practice location.
Providers and suppliers should contact their local MAC.
NORIDIAN HEALTH SOLUTIONS (provided as an example)
Noridian is issuing PTAN’s while on the call but the group that the provider is joining must already be established and have a current/active group PTAN.
You will need the following information to add a provider:
- Group TIN (tax identification number),
- Group PTAN (provider transaction access number),
- Group NPI (national provider identifier),
- Provider First and Last Name,
- Provider NPI,
- Provider Social Security Number,
- Provider Specialty,
- Provider License #,
- Provider License State,
- Provider Telehealth (YES or NO); if YES to Telehealth include providers home address.
If you have multiple providers to add to a Group PTAN, Noridian will provide you a reference number and email you a spreadsheet in which you can complete for multiple providers/groups. You can complete the spreadsheet and respond directly back to the email with the information and obtain your temporary PTAN’s.
If after the crisis you wish to keep the providers temporary PTAN and move it to a permanent status you will have to complete the formal application process by PECOS (Provider Enrollment, Chain, and Ownership System) or by paper forms utilizing the temporary PTAN.
COVID 19 Medicare provider Enrollment Relief FAQs Link that includes all MAC Hotline numbers:
DEA - https://www.deadiversion.usdoj.gov/
Registration of Emergency Temporary Sites: If you need to set up an emergency or temporary off-site location and use controlled substances, please contact DEA at [email protected]. DEA will issue you a temporary registration number for each designated alternate location. This will enable the drug supply chain to continue uninterrupted and maintain patient access to needed controlled substances.
DEA Policy: Exception to Separate Registration Requirements Across State Lines
Many states have issued their own public health emergencies, resulting in changes to Medicaid, private payer and licensure with a primary focus on telehealth. The following are some resources and links to help navigate the information on a state level.
Americas Health Insurance Plans has created an extensive list of payers and how they are responding to the COVID crisis:
Federation of State Medical Boards (FSMB):
States Waiving Licensure Requirements/Renewals
States Waiving In-State Licensure Requirements for Telehealth
Center for Connected Health Policy:
CCHP provides an up to date summary of telehealth rules, including state licensure and private payer policies regarding telehealth coverage.
Quick Reference Chart with active links
Payer Enrollment Services
Creating a successful payer enrollment work flow ensures a solid foundation for practitioner payer enrollment, minimizing delays in reimbursement, and securing revenue cycle success. Effective physician onboarding is a process that depends on an organized approach to the many details that need to be addressed. This requires a synergy and expertise level that we can bring to your organization.
We are your resource for:
Disclaimer: V2V Management Solutions is a healthcare consulting firm. We are not licensed attorney’s or certified public accountants. This guide is not intended to replace legal or financial advice from your trusted resources. Before acting on any information provided check with the appropriate legal or financial team. This situation is a constantly evolving landscape be sure to research for most current information.The following content consists of key takeaways on information published in the above referenced articles, facts sheets, and our personal/professional experiences in financial management throughout a crisis.
V2V is here to help
Please keep in mind you should verify all information you are receiving from outside sources to ensure your interpretation on its implications for your business are accurate and appropriate.
Our V2V team stands by ready to assist you in navigating these turbulent times. We can quickly deploy resources to assist your team.