General Category > General Questions

Radiologist Credentialing

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macbook:
We have an inquiry from a radiologist who wants to work from home. He has contacts from all over the States. Do we need to credential him from every state? He will be based in Texas. What will be the POS be when it comes to billing? I am thinking he has to establish part of his home as a business office as well.

Appreciate any insight!

macbook:
For the POS portion, the Radiologist POS is still 11 being home based. Will find out more about the credentialing portion from other States when I get some answers. :).

Michele:
I'm assuming he is reading the xrays online?  Since he is reading them in TX, he will be billing TX and only needs to be credentialed in TX.  We actually billed for a radiologist who did this from TN.  She read xrays online, from her home, which was her office.  POS was 11, all billing went thru TN.  The problem is with Medicaid since that is a state program.  If pts have Medicaid provider can only bill if they are enrolled as a Medicaid provider with the state the patient is from.

macbook:
Thank you so much Michelle! He hasn't called us back yet. But we wanted to be ready when he does. Thanks again.

Sriram_Sub:
I am interested in this topic. How should the provider handle claims that might be denied for provider being out of network or Non-Par? I think this could be a common problem with commercial carriers when the radiologist's patients are from other states. Correct? Please throw more light on this.

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