The first thing to do is to check your National Registry account to verify that the exam has in fact been submitted.

One thing that prevents an exam from being transmitted from the National Registry to the state is if there is anything incorrect with one of the key identifiers such as name, DOB, license #, etc.. An error will appear in your task bar to the right of the menu and it must be corrected before the exam can be processed. The most common reason for this to occur is when CDL applicants are submitted, because the National Registry does not recognize them. When this is the case, simply acknowledge that everything is correct.

Medical certifications requiring a variance (an exemption, waiver, or skill performance evaluation certificate) from FMCSA will not be transmitted to the SDLA until FMCSA issues the variance.

• The Medical Examiner’s Certificate (Form MCSA-5876) will indicate "Accompanied by a waiver/exemption" or "Accompanied by a Skill Performance Evaluation (SPE) Certificate" if the driver requires a variance from FMCSA.
• NOTE: If the certificate (MCSA-5876) indicates that the driver requires a vision or diabetes exemption, the ME will need to correct the error. FMCSA no longer issues vision and diabetes exemptions because they published revisions to these standards under which the ME evaluates the driver.

The exam reporting process between the National Registry and the states consists of two steps: (1) the push transactions from the National Registry to the SDLAs and (2) the pull transactions that allow the SDLAs to retrieve a driver's medical examiner’s certificate information from FMCSA’s National Registry. After the examiner submits a certification via his/her national registry account, the trouble appears to be with step 2, that is, the state does not automatically “pull” the transaction from the FMCSA’s national registry.

As a result, the FMCSA has published a document that outlines the steps the state DMV should take to obtain the driver’s record. This document can be found here: Best Practices for SDLAs that Have Implemented NRII

If the driver has taken this document to the SDLA and there is still an issue or they refuse to try, the next recommendation is to resubmit the exam. In this instance, you shouldn't change the exam date, certification date, or any other information unless you perform a new exam. Unfortunately, this will cause you to receive a "late submission" notification, but this is not something that you should be concerned about.

If there is anything incorrect with one of the key identifiers such as name, DOB, license#, etc., an error will appear in your task bar to the right of the menu, and it must be corrected before the exam can be processed. If you’re not already doing so, I recommend obtaining a copy of the driver's license.

Sometimes MEs will receive this error message, but they find no error. The most common reason for this to occur is when CDL applicants are submitted, because the National Registry does not recognize them. When this is the case, simply acknowledge that everything is correct.

The late submission notification banner appears at the top of your National Registry dashboard any time an exam is submitted or resubmitted past midnight of the following calendar day from the time the exam was performed. This is an automated system that does not consider the many instances in which a "late" exam submission occurs intentionally.

The goal of this notification is to recognize that an exam has been submitted late and to determine what needs to change so that the same thing doesn't happen again. The banner will automatically disappear once no late exams exist in the last 30 days. There is no additional action needed.

If a driver is approaching expiration of their medical certificate and worried about their driver's license being downgraded, you can refer to the State-by-State Instructions for Submitting Medical Certificates. This document delineates each State's consequences for driver's failure to keep their medical certificate current. States have a timeframe allotted (usually at least a year) for a driver to acquire a new medical certificate before they will have to undergo CDL training once again.

We have developed a relationship with BetterNight who is very familiar with the DOT space. They have been in the business for over 30 years.

BetterNight provides a home sleep test that can be done in the sleeper bed of a truck and then receive results in as little as 1-2 days. They can bill insurance and they offer payment plans if needed.

You can make a referral by heading to the TeamCME member center and clicking on the Sleep Apnea Testing button. You can also hover over Providers in the top menu and select "Sleep Apnea Referral" from the dropdown menu. Here is a direct link to the referral form: https://teamcme.com/wp-content/uploads/2026/03/Driver-Referral-Form.pdf

We have an article that will answer most of your questions. Here is a direct link: https://teamcme.com/resources/providers/how-to-become-a-dot-certified-medical-examiner/.

FMCSA requires all examiners to complete NRCME-approved training covering:

• the FMCSA medical standards
• physical qualification rules
• documentation and reporting
• driver health history review
• disqualifying conditions and exemptions

This training prepares you for the certification exam and ensures you understand federal expectations. Learn more about FMCSA-required training here: NRCME Certification Training

The equipment that you need to perform DOT physicals are the following:

• Sphygmomanometer (blood pressure cuff)
• Stethoscope
• Digital Finger Pulse Oximiter
• Snellen eye chart
• Eye occluder
• Urinalysis supplies & CLIA Certificate of Waiver from your state

If your state license allows you to puncture skin, we suggest a Hemoglobin A1c testing kit. You can charge the driver for this, and it saves them time and money.

Having color vision test cards makes it easy to check if they can differentiate between traffic signal colors red, amber, and green. If you have these colors on your Snellen chart, you can use those instead.

The DOT is working to add Fentanyl to their drug testing panel. Therefore, there has been a delay in the Department of Health and Human Services’ (HHS) final approval of testing devices and labs. Once the course is available, it will contain both the Qualification Training and the Proficiency Demonstration (mock collections). Upon completion, you will be certified to perform DOT oral fluid specimen collections.

To use our lab and consortium services, you must be a TeamCME member. Here is a link to the webpage that provides a brief overview of our membership program: https://teamcme.com/why-join-teamcme/. There is a Register button on this page if you choose to become a member.

The TeamCME lab account setup form is accessed by first logging in to the TeamCME member center, then clicking on the Lab Account button. Clicking on "Create a Personal Lab Account" will take you to the lab account set-up form. Once submitted, we will work with Quest to assign DOT and non-DOT lab account numbers and place an initial supply order which will be shipped to the address indicated on your setup form.

Creating an employer lab account will allow you to have CCFs with the employer’s information pre-printed on the form. If desired, you can also opt to have lab results sent to the employer. The Employer Lab Account Setup Form is accessed through the Lab Account page and clicking the button “Create an Employer Lab Account”.

The MRO will review both DOT and non-DOT lab results, and our lab prices include this MRO fee. The cost of a Federal 5-panel test is $20.25, and the cost for the commonly ordered non-federal tests is $17.75.

Our Lab Panel Codes & Member Pricing Reference webpage is accessed through the Lab Account page. This page lists all the panel codes for DOT and non-DOT drug tests, what substances are tested, and each panel's price.

When a clinic desires to perform a non-DOT test using one of the panels other than the basic 5-panel or 10-panel test, they must first ask a TeamCME representative to have this added to their list of approved panels.

Before performing tests using an instant kit, TeamCME must first create an Instant Kit account number for you. The Quest panel code for these tests is 45239Na.

These instant kits can be purchased through the TeamCME store by hovering over "Store" in the top menu and selecting "Drug Testing Forms & Supplies" from the dropdown menu. They are sold in boxes of 25 for $325.50 per box. Each test includes specimen validity testing and MRO confirmation testing is included.

Please view our How to guide titled "How to Send CCF2 to the MRO". All our How to guides are located on our Lab Account webpage.

Name:
Janelle A. Jaworski, MD
Certified Medical Review Officer (MRO)

Organization: i3Screen

Address:
9501 Northfield Blvd
Denver, CO 80238

Phone: 877-585-7366

Fax: 855-253-5666

Email: mrs@i3screen.com

All lab test results are located within the TeamCME Vault. This results portal can be accessed by clicking on the TeamCME Vault button on the Lab Account page or by going to teamcmevault.com.

For instructions on how to navigate the TeamCME Vault lab results portal, please view our How to guide titled "How to Find Pending & Completed Lab Results in TeamCMEVault.com". All our How to guides are located on our Lab Account webpage.

If you cannot find your lab test results in the TeamCME Vault results portal, please complete the online form titled, "Missing Lab Test Results Form". This will provide us with the information we need to investigate why these results do not appear. This form can also be accessed from the Lab Account page by clicking on the "Get Help Finding Missing Lab Results" button.

The TeamCME Vault has made it easy to make corrections to a donor's name or the name of their employer. Our guide, "How to Make Corrections to a Lab Result Form" provides a step-by-step approach and includes images to walk you through the process. It can be found within the How to Guides section on our Lab Account webpage at https://teamcme.com/lab-account/.

The TeamCME Vault ePassport system allows you to create a donor pass and have a donor tested at a different location that you designate. When creating the ePassport, you will be provided with locations to choose from that have Quest lab accounts and that are near the donor. It's best if you make arrangements with the collector prior to creating the ePassport. The ePassport will automatically be generated with a unique barcode and instructions which are sent to the donor. The donor brings the ePassport and a valid photo ID to the collection site, and the clinic scans the barcode. It's easiest to have the collector charge the donor their usual customary fee rather than trying to coordinate payments.

To create an ePassport, (1) login to the TeamCME Vault, (2) open the Occupational Health Screening folder in the top left corner, and (3) select "Create New Order". The form will guide you through the process of choosing the test type, entering the participant's information, choosing a collection site, and submitting the order.

You must be logged in to order supplies. These can be ordered through our online store by hovering over "Store" in the top menu and then selecting the appropriate item from the dropdown menu. When ordering:

1. Enter your Quest lab account number
• Your lab account number can be found in two locations on your CCF form. It is the farthest number to the left, under the barcode, and can also be found to the right of the barcode.
2. Click Add to Cart, then click View cart that will appear above
3. On the cart page, click Proceed to Checkout

To perform a USCG specimen collection for drug testing, all that is needed is to send an email to MRS@i3screen.com. They will complete the form and upload it directly to the case. Someone from their team will respond to let you know once that has been completed.

Our webpage Consortium/TPA Services discusses what a consortium is, how to get started, and the difference between the traditional model and the TeamCME model.

As a TeamCME member, the best first step is to review the TeamCME Consortium Member Guide that outlines specifically how the TeamCME consortium program works, your responsibilities, adding companies to the consortium, the random selection process, and the FMCSA Clearinghouse.

Consortium fees typically include an initial enrollment fee and an annual consortium fee. After the initial enrollment year, companies are generally billed only the annual fee each January. This structure is standard practice throughout the industry.

The TeamCME Consortium Fee Schedule is located on the Consortium webpage. These are our member fees and are based on the size of a company and the time of year the company joins. Most TeamCME members charge their clients at least double the amount of the TeamCME member fee to account for their own administrative time, customer support, and collection coordination.

The Consortium webpage includes online forms for adding a company and making updates to existing consortium companies. When enrolling a company, you will need to provide:

Company Information

• Company name
• Business address
• Contact information
• Participant start date
• Regulatory mode (FMCSA, FTA, FAA, non-DOT, etc.)

Designated Employer Representative (DER)
Important considerations:

• The DER should generally not be someone who may be selected for random testing
• The exception is for owner-operators, where the owner may also serve as the DER

Participant Information 
For each participant, you must provide:

• First and last name
• License number
• State of issuance

You will also need to provide documentation from within the last 30 days of ONE of the following: 

• Specimen ID# for each participant when using a TeamCME account CCF
• Test results for each participant from a non-TeamCME lab account
• Proof of previous enrollment in a randomized drug and alcohol testing program
• Certificate of Enrollment from previous program; OR
• Have the company complete the Prior Consortium Enrollment Verification Form

Changes to existing consortium accounts can be made through the "Update Existing Consortium Company Info" form found on the Consortium webpage.

This form can be used to:

• Add employee
• Reinstate employees
• Remove employees
• Update company contact information

Changes to existing consortium accounts such as changing the changing a company's contact or their DER information can be made through the "Update Existing Consortium Company Info" form found on the Consortium webpage.

To remove a company from your consortium, the Consortium Company Removal Form must be completed. The link to this form is in the left-hand column of the Consortium webpage.

Here is a direct link to the random testing rates for each DOT agency: https://www.transportation.gov/odapc/random-testing-rates

Non-DOT consortium pools are not required to follow DOT random testing percentages or procedures. Non-DOT employers may determine the testing frequency and which tests are performed.

Random selections are conducted on a quarterly basis throughout the calendar year.

• Quarter 1 = January – March
• Quarter 2 = April – June
• Quarter 3 = July – September
• Quarter 4 = October – December

When quarterly selections are completed, you will be emailed a Notification of Random Selection letter identifying the individuals selected for testing.

Unless dealing with an owner-operator, notification timing should be coordinated with the company’s DER.

Employees should generally be notified:

• While reporting to work
• While actively working
• Immediately after completing work duties

Employees should never receive advance notice of a random test. Whenever possible, employees should be notified while they are available to report immediately to the collection site.

If the DER is also the selected individual, we recommend:

• Having the individual report to the collection site first
• Informing them of the random selection upon arrival
• Immediately proceeding with the collection process

If an employee cannot complete testing due to a legitimate reason such as extended leave, long-term illness, or other documented absence, the reason should be documented appropriately. You may then submit a "Request an Alternate to be Tested" form located on the Consortium webpage or conduct an additional selection during the next testing cycle.

If the driver does not appear and the test is not terminated or reassigned to an alternate, the test will remain uncollected on the record. TeamCME will continue to notify the clinic of any outstanding random assignments that require collections.

Employees on Scheduled Days Off

• If an employee has not yet been notified and is off duty, testing may occur during their next shift
• If the employee has already been notified, they must still report immediately for testing, even if they are off work that day

If you are notified that a company in your consortium is being audited, use our email address contact@teamcme.com to either forward us the email notification, have the requesting authority send us the notification, or let us know what documentation is being requested. We will then gather the information and provide it to the requesting authority.

The FMCSA Clearinghouse is a secure online database that provides employers and other authorized users with real-time information regarding CLP and CDL driver drug and alcohol program violations. All CDL holders who actively operate under their commercial license should maintain a Clearinghouse account. In addition, owner-operators and companies employing CDL drivers should designate a consortium/third-party administrator (C/TPA) to manage their DOT drug and alcohol testing program requirements.

Employer Clearinghouse Responsibilities

Under FMCSA regulations, employers are required to use the Clearinghouse to:

• Conduct queries on prospective drivers to determine whether they are prohibited from performing safety-sensitive functions due to unresolved drug and alcohol program violations
• Conduct annual queries on all current CDL drivers
• Obtain driver’s consent before conducting any query
• Report drug and alcohol program violations, including:
• Alcohol test results with a concentration of 0.04 or greater
• Refusals to submit to required alcohol or drug testing
• Actual knowledge violations
• Report negative return-to-duty (RTD) test results
• Report successful completion of a driver’s follow-up testing plan

We recommend downloading the document "How to Designate Your C/TPA" that the FMCSA created. It provides a step-by-step approach with images.

If TeamCME has accidentally rejected the designation request, the company can simply clear out the old request and send a new one:

• Step 1: In your Clearinghouse account, go to My Dashboard → Manage → C/TPAs
• Step 2: Locate TeamCME and the status of "Rejected"
• Step 3: Use the option to revoke/remove that rejected request. This clears it from the account.
• Step 4: Search for TeamCME once again and repeat the original process

Completing tasks in the Clearinghouse is something that companies can do with relative ease. We have a section on our Consortium webpage titled "Clearinghouse Instructions for Employers & Drivers" that includes links to download easy-to-follow guides.

If a company prefers not to perform these tasks themselves, then as the company’s designated C/TPA, TeamCME can perform many Clearinghouse-related tasks on their behalf, including conducting queries, reporting return to duty tests, reporting the completion of follow-up testing, and reporting violations.

To authorize TeamCME to perform these services, please complete the with relative ease. We have a section on our Clearinghouse Request Form located on our Consortium webpage. There is a minor fee involved with the completion of these tasks. These fees are listed on the second page of our Consortium Pricing document that can be found on our Consortium webpage.

Conducting a query in the Clearinghouse is something that companies can do with relative ease. They are required to purchase a query plan to conduct these queries on current and prospective employees. Query plans may only be purchased directly through the official Clearinghouse website by registered employers. TeamCME has a section on our Consortium webpage titled "Clearinghouse Instructions for Employers & Drivers" that includes links to download easy-to-follow guides.

If a company prefers not to conduct a query themselves, then as the company’s designated C/TPA, TeamCME can conduct queries on their behalf.

To authorize TeamCME to conduct a query, please complete the Clearinghouse Request Form located on our Consortium webpage. There is a minor fee involved with the completion of these tasks. These fees are listed on the second page of our Consortium Pricing document that can be found on our Consortium webpage.

Completing tasks in the Clearinghouse is something that companies can do with relative ease. We have a section on our Consortium webpage titled "Clearinghouse Instructions for Employers & Drivers" that includes links to download easy-to-follow guides.

If a company prefers not to perform these tasks themselves, then as the company’s designated C/TPA, TeamCME can perform many Clearinghouse-related tasks on their behalf, including conducting queries, reporting return to duty tests, reporting the completion of follow-up testing, and reporting violations.

To authorize TeamCME to perform these services, please complete the with relative ease. We have a section on our Clearinghouse Request Form located on our Consortium webpage. There is a minor fee involved with the completion of these tasks. These fees are listed on the second page of our Consortium Pricing document that can be found on our Consortium webpage.

Completing tasks in the Clearinghouse is something that companies can do with relative ease. We have a section on our Consortium webpage titled "Clearinghouse Instructions for Employers & Drivers" that includes links to download easy-to-follow guides.

If a company prefers not to perform these tasks themselves, then as the company’s designated C/TPA, TeamCME can perform many Clearinghouse-related tasks on their behalf, including conducting queries, reporting return to duty tests, reporting the completion of follow-up testing, and reporting violations.

To authorize TeamCME to perform these services, please complete the with relative ease. We have a section on our Clearinghouse Request Form located on our Consortium webpage. There is a minor fee involved with the completion of these tasks. These fees are listed on the second page of our Consortium Pricing document that can be found on our Consortium webpage.

We help our members institute key factors and additional service opportunities that will jumpstart practice growth, boost referrals, and maximize efficiency. Here are a few of the benefits:

• We create a personalized, search engine optimized, DOT-specific webpage for all our members. We also place your office location on our referral map to help drivers find a location near them for the DOT services you may provide
• Our member center has free training for Medical Examiner Administrative Assistants (MEAA) that helps your staff become knowledgeable in regulations and procedures surrounding the DOT physical exam. It also includes medical clearance letter templates, FMCSA documents, a sleep apnea testing referral system, and a link to our TeamCME Medical Examiner Reference Manual.
• Our DOT Exam Expert chat bot is available at all times through the member center. This is a program that we have trained and tested on the most current FMCSA resources and medications.
• TeamCME members also receive a $10/month discount on Simple Physical, a DOT exam-specific electronic health record system we co-created. This is a way to complete the exam electronically, guiding examiners through the exam, providing prompts and alerts along the way, then reporting exams to the National Registry.
• As a company with members nationwide, we have been able to negotiate discounted lab prices that we pass on to our members. We also make it possible for our members to offer randomized drug testing consortium services to drivers and other DOT-regulated organizations.

Most of the information about the benefits we provide to TeamCME members can be found on our webpage "Why Join TeamCME".

To access the training portal, make sure you are following these steps:

1. Hover over "My Account" in the top right corner, then select "Training Portal"
2. Enter your email and password. If you do not remember your password, you can click the "Lost your password?" link just below the login button and you will be sent an email with a link to reset your password.
3. After clicking "Login" you will be redirected to your training portal.
4. In the training portal, simply click on the picture of the course to access its content.

To access the member center, you must have a membership account. If you are not already a member, you can learn more about our member benefits by heading to https://teamcme.com/why-join-teamcme/.

TeamCME members access the member center by:

1. Hovering over "My Account" in the top right corner, then select Member Center
2. Enter your email and your password. If you do not remember your password, you can click the Lost your password? link just below the login button and you will be sent an email with a link to reset your password.
3. After clicking “Login” you will be redirected to the member center

Orders placed with TeamCME get processed by the end of the following business day. Once the ordered items are in possession of the delivery company, the rest is out of our control. Orders that are packaged and sent from our office can be tracked. This is also the case with lab orders.

Larger items such as the alcohol testing devices, Jant UA analyzer, and the EasyOne portable spirometer are shipped directly from the manufacturer. Although these companies are usually quick to process orders, this is not something we can control. To learn the status of an order, the perspective company must be contacted directly.

TeamCME members can edit their own information as needed. You simply need to login to the TeamCME member center and find the Account Information subheading in the left column. Under Account Information, click on the link Update Your Clinic Listing(s).

On the next page you’ll need to select the clinic you are editing from the dropdown menu (there will only be one listed if you only have one clinic). Every field on the form is blank but only complete the fields for the information you want to change. Then save your changes.

Simple Physical is an electronic health record system (EHR). It guides examiners through the exam, providing prompts and alerts along the way, then reports exams to the National Registry. If you'd like, you can Schedule a live demo by clicking on the "Book My Demo" bar at the bottom of the Simple Physical home page. There are also multiple videos located on the Simple Physical website that can be found by scrolling slightly down the page.

The most unique feature of DOT Exam Expert is our DOT exam assistant that we have trained and tested on the most current FMCSA resources. Users can also use it to perform a medication search that will provide the type of drug, its indications, side effects, and DOT medical certification criteria. Examiners can also find the information they need by searching through the Body Systems categories. There are also additional resources such as a library of all FMCSA documents, clearance letters templates, BMI calculator, and interactive algorithms for hypertension, seizures, and sleep apnea.

To make changes to your membership account information, login to the TeamCME Member Center. The second column from the left has the heading, “Account Information”. The necessary edits can be made by clicking the appropriate link in this column.

We are no longer providing the Motor Carrier list directly. However, you can access this information for free through the U.S. Department of Transportation’s website. The platform allows you to filter by state and city, view detailed company information, and export the data into Excel, Google Sheets, or other formats.

Please use the following link to explore the data: https://data.transportation.gov/Trucking-and-Motorcoaches/Company-Census-File/az4n-8mr2/explore

We have approximately 60 medical clearance letter templates that can be used when performing DOT physical exams. They are found by logging in to the TeamCME Member Center and clicking on the Clearance Letters button under the DOT Physicals subheading.

Our free training for members and their staff includes our Medical Examiner Administrative Assistant (MEAA) Training and our FAA BasicMed Exam Training, as well as various instructional videos and documents. The Free Training webpage is accessed by clicking on the Free Training button located under the Additional Resources subheading.

TeamCME has partnered with BetterNight to provide drivers with the best service available. Drivers who are referred for a sleep study will have a 10-15 minute consult with a physician. They will then be sent a home sleep test that can be done anywhere they are.

The cost for this test is $224. Insurance is accepted and financing is available. If the driver has sleep apnea, they will receive therapy, ongoing coaching support, and BetterNight will provide all necessary reporting. This is all for $799.

Complete the Sleep Apnea Referral Form to get a consult started.