Locum Tenens Physician Billing

Locum Tenens Billing

In all areas of medicine, locum tenens staffing is increasing and definitely a growing trend. However, even with its popularity, a lot of medical professionals are not exactly clear about this sort of service, and most especially where billing is concerned.

There are some very specific guidelines that you must follow, and we are going tophysician-billing
look at some of the basics; you must, as one locum tenens staffing group said: “When you understand how to properly bill for locum tenens services provided, you’ll find that locum tenens staffing is an effective way to generate revenue while ensuring patient access and continuity of care.”

The Most Basic Demands

To begin with, a locum tenens position is one that designed to “hold a place” for locum tenen physician billinganother physician. Generally, any locum tenens position is purely temporary (ranging from a few days or a few months or more), and is meant to help fill temporary staffing shortages. These tend to be shortages brought about by illness, vacation, vacancies or other causes, and a practice hires the locum tenens medical provider as a means of maintaining patient care and quantity.

Occasionally, a locum tenens is hired simply by a practice to test the need for an additional staff member before going through a hiring process. It is an ideal solution to the growing practice working on staffing plans or expansions.

Most locum tenens employees will come from a staffing service, and the medical professional always understands that their role is temporary. The flexibility and challenge that this role offers is often a reason that a seasoned professional is happy to work in the locum tenens style.

Generally, the role and the duration of the locum tenens professional is going to actually dictate the kind of billing used for their services. For instance, if you have hired them strictly in the classic sense of holding a place open for another physician to return after their extended leave, you may bill them using the original physician’s billing information.

The Conditions

medicare billingThe locum’s temporary placement allows practices to use the Medicare guidelines.
This means you bill their fees under the absent physician’s billing information when:

  • The original physician is unavailable
  • The patient has planned to receive care from the absent physician
  • The locum is paid “per diem” or another sort of fee-for-time method
  • The locum will not provide services to Medicare patients for longer than 60 days

This means that the NPI of the absent physician is used along with the modifier (-Q6) to identify a locum tenens provider at work.

When the physician is to be absent for more than 60 days, you may have to hire a different locum tenens provider after the initial 60-day window. You may also have to begin enrolling them in the Medicare program directly and then begin billing under the locum’s new Medicare PTAN. You may be able to have the original physician return to work for a short period, as this allows you to start the 60 days again, and keep the original locum tenens physician.

Private insurers also allow practices to use the absent medical professional’s NPI for a set amount of time. They typically also ask the locum to become credentialed after that. Some private insurers do not allow for the absent physician’s NPI to be used, and would demand that any locum be credentialed to enable payment.

Know about locum tenens billing requirements for your practice. They are a remarkable answer to shortages, and enable you to provide quality care, begin new services, and even augment staff requirements while you search for a permanent member of your treatment team. There are pros and cons to run to ensure you get your money’s worth from this solution, but most medical practices find them beneficial.

Contact Medynamix today to discuss a billing solution for your medical practice.  Complete our information request form to have someone call you or contact our office at (423) 822-5655.