Locum Tenens – The Rules and Paperwork Required

Locums or Locums Tenens is a concept of a physician’s substituting or filling in for another physician.  This can be for a variety of reasons.  It allows them to see patients for in a temporary manner without the need for credentialing.

As is often the case, first we look to Medicare for their rules on the topic of Locum Tenens.  Medicare made major changes to the Locum Tenens section of the Manual in the last few years.  Understanding those changes and the sometimes-complex billing and documentation requirements for Medicare patients is a start.  Researching and implementing the policies of other insurance carriers is the next step in making sure your office has compliant documentation in patient’s charts as well as other documentation carriers may require.  Locum Tenens is not as simple as putting a modifier on a claim when another physician sees patients in your office.  Compliant documentation, tracking and knowing who can perform these “substitute provider” services is an important part of the process and will be explained during this webinar. 

As national agencies market for Locums providers, knowing the rules will keep providers from engaging in non-compliant relationships.

Webinar Objectives

• Locum Tenens is the concept of a substitute physician.  For billing purposes there is a modifier that Medicare recognizes on claims that identifies this substitution
• Other carriers may not recognize this modifier which may create a payment problem for the billing and rendering physician.
• Other rules such as lists to keep and the timelines these substitute services can be held are important to understand for compliant use of this concept of one physician covering for another
• Researching other insurance payers is imperative in this process.  Tips on how to do this and what documentation should be kept will be shared.

Webinar Agenda

• Length of the life of a Locums physician
• What paper trail Medicare mandates be kept  
• Identifying any restrictions placed on your “substitute” physician by the insurance carriers
  • This will avoid jeopardizing their work or your payment for those services will ensure a smooth transition into and out of their time with your practice.
• Documentation of services provided under the Locum Tenens concept is an important step in the compliance process
• The technical aspects of how to bill for their services from carriers is next. What numbers go in which boxes and which modifiers are appropriate
• FAQ from Medicare MAC’s to address common questions

Webinar Highlights

• Who can be a locums tenens provider?
• Length a locum’s physician is allowed to provide services per Medicare. Are there exceptions? Do other carriers have restrictions?
• Medicare specific rules
  • Documentation guidelines
  • Master list of patients
  • Incident to services
  • Claim specific information
• Other insurance carriers
  • How to research
  • What do to if there are not answers

Who Should Attend

Practice Managers, Office Managers, Coders and Billers