BC Advantage - 2018 Issue 11
Avoid Physician Burnout with Fee For Time Compensation
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Article Overview
This article reviews Medicare guidance on fee-for-time compensation arrangements, the current terminology used for temporary physician coverage, and the practical compliance issues that arise when a regular physician uses a substitute. It is aimed at physicians, group practices, and billing or compliance staff who need a general understanding of how temporary coverage is treated under Medicare and what recordkeeping and claim-submission topics are involved.
Why This Topic Matters
Temporary coverage can help practices maintain continuity of care when physicians are away, but it also raises billing, documentation, and compliance questions. Understanding the broad Medicare framework helps practices evaluate whether this type of arrangement is relevant to their operations.
Article Sections
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Overview of fee-for-time compensation arrangements
Introduces the concept of temporary physician coverage, the terminology change, and the Medicare context discussed in the article.
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How long can the regular physician be away?
Summarizes the time-related Medicare discussion for temporary coverage and notes the article’s example involving a coverage period.
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How is the substitute compensated?
Describes the general compensation relationship between the regular physician and the substitute and discusses the substitute’s status.
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Does the regular physician receive usual reimbursement?
Addresses the article’s discussion of when the regular physician may submit claims and receive payment for services furnished during the temporary arrangement.
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How must claims be submitted?
Covers the claim-submission and documentation topics discussed for substitute coverage, including the forms and records referenced in the article.
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Does the substitute have to be the same specialty?
Notes the article’s discussion of specialty differences for substitute coverage.
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Are there compliance requirements?
Summarizes the article’s compliance-oriented discussion, including certifications, record availability, and potential consequences referenced by the source.
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When are we prohibited from a fee-for-compensation arrangement?
Reviews the situations the article identifies as not appropriate for this type of temporary coverage arrangement.
What You Will Learn
- The Medicare context for temporary physician coverage arrangements
- How the article frames coverage planning for physician absences
- The documentation and claim-submission topics associated with substitute coverage
- The compliance concerns highlighted for practices and billing staff
- The kinds of situations the article says are not appropriate for this arrangement
Who Should Read This
- Physicians
- Medical group administrators
- Billing staff
- Compliance staff
- Practice managers
Codes Discussed
Modifiers Discussed
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