decisionhealth Newsletters, Part B News - 2007 Issue 7 (July)
Answers to tough locum tenens billing questions
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Article Overview
This article explains a set of practical Medicare billing and enrollment questions that arise when a regular physician is temporarily absent and a substitute is used. It is aimed at medical billers, coders, practice managers, and physicians who need to understand how locum tenens, credentialing, and related claim-submission requirements are discussed in current guidance. The article focuses on general policy interpretation, form and enrollment processes, and how these issues differ for physicians, non-physician practitioners, and reciprocal billing situations.
Why This Topic Matters
Locum tenens arrangements can affect claim submission, enrollment, and whether a practice can continue billing smoothly during a physician absence. Understanding the policy topics covered here helps practices avoid avoidable billing interruptions and compliance problems.
What You Will Learn
- How locum tenens billing questions are handled under Medicare policy
- What operational issues can arise when a substitute physician is needed for an extended absence
- How credentialing and enrollment topics intersect with substitute-provider billing
- How Medicare treats certain substitute-provider and reciprocal billing scenarios
- What kinds of provider-status questions commonly come up when using temporary coverage
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Physicians
- Compliance staff
- Revenue cycle staff
Modifiers Discussed
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