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 billing and credentialing questions that arise when a physician is absent and a substitute is used under Medicare rules. It is aimed at practices, billing staff, and compliance readers who need a high-level understanding of locum tenens, reciprocal billing, enrollment, and identifier-related form handling. The discussion focuses on operational guidance tied to Medicare policy and references related CMS form and manual material.
Why This Topic Matters
Locum tenens billing can affect how claims are submitted, which provider identifiers are used, and whether a practice stays aligned with Medicare requirements. Understanding the article helps practices evaluate substitute-physician arrangements and avoid common administrative mistakes.
What You Will Learn
- How locum tenens arrangements are discussed in relation to Medicare billing and credentialing
- What kinds of substitute-provider scenarios are commonly addressed in practice management
- How enrollment and form-related issues can affect claims handling
- How reciprocal billing is distinguished from other substitute coverage arrangements
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance professionals
- Physician office administrators
Modifiers Discussed
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