decisionhealth Newsletters, Part B News - 2000 Issue 4 (April)
How to bill if doctor knows he will be gone for more than 60 days
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Article Overview
This premium article discusses Medicare billing concerns for practices that need a substitute physician during an extended absence. It covers locum tenens arrangements, the relevant Medicare billing context, carrier guidance, enrollment and credentialing considerations, and compliance issues that can arise when substitute coverage extends beyond the usual time limit. The article is aimed at coders, billers, practice managers, and compliance staff who need a general understanding of the policy landscape without missing important administrative or fraud-and-abuse implications.
Why This Topic Matters
Extended physician absences can create billing and compliance problems if substitute coverage is not handled correctly. Understanding the general Medicare framework and related oversight concerns helps practices avoid claim issues and administrative risk.
What You Will Learn
- How extended physician absences affect substitute billing arrangements
- What general Medicare billing and enrollment issues may arise in locum tenens situations
- Why carrier guidance and credentialing checks matter for temporary physician coverage
- What compliance concerns have been raised in relation to substitute physician billing
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Compliance officers
- Revenue cycle staff
Modifiers Discussed
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