decisionhealth Newsletters, Part B News - 2016 Issue 7 (July)
How to hire, bill appropriately for temp providers and avoid lost payments
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Article Overview
This article discusses how practices can approach temporary provider coverage and related billing administration across Medicare and other payers. It focuses on locum tenens arrangements, payer-specific requirements, provider type differences, documentation and contract considerations, and upcoming Medicare physician fee schedule and Medicare Advantage enrollment issues. The piece is aimed at billing staff, practice managers, and coding or reimbursement professionals who handle coverage for absent providers.
Why This Topic Matters
Temporary provider coverage can create claim denials, payment delays, or compliance risk if payer rules, documentation, and enrollment status are not handled consistently. Understanding the broad categories of guidance in this article can help practices determine whether the full piece is relevant to their billing and operations workflow.
Article Sections
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Billing
Introduces the general topic of temporary provider billing and highlights that payer handling may differ across plans.
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Temporary or permanent — recognize intent
Discusses the broader distinction between short-term coverage and longer absences, including the role of intent and payer or contractor differences.
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3 more locum tenens billing tips
Summarizes additional administrative and billing considerations tied to temporary provider coverage, including documentation, contracting, and enrollment-related matters.
What You Will Learn
- How temporary provider coverage is generally handled in billing workflows
- Why payer-specific rules matter for locum tenens arrangements
- What administrative factors practices should consider before using temporary providers
- How broader Medicare policy changes may affect coverage and payment processes
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Revenue cycle professionals
- Physician office administrators
Codes Discussed
Modifiers Discussed
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