PBN Special Report: Tips to get locum tenens claims paid

Why This Topic Matters

Locum tenens coverage can affect claim accuracy, reimbursement, and compliance if documentation, reporting, and credentialing are not handled properly. Understanding the administrative and coding-related considerations helps practices reduce denials and maintain continuity of billing.

Article Sections

1. Medicare billing rules

   General Medicare-related billing considerations for locum tenens coverage are discussed, including how services are reported and the time limits associated with substitute physician arrangements.

2. Track locum's work

   This section covers administrative tracking of locum physicians, recordkeeping expectations, and the specialties most commonly associated with temporary coverage needs.

3. Documentation skills

   The article addresses documentation quality concerns, chart review practices, and ways practices monitor locum performance related to claims processing.

4. Hospital privileges

   This section discusses credentialing and privileges for hospital-based coverage, including timing considerations and the difference between hospital and payer approval processes.

5. Top locum tenens billers are radiologists, CMS data show

   A CMS-based data summary presents specialty and service-level billing trends for locum tenens claims, including a ranked table of frequently billed services and denial patterns.