On-call Services: Avoid On-Call Fraud Accusations With These FAQs

Why This Topic Matters

On-call and substitute-physician scenarios can create billing errors if coverage, rendering provider, and payer requirements are not handled consistently. Understanding the article’s scope helps practices evaluate whether their billing workflows for after-hours and reciprocal billing arrangements need review.

Article Sections

1. Which Physician Bills for the Services?

   Explains the general topic of billing responsibility when one physician covers for another and a patient is seen by a substitute or on-call physician. It focuses on provider identification and documentation considerations.

2. How Do You Report On-Call ER Services?

   Covers emergency department encounters, after-hours reporting, and payer treatment of on-call coverage situations. It also discusses general distinctions between office-based and emergency department settings.

3. Can We Skip Billing Altogether?

   Discusses reciprocal billing arrangements between practices, including the general conditions and compliance concerns associated with shared coverage. It also addresses payer-specific handling of substitute-physician reporting.