tci Medicare Compliance & Reimbursement - 2007 Issue 28
CODING: Doc On Summer Vacation? Ease Locum Tenens Headaches In 3 Steps
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Article Overview
This article covers the practical basics of locum tenens billing for physician practices, including how temporary coverage is distinguished in claims, how the claim should be prepared, and what operational considerations can affect compliance. It is aimed at coders, billing staff, and practice administrators who need a general understanding of substitute-physician billing workflows and related Medicare or carrier guidance.
Why This Topic Matters
Temporary coverage arrangements create billing and documentation challenges that can affect compliance and payment. Understanding the general structure of locum tenens billing helps practices reduce claim errors and manage fill-in physician arrangements more confidently.
Article Sections
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1. Don't Confuse Q6 And Q5
Introduces the article’s first topic: distinguishing locum tenens billing from other substitute-physician billing arrangements and the general coding framework involved.
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2. Fill Out the Claim Properly
Covers claim preparation and form completion for temporary physician coverage, including where provider information is reported and how payer rules may vary.
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3. Avoid Logistical Pitfalls
Discusses operational and compliance considerations that can arise when using locum tenens physicians, including payment arrangements and practice relationship limits.
What You Will Learn
- The basic purpose of locum tenens billing
- How temporary physician coverage is represented in claim workflows
- Which claim-filing areas are relevant to substitute-physician billing
- What practical issues practices should review before using locum tenens services
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Physician office administrators
Codes Discussed
Modifiers Discussed
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