PART B MYTHBUSTER: Avoid Billing Locum Tenens For New Docs Who Aren't Yet Credentialed

Why This Topic Matters

It helps practices avoid billing patterns that may create compliance risk when onboarding new physicians and clarifies the difference between legitimate temporary coverage and improper claim submission during credentialing delays.

Article Sections

1. Locum Tenens Billing and Medicare Guidance

   Introduces the Medicare framework for temporary physician coverage and the general circumstances discussed in the article. It also describes the source of the guidance referenced by the author.

2. Why New Physician Credentialing Delays Do Not Fit the Scenario

   Explains the common practice concern that prompted the article and outlines the compliance concerns tied to treating a new hire as temporary coverage. The section frames the issue from a Medicare billing perspective.

3. Billing Process and Time Limits for Locum Tenens

   Summarizes the operational elements of reporting temporary coverage, including the use of the relevant modifier, billing under the appropriate physician identifier, and the temporary nature of the arrangement. It also notes timing limitations discussed in the article.

4. Compliance Risks and OIG Commentary

   Describes the risk of omitting required identifiers and the broader compliance concern raised by federal program oversight. It also references the article’s discussion of misrepresentation and audit exposure.