Medicare Compliance & Reimbursement - 2009 Issue 37
Part B Mythbuster: Avoid Billing Locum Tenens for New Docs Who Aren't Yet Credentialed
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Article Overview
This article reviews Medicare guidance on locum tenens billing in the context of physician staffing and credentialing delays. It is intended for medical billers, coders, practice managers, and compliance staff who need to understand when temporary-physician billing applies, what documentation elements are involved, and why improper use can create compliance risk. The discussion also references Medicare manual guidance, CMS form reporting, and oversight concerns tied to inaccurate physician billing.
Why This Topic Matters
Improper locum tenens billing can create compliance exposure, payment errors, and audit risk for physician practices that are waiting for Medicare credentialing or trying to bill temporary coverage incorrectly.
What You Will Learn
- The general Medicare context for locum tenens billing
- How temporary physician coverage is discussed in relation to credentialing delays
- What documentation and claim-reporting elements are associated with locum tenens claims
- Why compliance and audit concerns arise when locum tenens is used outside its intended purpose
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Compliance officers
- Physician office staff
Codes Discussed
Modifiers Discussed
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