Locum Tenens billing depends upon many factors, including state, carrier, and function of the temporary physician. Billing correctly will ensure proper insurance reimbursement.
Locum Tenens physicians offer many excellent benefits to healthcare organizations. Not only can they fill in for full-time physicians who are on leave, but they can also fill in gaps in service that are currently vacant. By nature, Locum Tenens physicians are temporary, and as such, medical facilities may be unsure when it comes to billing for their services. Don’t let any billing questions hold you back from obtaining the benefits of Locum Tenens physicians, simply use the following guidelines.
Supplemental Physician Billing
Locum Tenens physicians are considered “Supplemental” if they are adding additional services to your practice when there are gaps or vacancies. To bill for Supplemental Locum Tenens physicians:
- Follow the standard billing process for Medicaid and private payer insurance, including the enrollment process. This will vary based upon what state your practice is in and what insurer you are dealing with. Ensure that the Medicaid and private payer application is properly filled out.
- For Medicare reimbursement for Supplemental physicians, follow the guidelines under Section 30.2.7 of the Medicare Claims Processing Manual. It is important to note that your facility and the physician will both be responsible for any overpayment to Medicare. Ensure that Medicare form 855R is properly filled out.
Replacement Physician Billing
Locum Tenens physicians are considered “Replacement” if they are filling in for a full-time physician who is on leave (typically 60 days or less). To bill for Replacement Locum Tenens physicians:
- For Medicaid and private payer insurance, the above-referenced enrollment process may still be required, especially if the physician will fill in for longer than 60 days. As such, it will be necessary to check with each state and/or insurance carrier for the proper procedure.
- For Medicare, follow the guidelines under Section 30.2.11 of the Medicare Claims Processing Manual. If the appointment is for longer than 60 days, bill under code modifier Q6, but start the enrollment process immediately.
For any other inquiries regarding Locum Tenens billing, please feel free to contact us at Medstaff today. Don’t miss out on the benefits of Locum Tenens physicians because of billing questions, use our resources to make the transition as quick and easy as possible.