Billing Tips You Should Know for Locum Physicians

Working as a locum can be an excellent opportunity to gain experience in various practices with various patients, systems, and education. Traditionally, locum tenens meant "to hold the place of." But for doctors, nurses, and physician assistants who practice this way, and for their patients, locum tenens means so much more.

The problem with patients arises while billing for them as it can sometimes feel confusing for users how to bill locum tenens physicians for their services. In this article, we provide you with the information you need to use the billing process for locum tenens physicians.

This article just gives a brief introduction to billing tips. For a more detailed explanation, you can connect with ProLocums, the trusted healthcare staffing agency, and get all your queries or doubts solved.

Medicare Rule: The Mandatory Norm

Billing for locum tenens providers is not as simple as billing for regular employees because the rule governing reimbursement is Medicare specific and only applies to Medicare.

Medicaid and commercial payers may have adopted Medicare's rule. Still, if not, you must confirm with the payer that their rules govern locum tenens billing, and if not, you must understand their specific rules.

Duration 60 days of Service

CMS policy recommends that locum tenens physicians provide services to Medicare patients for 60 consecutive days during their duties. The only exception to this rule is if the regular physician is called to active military duty.

If you're a Locum Tenens Physician for less than 60 days:

Suppose you utilize a locum physician for much less than 60 days. In that case, the locum's treatments can be invoiced using the missing physician's NPI number with the Q6 qualifier to indicate that they're a locum tenens physician.

Using the missing physician's NPI number allows the absent physician to charge Medicare as though they provided the therapy personally; however, this time cannot exceed 60 calendar days.

What if you extend your position for 60 days or more?

An individual serving as a locum tenens covers an absent physician for at least 60 consecutive days. A Locum Tenens physician must be credentialed separately if the assignment exceeds 60 days. Rather than being paid for individual services, locum tenens physicians are paid on a per diem or fee-for-service basis. Medicare beneficiaries must seek care from an absent credentialed physician who is physically unavailable to see patients.

The locum tenens doctor can be utilized for 60 days with the Q6 modifier if the regular physician returns for a brief period, even one day. You can ensure long-term coverage this way.

What documentation is required for billing?

Generally, Locum Tenens physicians are familiar with the documentation requirements for reimbursement of services provided under the regular physician's NPI. Locum Tenens physicians must enter a Q6 modifier for their services in box 24D of the CMS-1500 claim form. You must enter the original physician's NPI in box 24J, which is the rendering provider's ID.

Locum tenens nurse practitioners and other non-physician providers are not subject to the same billing guidelines as locum tenens physicians. In the case of APP contracts covering the absence of a physician, contact your local Medicare administrative contractor for details regarding billing and the Q6 modifier.

Final Words!

The best way to make this process easier is to work with a trusted healthcare staffing agency like ProLocums. A right partner like ProLocums will provide you with a credentialing team that will know about your enrollment process and helps your staff with billing on time.

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