Locum Tenens – When you need a Substitute for your Provider – Know The Rules!

Jill M. Young

Jill M. Young

Jill M Young is the Principal of Young Medical Consulting, LLC. A company founded 18 years ago to meet the education and compliance needs of physicians and their staff Jill has over 40 years of medical experience working in all areas of the medical practice including clinical, billing and rounding with physicians. Her unique style of working...
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60 Mins
Jill M. Young

Medicare Rules on Locum Tenens

Looking for a way for your provider to take a break and still have someone cover your patients? Locum Tenens meaning to hold the place of or to substitute for is a concept that applies to all providers. The concept of substituting is called Locum Tenens but for a long time, it was also a way of billing until Medicare changed their policy. This major change in the name of and redefinition of how to bill for a substitute provider is only applicable to physicians. Other provider types do not fall under this Medicare billing policy.

Researching and implementing the policies of other insurance carriers is an important step in making sure your office has compliant documentation in patient’s charts, as well as other documentation carriers, may require. Locum Tenens is not as simple as putting a modifier on a claim when another physician sees patients in your office. Compliant documentation, tracking, and knowing who can perform these “substitute provider” services is an important part of the process and will be explained during this webinar.

Webinar Objectives

As is often the case, first we look to Medicare for their rules on the topic of Locum Tenens. Medicare made major changes to the Locum Tenens section of the Manual in the last couple of years. Understanding those changes and the complex billing and documentation requirements for Medicare patients is a start. Compliant documentation, tracking, and knowing who can perform these “substitute provider” services will be covered in this webinar.

Webinar Agenda

  • Length of the life of a Locums physician 
  • What paper trail Medicare mandates be kept   
  • Identifying any restrictions placed on your “substitute” physician by the insurance carriers 
    • This will avoid jeopardizing their work or your payment for those services will ensure a smooth transition into and out of their time with your practice. 
  • Documentation of services provided under the Locum Tenens concept is an important step in the compliance process
  • The technical aspects of how to bill for their services from carriers is next. What numbers go in which boxes and which modifiers are appropriate
  • FAQ from Medicare MACs to address common questions

Webinar Highlights

  • Who can be a locums tenens provider?
  • What is the length a locums physician is allowed to provide services per Medicare
    • Are there exceptions?
    • Do other carriers have restrictions?
  • Discussion of  Medicare specific rules including:
    • Documentation guidelines
    • Master list of patients
    • Incident to services
    • Claim specific information
  • Discussion of rules other insurance carriers have including:
    • How to research
    • What do to if there are not answers

Who Should Attend

  • Coder
  • Billers
  • Office Managers
  • Practice Mangers
To access this webinar, kindly reach out to our customer support team at support@complianceducator.com.

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