Locum Issue

We find ourselves without an OB Providers and for NOW we want to bring in an MD Locum to cover till we hire Permanently. How Do I Bill? What are our options?

Tina Sparke

Comments

  • Unfortunately, you will not be paid until credentialed with each payer. You cannot bill as a Locum with the Q6 modifier since your physician is gone and not out sick or at a conference, etc.

    Alicia M. Cooper, CPC




  • The Provider would be a Locum - no credentialing. I seem to remember there is a way for special cases.
    Tina Sparke

  • edited May 2017
    You didn't give us enough information. What happened to your previous OB?

    Don


    Don Self & Associates, Inc

    305 Senter Ave, Whitehouse, TX 75791
    903 871-1172 fax 480-247-5650
    donself@donself.com web: www.donself.com
    free webinars at www.donself.com

    DISCLAIMER: This email should not pose any visual, auditory or sensory defects in the average reader. If you are now or have been dead or stupid in the past, this email will probably not help you. If you know anyone reading this email who is not from earth - you should immediately seek medical attention. If you have been or plan to be an imbecile in the future, please do not read this disclaimer. These warnings are not valid in the state of Hawaii, Alaska or New Hampshire.

  • They no longer work for us, but we still have a midwife, and need to bring in a locum

    From: Don Self [mailto:donself@donself.com]
    Sent: Friday, July 01, 2016 5:06 AM
    To: Multiple recipients of list PARTB-L
    Subject: Re: [partb-l] Locum Issue

    You didn't give us enough information. What happened to your previous OB?

    Don


    Don Self & Associates, Inc

    305 Senter Ave, Whitehouse, TX 75791
    903 871-1172 fax 480-247-5650
    donself@donself.com web: www.donself.com
    free webinars at www.donself.com

    DISCLAIMER: This email should not pose any visual, auditory or sensory defects in the average reader. If you are now or have been dead or stupid in the past, this email will probably not help you. If you know anyone reading this email who is not from earth - you should immediately seek medical attention. If you have been or plan to be an imbecile in the future, please do not read this disclaimer. These warnings are not valid in the state of Hawaii, Alaska or New Hampshire.

  • edited May 2017
    That is not a locum situation.

  • edited May 2017
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    Erica-
    Why are you saying this is not a locum situation?



  • edited May 2017
    Oh you are right, I stand corrected. I thought that you couldn’t do locums for physicians who left the practice but I just reread the guidelines and you certainly can. I apologize! That’s what I get for answering too fast and not doing my research first! 

    http://www.wpsmedicare.com/j5macpartb/claims/submission/locum-tenens-reciprocal-billing-qanda.shtml

  • Any help on the below Medicare guideline is very vague, when a provider leaves and we need to hire a locum and we are part of a group practice can we use any provider such as our medical director on the claims? Or does it need to be a provider of that specialty that we bring the locum in for?

    Thank you,
    Bobbi Ranis

  • The medical group physician for whom the substitution services are furnished must be identified by his/her NPI in block 24J of the claim.



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  • So even if the providers have left the group (working for another clinic), we still use their credentials?

    Thank you,
    Bobbi Ranis




    .
  • Yes, but you can't use another provider from the same group. It has to be a ***temporary*** physician with whom the group has a written contract. Locum tenens can be confusing if you're new to it. Here's a few good sites from CMS and WPS with information. You may want to read these and then post further questions if you're still not understanding.

    https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c01.pdf section 30.2.11

    http://www.wpsmedicare.com/j8macpartb/claims/submission/locum-tenens-reciprocal-billing-qanda.shtml

    http://www.wpsmedicare.com/j8macpartb/resources/modifiers/modifier-q6.shtml


    Kris

    Kris Cuddy, CPC, CIMC
    Healthcare Compliance Analyst
    Compliance Office
    Michigan State University HealthTeam
    East Lansing, MI
    Ofc: 517-355-4547
    Fax: 517-353-5292


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