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Wiki Billing for a physician that is not longer employed

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Maryst

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I have a clinic that is billing for a physician that is no longer employed at that clinic. Can someone give me the link on CMS or any other site that states you cannot bill for a physician that is no longer employed by that clinic.
 
I don't have the link but I can tell you that if the physician has any lingering billing out there from when he was there then it can be bill. If the dates of the billing is happening after the physician left then this is clear fraud.
 
Is there a locum provider covering until they find a replacement? If so, they can continue to bill under the previous provider for up to 60 calendar days. You use the credentialed providers billing information and add a Q6 modifer to the cpt codes.

Look up locum tenens on CMS for the guidelines.

http://www.cms.hhs.gov/transmittals/downloads/R1335CP.pdf

Hopefully this will cover your situation. If not, it would be fraud.


Laura, CPC
 
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