Wiki Inpt : Providers completing visits for former providers

[Chrisd]

Does any one have an answer for this or has encountered anything like this before? And if so, any guidelines or more information?

We had an encounter of Providers signing and completing as Surrogates for providers who are no longer employed with the company after the fact. At times the providers would be out for a month to months at a time and return. Is this legal? How would auditors interpret this issue? What do we need on file?

please help......

 

[losborn]

I need to know a little more. In order to determine appropriatness fo billing, is this "surrugate" provider being paid a daily rate for coverage (Locum Tenens) or is the provider is actually substituting completely for the provider.

But also - if the provider is no longer employed - neither of these scenarios could apply. Not coding regulation: contract law.

OMHO

Lin

CPC, CEMC, CPMA