smoore0808
New
I am being told by my physician billing group that they are constantly billing under locum rules when they have a provider in the midst of being affiliated under our Medicare PTAN and has yet to be approved. They stated that they are billing under the Chief Medical Office or the lead physician in the group. I feel like this is really not correct billing but cant find documentation either way other than the locum billing section of the claims processing manual.
Another scenario:
We have two Endo doctors that come every other weekend but our contract with them is for 'locum' yet we do not bill for the Endo doctors they are covering for. We pay them to basically cover gaps in coverage because we don't own any Endo doctors and have weekends with no coverage (they are contracted). So they have been billing these 'locum' doctors with the CMO's information since the actual Endo doctors that are here the other weekends bill through their own group (have privileges, not employees).
Can any one direct me to CMS regulations that can back their actions up or prove they are wrong?
Thank you,
Another scenario:
We have two Endo doctors that come every other weekend but our contract with them is for 'locum' yet we do not bill for the Endo doctors they are covering for. We pay them to basically cover gaps in coverage because we don't own any Endo doctors and have weekends with no coverage (they are contracted). So they have been billing these 'locum' doctors with the CMO's information since the actual Endo doctors that are here the other weekends bill through their own group (have privileges, not employees).
Can any one direct me to CMS regulations that can back their actions up or prove they are wrong?
Thank you,