Wiki Locum Question

[Peter Davidyock]

If after the 90 locum period expires and the practice begins to credential (but not fully employ) a locum must the Q6 modifier continued to be reported?

 

[ellzeycoding]

Most of the time, you cannot use a locum for more than 90 consecutive days (length may change with carrier).

If you hire the provider and are attempting to credential them through the practice, then it wouldn't be considered a locum any longer. You would have an employee that isn't credentialed and can't provide services, unless providing them under an incident-to scenario. However, some carriers allow you to retroactively bill if the credentially process is "in the works" so to speak, but I would think that you would need to have a supervising provider on-site in this case.

Doesn't sound like that may be the case, unless I'm not understanding the question. Sounds like the provider was absent for whatever reason. You hired a locum for 90 days. Provider is still absent after 90 days, so you hired the former "locum" as a NEW PROVIDER and are now trying to credential this new provider into the group? Usually it can be billed under an "incident-to" scenario until credentialling is obtained, but this requires a supervising provider on-site.

Some info here...

http://medicaleconomics.modernmedicine.com/medical-economics/news/modernmedicine/modern-medicine-now/billing-noncredentialed-providers

 

[Peter Davidyock]

Thanks Karl

I suspect I am over thinking this too much.