Locum Tenens guidance needed

MarilynS

Contributor
Messages
20
Location
Ruskin, FL
Best answers
0
I have a new doctor ( Dr A) that starting seeing patients before she was fully contracted with some insurances. The owner/top doctor ( Dr B) wants me to bill all of Dr A's claims as locum tenens using Dr B credentials. Some how I don't think this right. I have read the CMS guideline on LT but I'm still unclear. Can someone please guide me on this issue. If anyone has an article I can show Dr B that would be wonderful. Thank you!
 

csperoni

True Blue
Messages
1,548
Location
Selden
Best answers
3
Locum tenens is for a replacement physician while that physician is unable to provide services. It is not to be used for new hires that are not yet credentialed.
From a quick google search:

Note: according to the AAFP article, incident-to might apply, but I would do more research on that as I had been under the impression incident-to would not apply in these situations.
 
Messages
235
Best answers
0
At least one MAC has has an FAQ on this From a paid article, used with permission

A FAQ from WPS Medicare, the Medicare administrative contractor (MAC) covering Indiana, Michigan and four other states, clarifies that the arrangements do not apply to new hires:
“If we are not losing any physicians but just want to expand and add new physicians to our group, can we bill fee-for-time compensation arrangements physicians to add new physicians to our group?
Answer: No. A fee-for-time compensation arrangements physician is meant only for the temporary absence of a regular physician or when a regular physician has left a group practice.”

If you're billing private payers you need to check their policies.

What I've heard about incident-to for doctors is that it is a bad idea because people don't remember to follow all of the rules for incident-to and they wind up with a bunch of unintended violations.
 
Top