Wiki Locum Tenens with Insurances other than Medicare

[dmontry]

Does anyone know if all of the insurance companies follow the same rules with locum tenans as Medicare.

I called Aetna today and the woman state "Locum what I have never heard of that in all my years here... "

I wonder how long she has been working there... eventually I spoke to three people and not one of them had the answers.

Please let me know what you have learned. I have a physician out on maternity leave two months earlier than we anticipated and I was in the process of credentialing a new physician. Now we are switching gears and bringing the new physician on as locum tenans until the new mom returns (or 60days which ever happens first).

Thanks,

Dana

 

[Quaker]

Hi Dana,
I'm also in the process of researching this topic. In particular, I was interested in finding out if Medicaid recognized locum tenens providers. I called Aetna Better Health (provider relations) today and they could not give me a concrete answer. At first they advised that Aetna Medicaid follows PA Medicaid rules but they could not give me those rules. They went on to say that they don't recognize locum tenens providers and then they said that they do. I'm waiting for a final response from them. In the meantime, I called PA Medicaid (Promise) who finally advised (after changing their story) that they do not recognize or credential locum tenens physicians and they will not cover their services. I'm not completely confident with their answer. I'm hoping Aetna can get something in writing from PA DHS. For all the other insurances, so far, it appears that they follow Medicare guidelines set forth in MCPM, Chapter 1, Section 30.2.11.

Please keep me posted on what you find out!

Thanks.