Wiki Locum

[adriennedolezal]

I have been trying to figure out if a situation can bill a locum. Every time I think I have It figured out management changes their mind on what they plan to do.
So we have an MD leaving the practice (and have had a few over the last few months). We are struggling to hire and fill those holes in our practice. So my understanding at first is we were using temp providers and billing as locums which is ok. Now we are working to hire someone providers but will not be credentialed for some time so the plan is to hire them for locums for 60 days. After the 60 days hire them on as providers in hopes credentialing is completed by then.
My question (as I see Conflicting information) can a new hire be a locum (for 60 days) cover for an MD that has left our practice before their credentialing is completed? Also when does the actual clock of 60 days start as we had a few providers leave over the prior months?
I’ve read the CMS billing requirements but still not 100% clear to me.

 

[SharonCollachi]

I had an entire answer typed out, but I started reading things about the 60-day rule changing. It used to be that you had 60 days, with the first date of service being day 1, to use a locum, then the original doctor had to come back and see at least one patient, then you could start the 60 days again. You couldn't just use a new locum (it was a total of 60 days without the original provider). Now I'm seeing info on using a second locum, so I wanted to research that further. Also, during the pandemic, you can use the same locum physician for the entirely of the pandemic, and when the pandemic ends, they can work for an additional 60 days.

I'm going into a conference call, will check back later.

 

[adriennedolezal]

So we can use a provider during the pandemic as a locum while we work on credentialing?

 

[SharonCollachi]

So we can use a provider during the pandemic as a locum while we work on credentialing?

Yes. The fact that you plan on hiring the provider is irrelevant.

 

[SharonCollachi]

On page 4 of this document, is the additional info you need. You will be using the CR modifier as described in that document.

 

[adriennedolezal]

On page 4 of this document, is the additional info you need. You will be using the CR modifier as described in that document.

This is great. So for the pandemic we can use the same locum? If we have hired this provider but they are filling a MD/DO that has left can we bill this locum with the Q5 modifier till they are credentialed or 60 days post pandemic?

 

[SharonCollachi]

That's what I'm reading.

 

[sarikaprasad.sanu@gmail.com]

Hello, May I know if we can bill for locum on every Monday? My provider is not available every Monday, she is hiring a locum to cover her every Monday. Please advise how can we file the claims for locum every week. Thanks

 

[SharonCollachi]

Hello, May I know if we can bill for locum on every Monday? My provider is not available every Monday, she is hiring a locum to cover her every Monday. Please advise how can we file the claims for locum every week. Thanks

As long as the hired person is a 1099 and not an employee.