Question Temporary Doctor Billing

Jwinant

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The specialist office I work at is losing a doctor in less than two months. We have two doctors that see patients at our main office and the one provider who is staying also sees patients at our satellite office. Management is strongly considering hiring a part time, temporary doctor for one or two days a week at the satellite office just so the other provider can be available at the main office more. How long they plan on having the temporary doctor on payroll depends on how soon they hire a new doctor. Management wants to have patients see the temporary doctor without going through the credentialing process since she might not need to be there long. Their thought process is that the temp doctor would sign the exam note and then our full time doctor would go in and add an addendum with his signature saying that he has reviewed and approves of her exam note so that we can continue to bill under his NPI. I've tried looking up the rules on this, but this situation doesn't exactly fit any scenario I've read. Thanks for any advice!
 

SharonCollachi

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You're overthinking it. This is a locum tenens situation. The temp doctor has 60 calendar days, starting from the first day he sees a patient, to see your patients and bill under the doctor who is leaving. The temp doctor does not have to go thru credentialing because they are temporarily in the place of another doctor. After 60 days, if the doctor who left does not come back and see at least one patient, then you are out of days for locum tenens and the temp doctor cannot see any more patients under that setup. If the doctor who left were to come back to see one patient, then the 60-day clock starts over.

Nobody has to sign off on the locum notes, and they don't have to add an addendum. The locum doctor should be a contractor and not an employee.

How to code and bill: https://www.aapc.com/blog/27489-bill-locum-tenens-according-to-cms-guidelines/

NOTE: During the COVID pandemic, Medicare has loosened the timeframe restrictions on locum tenens. A practice may use the same substitute physician for the entire time the regular physician is unavailable to provide care and for an additional period of up to 60 days after the end of the PHE. This means that the 60-day clock does not start until AFTER the end of the Public Health Emergency is declared.
 
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