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Most healthcare providers need to use locum tenens physicians at some point, such as when a physician takes a family leave of absence, gets injured, or retires. In these situations, many facilities leave money on the table by not understanding billing for services provided by locum tenens physicians.
These five steps will help you bill for the revenue generated by locum tenens, as well as understand how using a locum tenens physician can add enormous value to your facility.
1. Understand that physicians generate revenue, and without them, you have no revenue.
Even if it looks like there’s a loss on a locum tenens provider, that provider is critical because they:
• Help you meet standards required by law. Continuously staffing certain specialties is required by law to meet many designations, such as the Level I Trauma Center or Acute Stroke Ready Hospital. If you’re down a physician, you may have to bring in a locums in order to keep your designations.
• Generate downstream revenue. Even if for some reason you cannot bill for the locums’ services (at least initially) you will bill for the hospital bed, the IVs, medication, the labs, etc., that the physician orders.
• Fill a need. If you have to turn away patients, they’re going to get their healthcare needs met by your competitor – and not just for this instance, but probably most future ones too.
• Support current physicians. Asking current staff to cover an unstaffed position risks burnout, and a recent survey by Medscape found that 42 percent of physicians are already burned out. One of the top reasons, according to 39 percent of respondents, was too many hours at work. It’s smart to staff appropriately and cover gaps, in order to retain your current physicians.
2. Know that you can – and should – bill Medicare/Medicaid from day one.
Using the Q6 designation on Medicare/Medicaid billing forms, you can bill for services provided by a locum tenens physician from the very first day under the permanent physician’s Medicare/Medicaid payee number. This works for up to 60 days and is outlined in detail in the Centers for Medicare & Medicaid Services (CMS) guidelines.
If you’re replacing a physician for longer than 60 days, or adding a locums to supplement your current staffing, you also can get Medicare/Medicaid billing up and running immediately. Initially, use code modifier Q6 to bill for the first 60 days. Meanwhile, have the locum tenens physician complete a Medicaid and private career application and CMS Form 855R to bill after the first 60 days. Refer to Section 30.2.7 of the Medicare manual for more information.
3. Set up a comprehensive process for onboarding all locum tenens.
Even if you think the locum tenens is only going to be there for a few days, follow the standard onboarding process for new physicians. You’re using a locums because you’re understaffed, so chances are, you’ll need to bring the physician back.
Often the payor enrollment paperwork for private insurers takes 60-90 days to get approved. That means that you may lose out on billing insurers for the physician’s services for the first assignment, but following a standard onboarding process will get your locum tenens physicians closer for next time.
Be sure to provide us this enrollment paperwork when you sign a contract with us, so we can help our physicians through it.
4. Start fostering relationships with us and our physicians now, before you need them.
Many larger healthcare systems build a pool of locum tenens providers to bring back repeatedly. These physicians possess hospital privileges, know the healthcare facility, and have private payor privileges too. Reach out to us today to start building your own go-to network.
5. Get creative.
Let’s say that you need somebody to start in 30 days, not enough time to get the private payor paperwork through. You have options for capturing all billing revenue from private insurers from the get-go.
• Most locum tenens physicians already are enrolled in some private insurance plans. For instance, a physician who works in Wisconsin might already be enrolled with Anthem Wisconsin. If that’s the case, billing for that physician’s services is a matter of authorizing your facility to bill under the doctor’s number. We work with many physicians; thus, we may be able to fill a position this way.
• Because you can bill Medicare/Medicaid from day one, you might be able to use strategic scheduling. This means, for instance, scheduling all patients using private insurance with your permanent physicians; send all Medicare/Medicaid to the locums physician while the private payor paperwork is being approved. This might not work at a hospital, but private practice facilities often can employ this strategy.
Contact us today
Using a locum tenens physician to fill in gaps makes smart financial sense and can help you retain your full-time physicians too. It’s even better when you handle locums billing properly, capturing both indirect and direct revenue, by employing these steps.
Have questions? Talk to one of our representatives to learn more. You can call us toll-free from the U.S. & Canada at 1.866.858.6269 or fill out our contact form today.