The beginning of a new year is a great opportunity to review policies and reinforce important risk areas. Every year our objective at ADVOCATE is to assist our clients by providing these tips and guides to help practices manage their risk and remain in compliance.
The first area to be discussed is the appropriate use of Locum Tenens and common misunderstandings.
While not a new concept, Fee-For-Time-Compensation Arrangements, historically known as Locum Tenens arrangements, can be used to cover for a regular physician who is temporarily absent. This practice allows the substitute physician, or Locum, to bill under the NPI of the regular, absent physician for up to 60 days. These frequently asked questions will help clarify what constitutes appropriate, compliant use of this arrangement.
Q: Can we use a newly hired physician as a Locum while awaiting credentialing?
A: While awaiting the credentialing process, the new physician may not be treated as a Locum Tenens physician. Locum Tenens is only appropriate for absent physicians who retain a substitute physician to assume their professional practice during their absence, not for a member of their physician group. Locum tenens is an independent contractor rather than an employee. Once a physician is hired it is best practice to submit enrollment and wait for the process to be complete.
Q: Can we hire a Locum to cover nights and weekends?
A: The Locum Tenens concept does not apply to a group that is experiencing high volume and needs additional help. The Locum should only be substituting for work a regular physician would normally undertake.
Q: Can we hire a Locum for a physician who has left our group and is not returning?
A: When it comes to physicians that have resigned from the practice, the group may use a Locum Tenens physician to fill in for that physician for a limited amount of time. If, however, the physician has passed away, a Locum may not be used to bill under his NPI as deceased provider’s NPI must be terminated immediately.
Q: Can we use more than one Locum to cover for an absent physician?
A: A regular physician may use more than one Locum Tenens to substitute for his/her absence during the same 60-day period, however, the substitutes cannot act as such on the same day. Assuming that each Locum Tenens physician is providing services within his/her respective 60-day continuous period, Locum Tenens physician Dr. A can provide services, for example, on Monday, Wednesday, and Fridays, and locum tenens Dr. B can provide services on Tuesday, and Thursday, but Dr. A and Dr. B cannot be scheduled as the substitute for the regular physician on the same day.
Q: Can we hire a Locum to cover for an absent Physician Assistant or Nurse Practitioner?
A: No. Services of nonphysician practitioners may not be billed under the Locum Tenens arrangement. This scenario applies only to physicians.
Q: How do we cover for a physician who has to be out longer than 60 days?
A: No single Locum Tenens can fill in for a regular physician for longer than 60 continuous days, but a group could use multiple Locum Tenens physicians to extend that amount of time, or the absent physician can return to work for one day and reset the 60 day clock.
Although not a new concept, Locum Tenens requirements are often misunderstood. Practices can avoid risks by adhering to these clarifications. If you would like to learn more about Locum Tenens watch ADVOCATE’S free webinar.
As always, ADVOCATE will keep you up to date on this and all issues impacting radiology as they become available.
Colton Zody, JD
Chief Compliance Officer