While working with several agencies on a recent Locum search, I was constantly being inundated with numerous physician CV's that weren't even a good fit. Then I found Health Wise. They only send the best physicians and weed out the rest, unlike the other agencies who just present any and everyone.
Practice Manager
Resources for Medical Facilities: Billing for Locum Tenens
Locum Tenens: It's an Investment, Not a Cost. Optimize Your ROI by Billing for Services.
Navigating Locum Tenens Reimbursement: A Guide for Medical Facilities
The use of locum tenens physicians has become an essential strategy for many medical facilities to maintain patient care continuity and manage staffing shortages. However, navigating the reimbursement process for locum tenens services can be complex. This article provides a comprehensive guide to help medical facilities understand and manage locum tenens reimbursement effectively.
Understanding Locum Tenens Reimbursement
Locum tenens reimbursement involves billing for temporary physician services, which can differ from standard billing practices. It is essential for medical facilities to be aware of the rules and regulations governing this process to ensure accurate and timely reimbursement.
1. Know the Billing Rules
A. Medicare Guidelines
For Medicare patients, the billing for locum tenens services is governed by specific rules set by the Centers for Medicare and Medicaid Services (CMS). A locum tenens physician can provide services for up to 60 days. If the assignment extends beyond this period, alternative billing methods must be used.
B. Medicaid and Commercial Payers
Medicaid and commercial payer requirements may differ from Medicare’s rules. It’s important to verify with each payer whether they follow Medicare’s locum tenens billing guidelines or have their own policies.
2. Preparing for Locum Tenens Billing
A. Contractual Agreements
Before starting any locum tenens assignment, ensure that a clear contractual agreement is in place. This agreement should outline the terms of employment, including compensation, billing practices, and duration of the assignment.
B. Documentation
Maintain thorough documentation of the locum tenens physician’s hours, services rendered, and any special duties performed. Accurate records are crucial for substantiating billing claims and ensuring compliance with payer requirements.
3. Billing Procedures
A. Short-Term Assignments (< 60 Days)
For locum tenens assignments expected to last less than 60 days, follow these billing practices:
- Fee-for-Time Compensation: The regular physician or practice compensates the locum tenens provider on a per diem or similar fee-for-time basis.
- Use of Q6 Modifier: When billing for services provided by the locum tenens physician, append the Q6 modifier to the CPT code. This indicates that the services were provided by a substitute physician under a fee-for-time arrangement.
- Global Fee Services: If the locum tenens physician performs postoperative services covered by a global fee, there is no need to identify these services as provided by a substitute physician.
B. Long-Term Assignments (> 60 Days)
For assignments expected to exceed 60 days, medical facilities have two options:
- Enroll the Locum Tenens Physician: Enroll the locum tenens physician with the facility’s payer mix (Medicare, Medicaid, commercial payers) before or shortly after their assignment begins. After the 60-day period, bill under the locum tenens physician’s NPI number as if they were a permanent staff member.
- Regular Physician Return: Have the regular physician return for a brief period to reset the 60-day limit. This allows the locum tenens physician to continue working for another 60 days or facilitates a new locum tenens assignment. This cycle can be repeated as necessary.
4. Submitting Claims
A. Accurate Invoicing
Generate detailed invoices that include:
- Provider Information: Name, credentials, and contact details of the locum tenens physician.
- Facility Information: Name and billing address of the medical facility.
- Service Details: Dates of service, hours worked, and specific services rendered.
- Billing Breakdown: Itemized charges and total amount due.
B. Timely Submission
Submit invoices promptly to avoid delays in reimbursement. Utilize electronic billing systems to streamline the process and ensure accurate claim submission.
5. Handling Reimbursement Issues
A. Track Payments
Monitor payment status and follow up on any outstanding claims. Keep detailed records of all communications and transactions related to reimbursement.
B. Resolve Discrepancies
Address any billing discrepancies or claim denials promptly. Communicate with payers to resolve issues and adjust claims if needed.
6. Compliance and Best Practices
A. Regulatory Compliance
Ensure that all billing practices comply with applicable regulations and payer guidelines. Familiarize yourself with Medicare, Medicaid, and commercial payer requirements to avoid compliance issues.
B. Continuous Improvement
Regularly review and update billing procedures to incorporate best practices and address any challenges encountered. Training staff on locum tenens billing can enhance efficiency and accuracy.
Conclusion
Navigating locum tenens reimbursement requires a clear understanding of billing rules, thorough documentation, and effective claim management. By following these guidelines, medical facilities can ensure accurate and timely reimbursement for locum tenens services, maintaining financial stability and continuity of care.
We offer assistance with billing for our clients.
If you are interested to learn more and explore our services, please contact us directly. We look forward to speaking with you.
Why Temp-to-Perm Placements Are often Ideal
Health Wise LLC - Your Solution for Temporary Staffing
Why Temp-to-Perm Placements Are Often the Preferred Method for Hiring Permanent Staff
In today’s evolving healthcare staffing landscape, the traditional methods of hiring permanent staff or relying solely on temporary placements are increasingly being complemented by a more strategic approach: temp-to-perm placements. This hybrid model is gaining popularity in the locum tenens industry, offering significant advantages for both healthcare facilities and professionals. Here’s why temp-to-perm placements are becoming the preferred choice for locum tenens and how they can enhance your staffing strategy.
Most of the healthcare facilities we partner with are ultimately seeking permanent physicians. Similarly, many of the physicians we represent are in search of full-time, permanent positions. By connecting these two groups on a temporary, locum basis, we can effectively match candidates who are looking for permanent roles with facilities that need interim coverage. This approach allows for a “working interview,” where both the facility and the physician can evaluate the fit before committing to a long-term arrangement.
We’ve seen tremendous success with this model and firmly believe in its effectiveness. It not only helps facilities find the right permanent staff but also allows physicians to experience the work environment and culture before making a commitment. Temp-to-perm placements offer a strategic solution that aligns with the needs and goals of both healthcare providers and facilities, making it a valuable approach in today’s staffing landscape.
1. Mitigate Hiring Risks
One of the primary advantages of temp-to-perm placements is the ability to mitigate hiring risks. For healthcare facilities, this approach provides an opportunity to evaluate a locum tenens professional's fit within the organization before making a long-term commitment. By working with the professional on a temporary basis, facilities can assess their skills, work ethic, and compatibility with the team. This trial period reduces the risk of making a permanent hire that may not meet expectations, ultimately leading to more informed and confident hiring decisions with better long-term retention rate.
2. Flexibility for Both Parties
Temp-to-perm placements offer unparalleled flexibility for both healthcare facilities and locum tenens professionals. For facilities, it allows for a dynamic staffing approach that can adapt to fluctuating needs and demands. If a particular locum tenens provider proves to be a perfect fit, the transition to a permanent role can be smooth and seamless. Conversely, if the fit isn’t right, the facility can continue searching for the ideal candidate without the pressure of a long-term commitment.
For locum tenens professionals, temp-to-perm placements provide a chance to explore different work environments and roles before committing to a permanent position. This flexibility is especially appealing for those who are considering relocating or seeking a change in their career trajectory. It allows them to find a role that aligns with their career goals and personal preferences, leading to greater job satisfaction and long-term success.
3. Streamline Recruitment and Onboarding
The temp-to-perm model can streamline the recruitment and onboarding process for healthcare facilities. Since locum tenens professionals are initially hired on a temporary basis, the time spent on recruiting and onboarding can be more focused and efficient. Once the decision is made to offer a permanent position, the transition can be expedited, as the professional is already familiar with the facility’s processes and culture, is already privileged and credentialed. This can lead to a quicker integration and reduced downtime, ensuring that patient care remains uninterrupted.
4. Enhance Patient Care Continuity
Continuity of care is a critical factor in patient outcomes and satisfaction. Temp-to-perm placements can enhance this continuity by providing a stable presence in the healthcare facility. When a locum tenens professional transitions into a permanent role, they bring with them a deep understanding of the facility’s operations and patient needs. This continuity helps maintain high standards of care and fosters stronger relationships between patients and healthcare providers.
5. Optimize Cost Efficiency
From a financial perspective, temp-to-perm placements can offer cost efficiency for healthcare facilities. While temporary staffing solutions often come with premium rates, the opportunity to evaluate and onboard a permanent staff member through a temp-to-perm arrangement can result in long-term savings. By reducing the risk of turnover and ensuring a better fit, facilities can avoid the costs associated with repeated hiring and training processes, Health Wise LLC offers incentives for clients who utilize the Temp to Perm model. Ask us to learn more. Not to mention all the saved travel fees from site visits that don't lead to successful placements.
6. Attract Top Talent
The temp-to-perm model is attractive to top locum tenens professionals who are looking for stability, growth opportunities and full-time employment. It offers a pathway to secure permanent positions while providing the flexibility to explore different roles and settings. This approach can help healthcare facilities attract high-quality candidates who might otherwise be hesitant to commit to a permanent role without a trial period.
Conclusion
Temp-to-perm placements offer a strategic advantage in the locum tenens industry, providing a flexible and risk-mitigating approach to staffing. By allowing both healthcare facilities and professionals to evaluate fit and compatibility before making a long-term commitment, this model enhances recruitment efficiency, patient care continuity, and overall cost-effectiveness. For healthcare facilities looking to optimize their staffing strategy, embracing temp-to-perm placements is a forward-thinking solution that aligns with the dynamic nature of today’s healthcare environment.
Health Wise LLC has a strong history of creating successful, lasting matches. We would be honored to assist with your staffing needs. Reach out to us to determine if our services are the right fit for you.