January 7, 2016

Question:

Hi Jennifer,

Happy new year. I am a regular reader of your emails. Today I have a question. If I hire an independent contractor physician or a locum tenen physician without an agency, while I am on vacation, can I bill insurance companies as a billing provider and put their name as service provider ? She will have her own malpractice insurance and she is a licensed provider in same specialty. Anything else need to be checked ?

Hoping to hear from you soon.

Thanks,
Dr. S
Answer:

Happy New Year, Dr. S!  Thank you for your question. Absolutely you can identify your practice as the billing entity, or location where services are rendered, and indicating the patient is a patient of your practice. And, certainly it is appropriate and necessary to properly identify the individual providing the service - whether the independent contractor or the locum tenens physician.The one issue I did not see addressed is whether or not the rendering practitioner shares your in or out of network status and whether that practitioner is credentialed and linked to your office. I presume from your phrasing that you participate in the insurance plans. You would want to look in to your requirement to have practitioners working under your practice's tax id or PTAN as properly credentialed and linked.    

I would like to open this question to our readers who specialize in credentialing. If any one specializing in credentialing cares to comment, please respond to me and I will publish tomorrow.   

We'll do what we can to get you cleared for vacation with coverage!
 

 
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