The nature of locum tenens psychiatry jobs is somewhat unique in everything from the number of doctors actually practicing as locums to how they go about doing what they do. And with that uniqueness comes questions about billing. How do locum doctors bill for services and, in turn, how do hospitals and clinics get paid for the services offered by way of locum contracting?
Many of the questions surrounding billing depend entirely on the arrangements made by the facility contracting for locum-provided work. For example, does the facility contract with doctors independently or do they work through staffing agencies representing those doctors? Whichever party enters the contract with the facility is the one that submits the actual bill.
Doctors Working with Staffing Agencies
Let’s say a hospital in Bellevue, WA contracts with a Texas-based staffing agency for all of its locum assignments. That staffing agency agrees to provide doctors and nurses of all stripes on a per-assignment basis, commensurate with each contracted professional’s services, licensing, and credentials. Then the staffing agency recruits professionals to service those contracts.
The staffing agency bills the hospital for the work provided then turns around and pays the contractor according to the agreed-upon contract. As for the facility, they must collect from their patients for the services rendered by the locum. This is true whether you are talking about psychiatry jobs or locum hospitalists.
The tricky part of all this is dealing with insurance providers. Medicare is especially troublesome. A facility is allowed to bill Medicare for services provided by a locum as long as:
- a regular, staff psychiatrist is unavailable to provide the service;
- the patient has made the arrangements to receive care from the facility; and
- the facility pays the locum or staffing agency on a per diem or fee-for-time schedule.
There are a few other conditions that apply regarding how long the locum can provide continuous care and under what conditions. But as with anything government-related, the rules are ambiguous to some degree. This leaves facilities having to sometimes jump through hoops to get reimbursement. The good news for locums is that none of this is their problem.
Doctors Working Independently
Obviously, some locums prefer to line up their temporary psychiatry jobs by themselves. In such a case, they handle all contract negotiations and billing themselves. Collections are up to them as well.
As for the facilities, they run into the same kinds of challenges when dealing with insurance companies and government payers. Things may be a little bit easier because they are paying doctors directly instead of going through staffing agencies, but many of the same billing requirements still apply. They have to be able to document their use of locum psychiatrists in order to be able to bill for services rendered.
What does this mean for the doctor? It means that one of the factors to be considered when deciding whether to work independently or not is that of billing. Does the doctor want to handle billing and collections on his/her own? Is the doctor competent enough in the arena of taxes and accounting to contract without the help of a staffing agency?
The primary benefit of working with an agency is the assistance provided in billing, collections, and accounting and taxes. Locum doctors are still self-employed in most cases, but the assistance they receive from their agencies is well worth the relatively small cost of working this way. The less the doctor has to worry about billing, collections, and accounting, the more he or she can devote to treating the patients under his/her care.