When a provider is on medical leave or vacation, a locum tenens provider can be identified and authorized by that provider to treat his or her patients during the time he or she is out of the office. The following is our policy for assigning and billing for locum tenens providers.
Note: Locum tenens do not require credentialing.
- The provider utilizing a locum tenens must be participating with Asuris with an "active" status. Claims submitted in the name of a provider no longer working at the clinic or office will not be accepted.
- Claims for services rendered by a locum tenens are submitted under the authorizing physician's name and Tax Identification (ID) number. Modifier –Q6 must be appended to each procedure code, signifying that the service was rendered by a locum tenens provider.
- The locum tenens must be the same type of provider as the authorizing provider (for instance: an MD can only authorize another MD as a locum tenens, a DC can only authorize another DC, an ARNP can only authorize another ARNP, etc.). To be considered for locum tenens status, the temporary provider must be one of the following provider types:
- Doctor of Medicine (MD)
- Physicians Assistant (PA)
- Doctor of Dental Surgery (DDS)
- Doctor of Dental Medicine (DMD)
- Doctor of Podiatry (DPM)
- Doctor of Optometry (OD)
- Doctor of Osteopathy (DO)
- Doctor of Chiropractic (DC)
- Doctor of Naturopathy (ND)
- Advanced Registered Nurse Practitioner (ARNP)
- Physical Therapists (PT) - effective for dates of service beginning March 1, 2011
- The locum tenens must be licensed in Washington (as applicable based on practice location) and only perform services within their scope of license.
- The use of a locum tenens provider by a participating provider is limited to 60 days per 12-month period. However, Asuris may, within its sole discretion, and under exceptional circumstances, grant an extension. Call our Provider Contact Center for more information.
- Other health care professionals not mentioned in the list above can make their own arrangements for substitute personnel. However, if a Asuris member sees a non-participating provider, the member may receive reduced or no benefits for the services provided.