Thinking of hiring or working as a locum? Take these audit tips into consideration

Hiring a locum can provide a physician with the flexibility they require when they are away from their practice for extended periods of time. However, it is important that when hiring a locum, certain steps are taken to ensure protection for both the host physician and the locum in case of an audit.

Here’s how to comply with the Medicare Protection Act and avoid problems later:

The practitioner number belonging to the physician who personally provided the insured service should be used when submitting a claim to MSP for payment. Payment for the service can then be assigned to another physician (the host physician) or corporate body who owns the practice. To assign payment to the host physician, complete an Assignment of Payment form and submit it to the Ministry of Health. The form can be obtained from the Ministry of Health website.

If an Assignment of Payment form is not in place, billing statistics for the physician who owns the practice are distorted. In addition, noncompliance may impact the level of benefits that both the host physician and the locum are entitled to.

If you are the subject of an audit as a host physician and it is discovered that services provided by a locum were billed under your practitioner number, you could be responsible for paying back funds received in error. There are also medical-legal implications if a physician bills for services that they did not provide under another physician’s practitioner number.

Requirements pertaining to assignment of payment are provided in the Preamble (C. 7, C. 8, and C. 9) to the Doctors of BC Guide to Fees, which summarizes the requirements set out in the Medicare Protection Act. Login to your member account for access.

It is worth taking the time to complete the Assignment of Payment form correctly to protect both the host physician and the locum.

If you have questions about the auditing process, contact Juanita Grant at 604 638 2829 or View Email Addressjgrant@doctorsofbc.ca. For further Billing & Audit resources, click here. 

A version of this article originally appeared in the December issue of the BCMJ and is written by Keith J. White, Chair of the Patterns of Practice Committee.