Medicine, for many reasons, is a career path worth considering. The medical profession is as broad in scope as it is in pay scale. Physicians enjoy great pay and a very rewarding career. It is important to note, however, that medicine is among the most demanding professions, requiring years of education. If you are prepared to put in the effort and the years of study required, you could be well on your way to landing a lucrative Physician Job, with great benefits, in a field you love!
There are two ways to bill Medicare when using a locum tenens provider, depending on the situation.
One is to set up the locum tenens physician with their own NPI and the other is to use the NPI of the physician they are replacing, plus the Q6 modifier code.
This Q6 code is only allowed to be used for a 60-day period, at which time either the replaced physician or another locum tenens physician needs to come in to work for at least a day before the original locum tenens physician can come back and again be billed under Q6 – this resets the 60-day limit.
What do you do if a reset isn’t possible, and you want to keep using the same locum tenens provider as a replacement beyond 60 days?
Unless the physician being replaced is on active military duty (which waives the 60-day limit), you will need to bill Medicare using the locum tenens physician’s NPI.
In addition, any time a locum tenens provider is working in the place of another physician for longer than 60 days, you need to have a contract that includes joint and several liability and ensures access to claims submitted by the entity for the services provided by the locum tenens physician.
Here is a sample of the clause needed:
Physician and Client will have joint and several liability for any Medicare overpayment relating to claims made for Physician’s services, but Client will hold Physician harmless for any such liability.
Physician shall have unrestricted access to claims submitted by client for services provided by Physician.
Knowing which billing method to use when can be tricky, so we’ve mapped it out for you below.
Travelers who have both a Continental Airlines OnePass and a United Airlines Mileage Plus account can now go online to link their accounts, combine elite qualifying activity, and request an elite status match. Through the combination process, some customers may achieve elite status for 2012 status after combining their UA/CO miles.
Please be advised that some of the steps will appear similar. However, each process achieves a different goal: linking the accounts enables a member to combine award miles; combining elite activity may improve status. Elite members, especially, are encouraged to perform both steps!
We encourage you to complete this prior to 1/1/12. By combining miles today, you may be eligible for a higher status once the 2012 Mileage Plus year comes around. For questions, feel free to contact us.
Alternatively, you can also contact Mileage Plus Customer Service at 800-421-4655 or OnePass Customer Service at 800-554-5522.
VISTA Staffing Solutions wants you to know that if you are applying for or renewing a license in the state of Minnesota; the state government shutdown will affect you.
As of July 1, 2011, the Minnesota Legislature and Governor Dayton have failed to reach an agreement to fund state government. As a result, the Minnesota Board of Medical Practice is required to cease all operations.
The July 9, 2011 board meeting will be postponed and no licenses will be issued and no disciplinary actions taken. Please note the following:
- All temporary permits expiring on July 9, 2011 are valid until the next board meeting. The new board meeting date will be announced when the board re-opens.
- During this period of shutdown, online services including online renewal and professional profile will be unavailable.
- License status is available online at www.docboard.org/mn/df/mndf.htm
If you have any questions, you can reach the VISTA Licensing Department at 800-366-1884.
While working in Bermuda, my husband and I enjoyed seeing the local fishermen selling their catches on the side of the road. It happened to be lobster season, and as you can see, they were quite large! You could either take them home, or they had a steaming pot going to cook them right on the spot. Our favorite dining spot was right on the deck of our apartment. The sunsets from the deck were the best we've seen.
Note: VISTA Physician Blog Editor, Carolyn Rose, sent out a request for stories from locum tenens physicians about their eating adventures while on assignment. This is our first response. If you have a story to share please send it (with photos!) to your regular contact at VISTA, or email it to firstname.lastname@example.org. Thank you!
Monday, Sept. 13, 2010
It seems unbelievable to me that I am actually writing from Khovd, in the western part of Mongolia, on my laptop, in a hotel, looking out over the unpaved, dusty streets as the sun starts to rise on another day. A woman is herding her cow through what serves as a parking lot in front of the hotel, by throwing stones at its rump, as a pack of a dozen large dogs marches around the corner, off to do some damage someplace. From what I saw yesterday, these are not your sweet household pet type dogs, but serious animals who contend with all manner of abuse, from wolves to other animals, as well as competition within the pack. We are told to grab some stones if we are out walking and come across the dogs. Life is not easy here.
We arrived in Khovd after our three-hour flight on EZNIS airways, on a propeller driven SAAB 380, crossing a goodly portion of the Gobi desert. Deserts are obviously not all the same, as the dunes of the Sahara barely resemble anything I have seen of the Mojave, and this one seems to be widely varied as viewed from the air. There are dune-like areas, with undulating sand banks, to those with vaguely greenish tint which I suppose are grasslands, to lakes, to smooth, Santa Fe stucco-colored sandy flats without obvious changes in elevation. I was told it was going to be like arriving on the moon when we got to Khovd, and in fact it was. But I now realize that there are many places on earth that must then look like the moon, because it reminded me of the area around Tuba City, Arizona, a lot closer to home than the moon. Certainly, as the day breaks and I look at the faces of people, the similarities between Mongolian and Navajo visages is quite striking. Linguistically, of course, there appear to be no similarities, and if anything, one hears syllables that sound vaguely Korean.
Our hotel is across the street from the hospital where we are working, and of the many hospitals that I have seen in developing nations, this one is about the cleanest yet. People are constantly washing the floors, and there is no stench that one smells in the tropics. The only odor one perceives is that of mutton being cooked everywhere, and occasionally, a homeopathic dose of germicide, kept in an assortment of glass bottles everywhere. The stuff feels and smells like plain water to me, but who really knows? Ultraviolet lights are turned on in the operating room for example, to help sterilize things. I was told yesterday that the water within the10 liter bottles kept corked in the room becomes sterile through this mechanism. Interesting. Intravenous solutions are made in the hospital in on- liter bottles, which are covered with a type of canvas, secured by colorful orange string.
…The young doctor on call, who had been part of the group who had been trained in laparoscopic cholecystectomy last year here in Khovd, had a patient who had been in a truck accident, probably with some broken ribs. Over the next few days, he developed subcutaneous emphysema. An unlabeled, unnamed, unoriented CXR was shown to us, which indicated that the left lung had completely collapsed. The doctor had proposed to take the patient to the operating room to suture the hole in the lung. The other surgeon in our group, a wonderfully warm and cheery 64-year-old man, has had many years experience working with Italian relief groups in places as disparate as Peshawar, Kandahar, Sierra Leone and Malagasy Republic, looked at me, and it was all we could do to slow down our words to suggest that perhaps placement of a tube in the chest emptying into a water seal bottle might be a better and safer alternative. Of course, no such chest tube exists in the hospital, and so with the assistance of our anesthesiologist we fashioned one out of an endotracheal tube. Finding a suitable water seal apparatus was not easy, and we considered cutting apart some strange drainage bottle we found that had been left over by a Swiss team some time ago. In the bowels of some storage place a single Russian-made thick glass bottle with an appropriate cap was located. With additional tubing rigged from what we had, my colleague directed the Mongolian doctor as he placed this chest tube into the patient’s chest. Sterile conditions are a relative term here, and it is frequently said, I have learned, that “clean is good enough.” Maybe, but we offered some antibiotics to go along with what had been done so far. After some more bleeding than we might have liked, the tube was repositioned and the expected bubbling came from beneath the water seal. The fellow tolerated this all well, but it remains to be seen as how long it will take for this to resolve.
Last night, we were taken to the ger of the family of a Kazakh man who is a feldsher, or village medic, about 20 km northeast of Khovd. I am slowly learning the etiquette of Mongolian traditions, and now understand that what we have been calling a “yurt” is the Russian word for the Mongolian “ger,” and so now, I too shall try to use ger in my vocabulary. The campsite was on the banks of one of the numerous rivers that traverse the area, and was as colorful as one could imagine, with cashmere goats, sheep, yaks, and a few cattle outside, and inside a warm and toasty comfortable homestead. It was remarkably warm inside, and with all the Kazakh and Mongolian carpets lining the walls, two beds, a dresser, a wall of medals for horseback riding and family photos, and a central stove vented out the top. I can easily see how the winter can be survived despite the environmental challenges. The feldsher also captures eagles for training, and we saw at least one nearby, looking well fed and content. While we were there, a man came up on horseback, complaining of a headache. Some potion was dispensed, and off he went. Warm goat’s milk, fried biscuits, fried yoghurt cheese, tallow and yak butter were served, along with local watermelon. This is not a low fat, low carb diet at all, but if one considers what is available, it seems to work for them over many years. On the way back, we saw a herd of Bactrian camels (two humpers), and seeing them outlined against the grasslands, the snow covered peaks in the distance, and just the entire sense of foreign, I really did feel that I was on the steppes of Central Asia. Where was Borodin when we really needed him?
I am off to help with surgery this morning, and need to get going. I have been served a bowl of hot butter tea with rice, so I had better get my dose of calories early this morning. A long day awaits.
* “Best Regards,” per The National Telegraphic Review and Operators’ Guide, first published in April 1857.
VISTA Staffing Solutions has been the exclusive endorsed provider of physician locum tenens services for members of the Maine Hospital Association since 2004. The agreement was established by Associated Health Resources, an MHA subsidiary established to evaluate and select top quality, high-value products and services for all members.
Under the agreement, VISTA proactively recruits and licenses physicians and places a priority on filling Maine openings. Once they hit a threshold on locum tenens fees, they pay rebates to the MHA and member hospitals. It has been a positive, lasting relationship, so last year the AHR added divisions from VISTA’s parent company, On Assignment, to the contract to expand the service offering to include travel nurses and allied health professionals.
It is important to the AHR, and to me personally as chairman, to monitor the value members are getting from the vendors we endorse. This spring we commissioned a survey of members to determine if they were using the VISTA/On Assignment services, and why or why not.
Here is a recap of the results:
Twenty seven hospitals completed the survey, 21 of which have used VISTA locum tenens at some time. More than half were using VISTA services when the survey was conducted. In response to an open-ended question about their experience with VISTA, the comments were overwhelmingly positive, and included:
“Easy to work with. Physicians were highly trained.”
“Great experience, professional staff who are very helpful in getting all information needed for credentialing.”
“I have found them to be professional, the quality of the candidates they present to be top notch, and coordination of assignments to be easier with them than other companies. I also appreciate that they have one point of contact (Mary Bowers) checking in with me periodically. My experience with other companies is that you can field calls from 10-20 representatives of the various service lines each and every month. VISTA’s approach shows that they value my time.”
“Very positive—Mary Bowers is very responsive. Rates are competitive. Rebate is a good incentive.”
“VISTA is our ‘go to’ agency. Their staff are all exceptional to work with and we know the candidates have been screened well before being presented to us.”
We appreciate the value VISTA places on the relationships the company has built throughout Maine and the effort they have put into bringing value to our endorsement.
Roving Doc has worked in both domestic and international locum tenens assignments across the US and in Bermuda for the past 20 months. From Arizona to Alaska and back again, he has delighted patients, communities, and hospital colleagues with his warm yet meticulous manner. For these reasons and more he was our nomination for Locum Tenens of the Year in Locum Life magazine.
During the visit the pair regaled us with stories of life and work on the road (with Connie promising to work on writing up one about the hand in the Cuisinart in the small town ED.) Roving Doc said we all felt like extended family. We couldn’t think of a better compliment!