Highmark Updates Its Locum Tenens Policy

In February 2016, Highmark updated its locum tenens policy. The policy allows providers with established assignment accounts to use the services of locum tenens practitioners to cover for a group’s credentialed provider during a leave of absence for vacation, medical leave, military leave, or the event of retirement or death.

In order to obtain locum tenens status, a provider:

  • Must be licensed to provide services in the state in which they practice.
  • Can only provide services for a total of six months or less within any 12-month period beginning with the first date of active service.

Highmark credentials locum tenens physicians based on the length of time the physician will be providing care in Highmark network service areas. Locum tenens physicians who will be providing services for at least six months or longer will be required to undergo initial credentialing and, if applicable, recredentialing at least every three years.

Highmark’s update also includes clarification of their locum tenens termination policy. Access the complete policy online (see page 24).

How to submit a locum tenens request to Highmark

Practices should take these steps to request locum tenens status for a practitioner:

  1. Complete Highmark’s Locum Tenens Form—If the group provides services to Medicare Advantage members, a Medicare welcome letter for the locum tenens is also required.
  2. Get locum tenens to complete and sign a Request for Addition/Deletion to Existing Assignment Account Form, assigning payment for their services. The group must have a Group Practice Agreement in place for the traditional indemnity and credentialed networks.
  3. Fax completed forms to Provider Information Management at 1-800-236-8641.

PAMED members with questions on this issue or other Practice Support concerns can call PAMED’s Knowledge Center at 855-PAMED4U (855-726-3348).