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  • Summary date: Jun 7 2011 - View Summary

    House committee substitute makes the following changes to 1st edition. Amends proposed GS 58-3-231(b) to remove the requirement that a locum tenens physician be credentialed by the insurer prior to substituting for a regular physician before an insurer allows a patient’s regular physician to submit a claim and receive payment for covered visit services that a regular physician or a locum tenens agency arranges to be provided by a locum tenens physician. Makes other clarifying and technical changes.

  • Summary date: Apr 6 2011 - View Summary

    Enacts new GS 58-3-231, requiring an insurer that provides a health benefit plan and that credentials providers to establish and maintain a process to allow a patient’s regular physician to submit a claim and, if accepted, receive payment for covered visits provided by a locum tenens physician, provided seven requirements are met. Defines locum tenens physician as a physician who is not an employee of the regular physician, but substitutes for the physician on a temporary basis. Includes definitions for additional terms used in the statute. Permits a medical group or hospital to submit claims for a locum tenens physician substituting for a regular physician who is a member of the medical group or an employee of the hospital, provided the seven requirements are met. Specifies that per diem or similar fee-for-time compensation paid for the locum tenens physician is considered paid by the regular physician. Sets forth additional criteria for billing, substituting for a regular physician, and locum tenens agencies. Directs insurers to establish the claim and payment process within 180 days after the act becomes effective. Effective October 1, 2011.