Locum Tenens and Dentistry

Locum Tenens Guide | 1

What is locum tenens?

A locum is a person who temporarily fulfills the duties of another. For example, a locum tenens dentist is a dentist who

works in the place of the regular dentist when that dentist is absent, or when a practice is short staffed.

Will it make financial sense to hire a locum tenens dentist? What do I need to consider?

You will want to make certain that you are looking at a locum tenens situation in a financially sound way. As a business

owner you will need to generate a certain amount of collections in order to operate your practice while you are out.

Then you will need to consider the cost of using a locum tenens dentist, run the numbers and be certain that you are

comfortable with those figures..

When do you need to notify the dental insurance plan?

Many network agreements require that you notify the plan of any changes to the practice. There are regulatory reasons

for doing this including having accurate provider directories and keeping proper patient records. You will need to notify

the dental insurance plan in the event of death or disability of a benefit plan’s contracted provider as soon as

possible, especially if there is a possibility that you might need to hire a locum tenens dentist. Any delay could result in

claims processing delays and/or cash flow problems and plans may require the completion of different forms and/or

processes.

Claims processing can be affected as some plans may reject claims if a locum dentist is listed as the treating dentist and

the plan has no record of this. This can be a disruptor to the practice’s revenue stream. Dental plans often undergo

audits themselves and in the case of an audit the dental plan has a responsibility to produce the proper paper trail. Due

to this, the plan needs to conduct due diligence in ensuring documentation exists for a change in the treating dentist

before a claim can be paid.

Per the ADA’s research, all dental carriers have various reporting requirements; thus, you may wish to contact all plans

you submit claims to for information on what is necessary to report a locum tenens dentist. Some but not all plans,

require the completion of a form while others may require credentialing for locum dentists.

Vacations and other short-term absences are generally ineligible for locum tenens. Pregnancy is considered a disability

and a locum dentist could be brought in for a dentist on maternity leave.

What information will you typically need to provide to the dental plan?

• Practice Location(s)

• Tax identification number

• Date of death or disability

• License number of locum tenens dentist(s)

• Length of estimated coverage time

• Explanation of plans to sell practice or return to work

• List lines of business dentist wishes to participate in

Locum Tenens and Dentistry

Locum Tenens Guide | 2

Many plans will allow the locum tenens provider to contract on the same lines of business as the provider who

experienced disability or death. Check your state dental practice act to determine how long the locum tenens contract is

valid and for the length of time the practice has to transition to a new owner.

How does billing work in a locum tenens arrangement?

It is typical for locum tenens dentists to be treated as 1099 independent contractors. Dentists are hired for a specific

function and are paid a fee without other employee-like benefits such as withholding taxes, etc. Dentists generally agree

contractually to forfeit any reimbursement performed while working as a locum as the dentists are paid an agreed upon

fee for their services by the locum agency or owner dentist.

The locum tenens dentist should be listed as the treating dentist on the dental claim form. See the dental claim form

instructions below.

Locum Tenens and Dentistry

Locum Tenens Guide | 3

The billing dentist or dental entity could be the dentist who is out on disability. See instructions below.

Additional Considerations

The ADA Disability Income Protection Insurance Plan is designed to help provide a monthly income in the event a

dentist becomes disabled and unable to practice dentistry (“own occupation”). Additionally, optional coverage features

are available to help address cost of living adjustments and future monthly benefit increases as your income grows.

The ADA Office Overhead Expense (“OOE”) Insurance Plan provides up to $25,000 per month reimbursement of eligible

office overhead expenses to maintain a dental practice in the event a dentist owner becomes partially or totally disabled

and unable to work. This type of coverage compliments personal income disability even for non-practice owners as it

provides a loan repayment feature.

The ADA OOE Plan also provides a salary replacement* benefit to cover the cost of a replacement dentist (“locum

tenens”) while the dentist owner is out on disability. This salary benefit, paid in addition to the overhead expenses

reimbursed, is equal to the actual compensation paid to the replacement dentist up to a maximum of 50% of the

dentist’s monthly benefit amount. While this coverage has a 30-day waiting period, once satisfied benefits are

retroactively paid from the first day of disability.

Locum Tenens and Dentistry

Locum Tenens Guide | 4

*Note: Salary replacement benefits are not payable if the replacement dentist has an ownership interest in the practice

or is an employee of the practice.

Member dentists are best advised to consider purchasing disability income and office overhead expense reimbursement

coverage to protect their professional and personal finances.

It is further advisable for members to consult with their dental professional liability (malpractice) insurer or agent

representative when considering hiring a locum tenens dentist to discuss the proposed arrangements and ensure the

proper insurance coverage is in effect to guard against any potential exposures.

Where can I find organizations specializing in providing locum tenens dentists?

There are companies that specialize in providing dentists for temporary assignments. When researching these

companies, it is recommended you choose a reputable firm and asking for references is also a good idea. You may also

want to get a referral from a local dental office that has previously used a locum tenens dentist.

Archived Webinar

An archived webinar titled, Locum Tenens Dentists: Opportunities Abound

(scroll down the page to find the webinar

recording) features a dentist who needed a replacement doctor due to an accident and a dentist who provides locum

tenens services. Also, a representative from a major dental insurance plan discusses how locum tenens is handled from

the insurance plan perspective.

FAQs

1) What happens when the dentist going on leave is a network provider and the temporary dentist is not?

It is always a good idea to try to hire a temporary dentist who is in network with the same plans as the

dentist going on leave. In the event the temporary dentist is not in network and the patients are expecting

network fees, the temporary dentist will need to credential with the dental plan. Some dental plans will

expedite the contracting process in locum’s situations. It is always best to discuss this with the network plans of

the dentist who is going on leave.

2) What happens when the dentist going on leave is not a network provider and the temporary dentist is in

network?

This will vary by plan but there are dental plans that require dentists to be contracted by location. Thus, if a

dentist is in network at his/her primary location but not at the location of the dentist going on leave, the dentist

would be considered out-of-network at that location. Once again, it is recommended that staff call the dental

plans for the patients being treated to determine if certain forms or paperwork are required for the temporary

dentist treating patients at the location of the dentist going on leave.

3) How much notice needs to be provided to dental plans when a locum tenens dentist will be treating patients at

the office of the dentist going on leave?

Locum Tenens and Dentistry

Locum Tenens Guide | 5

The sooner the better. For example, when a dentist is going on maternity leave and a replacement dentist will

be hired, it would be a good idea to give 30+ days-notice to the plan. In the event of death or an accident or

injury, you should try to provide notice to the plans as soon as possible.

ADA Recommendations to Payers

• Dental plans should process requests for locum tenens doctors in an expeditious manner so that patients are

not adversely affected by the claim adjudication process.

• Credentialing, if necessary, should also be performed on an expedited basis so that patients can receive network

benefits as soon as possible instead of having to wait weeks or even months for credentialing to be finalized.

• All locum tenens paperwork should be kept to a minimum to try to minimize disruptions to the affected dental

practice.

State Legislation

The state of Missouri passed locum tenens legislation in 2020 - Temporary and Emergency Credentialing (Locum

Tenens) (HB1682) which essentially allows for providers to practice under another provider’s credentials for a period of

60 days for FMLA purposes without having to be credentialed. Dentists also can be reimbursed for covered services

provided during a credentialing period.

Summary

Hiring a locum tenens dentist can be very helpful in keeping a dental practice running due to the dentist being out on

disability for a short or extended amount of time. It can also be rewarding for the temporary dentist looking to generate

revenue for a short or extended time frame. The dentist who will be out on leave for a while will need to determine if

hiring a locum tenens dentist is a good idea from a financial standpoint and also for the overall well-being of the patients

in the practice.

Dentists should know that it is imperative to contact dental plans so that the plans have accurate records on the

locations of the treating temporary dentists and to determine network status. Obviously, the earlier a dental plan is

notified of a locum tenens situation, the better.

Locum Tenens and Dentistry

Locum Tenens Guide | 6

Locum Tenens Checklist

This checklist is designed to help you prepare your office in the event you need to hire a locum tenens dentist.

☐

Is it a fiscally sound business decision for you to hire a locum tenens dentist?

☐

You will need to notify the dental insurance plan in the event of death or disability of a benefit

plan’s contracted provider.

☐

Make sure the locum dentist is licensed to practice in your state.

☐

If you are a network provider, it is a good idea to hire a locum tenens dentist who is in the same

network plans as you are.

☐ Complete the proper forms and paperwork as required by the dental insurance plans.

☐ Get the locum tenens dentist properly credentialed for all of your network plans.

☐ The locum tenens dentist should be listed as the treating dentist on the dental claim form.

☐ The billing dentist or dental entity could be the dentist who is out on disability.

☐ Make sure all of your insurance policies are current and up to date.

☐ If using a locum tenens agency, make sure it is a reputable firm and ask for references.