Who bills the insurer for a locum provider?
It depends on the arrangement and the payer. Some payers allow the practice to bill for a covering locum under specific rules, while others require the provider to be enrolled. Check each payer’s policy and your agency agreement before the first visit, because a wrong assumption can delay or deny claims.
Practices usually settle this with their billing team and the agency up front: which provider number or arrangement goes on the claim, which payers are covered, and which patients should be scheduled only once credentialing is complete.
Why does cash lag the visit?
Agencies commonly invoice weekly or on short terms, while payers pay claims after the visit and after processing. The practice carries the cost of the locum from the first day and waits for reimbursement, so the cash gap is the time between the agency bill and the payer payment.
| Factor | Effect | What helps |
|---|---|---|
| Credentialing status | Claims may be delayed or held | Plan around credentialing |
| Claims processing time | Payment arrives weeks after the visit | Build lag into your cash plan |
| Billing system changes | Errors or rework slow collections | Avoid cutover during a locum start |
| Denials and resubmissions | Adds weeks to individual claims | Clean documentation up front |
How do practices cover the gap?
Many use working capital or a practice line of credit sized to the weeks between the first agency invoices and the first expected payer payments, plus a cushion for denials and resubmissions. The goal is to size the bridge to the gap, not to the whole cost of coverage.
Add up the agency invoices for the weeks before payer payments normally arrive, then add a buffer for denials. That number is the cash the practice needs to bridge. See practice working capital and practice lines of credit, and our guide to funding locum tenens coverage.
Updated October 24, 2026 · MedicalBizFunding Team
Frequently asked questions
Does a locum need to be credentialed before seeing patients?
It depends on the payer. Confirm with each payer and your agency before scheduling their patients.
Can the practice bill under its own provider number for a locum?
Some payers allow it under specific rules, others do not. Check each payer’s policy and your agreement.
How long do payers take to pay claims?
It varies by payer and claim. Plan on weeks, not days, and use your own history as the guide.
Can a practice finance the locum cost itself?
Working capital or a line of credit can bridge the gap between agency invoices and payer payments.