What locum tenens staffing is
Locum tenens is Latin for "to hold the place." A locum clinician covers shifts at a clinic without joining its permanent staff. The arrangement can be one Saturday or a standing block of shifts over several months.
The term started with physicians. In urgent care it's used for temporary coverage across the clinical team: physicians, nurse practitioners, PAs, RNs, and medical assistants.
When urgent care operators use locum tenens staffing
Urgent care volume is walk-in volume, so the schedule has to absorb swings that a fixed roster can't. Locum tenens staffing gets used in three situations.
- A vacancy. Someone resigns or goes on leave, and the alternative is the remaining staff covering the open shifts until a hire is made.
- A surge. Respiratory season, a local event, or steady growth pushes volume above what the roster was built for.
- A new location. Locum coverage staffs a clinic while its volume is still unknown, before the operator commits to permanent headcount.
The first is reactive. The other two can be planned, and the planning starts with your own visit data. Calculating coverage from patient volume and forecasting walk-in volume from historical data cover how to work out which shifts need locum coverage.
How locum tenens staffing is sourced: agency or marketplace
The agency model
A staffing agency keeps a roster of clinicians and assigns a recruiter to your account. You describe the need, the recruiter proposes candidates, and the agency handles credentialing, the contract, and payment to the clinician. You pay the agency a bill rate that covers the clinician's pay and the agency's costs and margin.
The agency model does real work. A recruiter sources candidates for you, and for coverage that involves flying a clinician in, the agency arranges travel and housing. An operator who wants all of that handled by someone else is buying something specific.
What you give up is visibility. The bill rate can arrive as one number with no breakdown, the clinician's file reaches you when the agency sends it, and each step depends on someone else's response time.
The marketplace model
A marketplace removes the intermediary from the conversation. You post the shift yourself with the clinician type, dates, and details. Clinicians see the posting and apply, and you see who they are before you accept.
The trade is that nobody is sourcing on your behalf. You write the posting and you make the choice. That suits per-shift urgent care coverage drawn from clinicians near the clinic. For a long placement that needs relocation, an agency may fit better.
What urgent care changes about locum tenens staffing
A hospital grants a locum physician clinical privileges through its medical staff before a first shift. An urgent care clinic has no privileging committee in its timeline. What stands between a locum clinician and a first shift is the clinic's own credentialing review.
Credentialing still has to be done. Before a first shift, the items to confirm are:
- A license valid in your state, checked against the board's own record. Urgent care licensing requirements by state covers how this differs by role.
- DEA registration for your state, for any clinician who'll prescribe controlled substances. A separate registration is required for a practice in each state.
- Exclusion screening. The HHS Office of Inspector General keeps a list of excluded individuals, and anyone who hires a person on it may face civil monetary penalties. This applies to RNs and MAs as much as to physicians.
- Malpractice coverage for the shift: who the named insured is, the limits, and whether the policy is claims-made or occurrence.
- Practice requirements for NPs and PAs. Some states require a collaborative or supervisory agreement, which has to be in place before the shift.
How Medicare treats a substitute physician
Billing is where the word "locum" has a specific legal meaning. Medicare lets a regular physician bill for a substitute physician's services when the substitute is paid per diem or on another fee-for-time basis and doesn't cover for more than 60 continuous days. The claim is filed with the Q6 modifier to show a substitute furnished the service.
The rule has further conditions, and it's written for physicians. How an NP's or PA's shifts are billed, and how each commercial payer treats a substitute, are questions for your billing specialist before the first shift is worked.
What good locum tenens staffing looks like
Three practices hold up whichever sourcing model you use.
Verify before day one. Every item on the list above is confirmed before the clinician arrives. A license check that happens the morning of the shift is a cancellation risk.
Orient for your clinic. A locum clinician knows the clinical work. What they don't know is your EMR, your supply layout, your referral contacts, and who to call when something breaks. The orientation mistakes to fix before a first shift goes through what to send ahead.
Bring the same people back. A clinician on a fifth shift at your clinic needs none of the orientation a first-timer does. Clear shift details, an accurate posting, and prompt approval of hours are what make a clinician willing to return.
This post explains how locum staffing generally works. It isn't legal or billing advice, and your counsel and billing specialist are the authorities on your clinic's arrangements.
Post a shift yourself
Rediworks is a self-service marketplace for urgent care shifts. You sign yourself up, with no demo and no intake call first, and post the clinician type, dates, and shift details you need. Sign up to post shifts.