1. Activate revenue opportunity from day one

Billing for locum physicians requires proactive planning. Every locum can be billed, whether they're covering as a replacement physician, for fewer than 60 days, or serving as supplemental staff. But in many health systems, enrollment is delayed until after the physician is on site. This delay results in uncompensated or under-reimbursed care.

Future-ready health systems ensure every patient encounter is billable from the start. When enrollment is built into the deployment plan, locums can contribute to gross patient revenue from the moment they walk through the door.

• Classify the physician early as "replacement" or "supplemental" to trigger the correct enrollment path.
• Start payer enrollment in parallel with credentialing — not after.
• Prioritize the three to six highest-volume payers in your market to ensure claims submissions can begin early.
• Align vendor and internal timelines to eliminate gaps.
• Leverage Q6 Modifiers and Form CMS-855I to streamline day-one reimbursement across Medicare, Medicaid, and commercial plans.

2. Plan for vacancies and keep credentialing timely

Most health systems initiate recruitment and credentialing after a physician departure is announced. Credentialing delays remain one of the most underestimated bottlenecks in healthcare staffing. Additionally, a long time-to-fill process threatens patient access, patient trust in the health system, and revenue streams.

To illustrate, a psychiatrist resigns and will leave in 60 days. A reactive health system starts sourcing a locum around day 30, and they can’t start the credentialing process until a doctor is confirmed. By the time the locum is credentialed and arrives on day 60-180, the Q6 modifier rule no longer applies. Because standard enrollment steps have been bypassed, the locum psychiatrist goes unbilled to commercial and public payers. Total gap in billing: 120 to more than 150 days, costing an estimated $768,000 in lost revenue.

In contrast, a proactive health system already has a physician staffing partner that can begin candidate outreach the same day the resignation is given. Credentialing and payer enrollment can both start. By day 60, the locum is credentialed and enrolled, patients are being seen, and claims are being submitted. Total gap in billing: 60 days or less, with no lost referrals, service line closures, or chaos.

Pre-credentialed or early-credentialed locums support seamless transitions, protecting both patient continuity and system margins.

3. Treat locums like clinical equals to catalyze workforce innovation and growth

Future-ready organizations create proactive locum tenens utilization as part of their physician workforce strategy. They use locums to launch service lines, test market demand, extend high-margin throughput, and strengthen long-term recruitment pipelines. That means locum tenens physicians are no longer just a coverage tool, but a catalyst for growth.

To make it work, treat locums like clinical equals: Integrate them into schedules, provide full systems access, and align with them to maximize coverage and productivity. Locums who are deployed with this lens become a lever for potential innovation and agility, even as systems scale.

Final thoughts

By activating revenue potential from day one, anticipating vacancies, and integrating locums as clinical equals, health systems can protect revenue and maintain patient care continuity. With proactive planning, locum tenens physicians become key contributors to growth — ensuring health systems remain agile, resilient, and ready for the future.

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This report is sponsored by CHG Healthcare, an Advisory Board member organization. Representatives of CHG Healthcare helped select the topics and issues addressed. Advisory Board experts wrote the report, maintained final editorial approval, and conducted the underlying research independently and objectively. Advisory Board does not endorse any company, organization, product or brand mentioned herein.

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