Your billing number travels with you; the facility number and the group arrangement do not. Settle three things before the first shift — facility numbers, whether claims go out under a group, and how encounters reach you — and locum billing becomes ordinary billing. Skip them and you spend the following month reconstructing a week of work from memory, which is where locum revenue is actually lost.
IntelAGENT keeps one billing record across every host site, so rejections from a finished locum do not quietly expire. See how →
Whose number the claims go under
Two separate questions that get conflated.
Who rendered the service is always you. Your billing number goes on every claim for work you did, at every site, regardless of the arrangement. That does not change and is not negotiable.
Which account gets paid depends on the arrangement:
- You bill, you are paid. Claims go out under your own number with no group number. The ministry pays you directly, and you invoice the host for nothing — the host's benefit is covered shifts. Simplest, and the default unless somebody has agreed otherwise.
- You bill, the group is paid. Claims carry the host's group number, so payment goes to the group and the group pays you on whatever terms you agreed. See group billing for what else this changes.
- The host bills on your behalf. Someone in the host's office enters and submits claims that carry your billing number. You are still the physician of record and still answerable for the claims, which is the part worth being clear-eyed about.
Get it in writing before the first shift. Not because of the ministry — because of the month after. The ambiguous case, where nobody is sure whether the host submitted or you were supposed to, is how whole weeks end up unbilled and then age out of the submission window.
What changes at each site
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The facility number
Hospital and institution work carries the facility number for the site. Wrong facility number is one of the most common rejection families, and for a locum it is the single most likely error, because the correct value changes every time you move. Collect it before you arrive rather than guessing from the hospital's name.
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The group number, if any
Different at every host, and absent for solo work. A group number carried over from the last site is a claim paid into somebody else's account — not a rejection, so nothing tells you.
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Which premiums apply
Premium eligibility often depends on the site and the hours. The same after-hours work can be billed differently at a hospital with an emergency department than at a site without one. Do not carry last week's assumptions.
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Nothing else
Fee codes, diagnostic codes and the submission mechanics are the same everywhere. The variation is almost entirely facility, group and premiums.
The real problem: capturing the encounters
Everything above is a setup problem you solve once per host. The recurring problem is different: the record of what you did stays in the host's chart, and your claims get built later from something less reliable.
The failure modes, in the order they cost money:
- Billed from memory at the end of the week. You remember the interesting cases and the volume. You do not remember the second procedure on the Thursday, or which visits qualified for a premium.
- Waiting on a list from the host. The list arrives, or it does not. If it arrives late and incomplete, you have no way to tell what is missing from it.
- Assuming the host billed. The most expensive one. Nobody finds out for months, and by then the claims are stale dated.
The fix is capture at the point of care, on whatever device you have with you, during the shift. Not because entering claims on a phone is pleasant, but because the alternative is reconstruction, and reconstruction always loses something. Reducing missed billings covers the general case; for a locum it is the whole game.
Before the first shift
A short list worth having answered in writing:
- Facility number for every site you will work at, including satellite locations.
- Whether claims go out under a group number, and which.
- Who submits — you or the host — stated plainly, with a name if it is the host.
- If the host submits: how you will see what went out, and what happens to rejections.
- Which premiums the host's physicians normally bill for the kind of shift you are covering.
- Whether you need to be added to anything on the ministry side before claims will be accepted — relevant if you are billing under the host's group.
If you are new to billing entirely, how to start billing OHIP and MCEDT registration cover the one-time setup that has to be done before any of this matters.
Reconciling across sites
A locum's Remittance Advice mixes sites, and a locum's unpaid claims are spread across hosts. Two things make this manageable:
- Know what you expected per shift. If you can compare a shift's expected total against what settled, a missing batch is obvious. Without that, the RA is just a number that is plausibly correct.
- Keep rejections visible across hosts. A rejection from a site you left three weeks ago is still your claim and still ageing. The common locum pattern is rejections from the current host getting worked and rejections from previous hosts quietly expiring.
Billing that follows you between sites
A locum’s billing problem is that the work moves and the paperwork does not. IntelAGENT keeps one billing record across every host site you cover.
- Capture during the shift. Mobile entry on iOS and Android, so claims are built from the encounter rather than from memory. See mobile billing.
- Facility and group follow the context. Defaults are per site rather than set once globally, so moving between hosts does not carry the last site's values.
- Rejections in one place. Everything outstanding across every site, sorted by remaining submission window rather than by host.
- Expected against settled. A shift whose claims never paid is visible rather than assumed fine.
Three months free, then 0.25% of paid claims, capped at $39.99 a month. IntelAGENT has submitted OHIP claims since 2016 for more than 2,000 Ontario physicians.
Frequently asked questions
Do locums bill OHIP under their own billing number?
Usually yes. Your billing number is yours and travels with you between sites. What changes per site is the facility number, and whether the claim is submitted under a group number — which depends on the arrangement you agreed with the host.
Can a locum be paid through the host practice instead?
Yes, if the arrangement is that claims go out under the host's group and the host pays you. That is a contractual matter between you and the host; the ministry pays whichever account the claims were submitted under.
What do I need from a host before my first locum shift?
The facility number for each site you will work at, whether to bill under a group number and which one, who holds the billing responsibility, and how encounters will reach you if you are not entering them at the point of care.
Why do locums lose more revenue to missed billings than other physicians?
Because the encounter record stays with the host and the billing happens afterwards, often from memory or from a list sent days later. Nothing in the host's system is tracking whether your claims went out.
Sources
- OHIP Schedule of Benefits and Fees — fee codes and premium eligibility.
- Ministry of Health — physician payment.