Seven Things You Need to Know When Hiring a Locum

If you’re going to be away from your practice for a significant period of time and your FHO colleagues can’t provide coverage, hiring a locum physician can be a good solution. If they are registered properly with the Ministry of Health (MOH), they can submit billings on FHO-enrolled patients without incurring outside use billings for you and your FHO group. In this blog, we will share seven things you need to know when hiring a locum:

1. Finding a locum.

There are various methods that you can to find a locum. Firstly, we recommend physicians to place a free advertisement on the Health Force Ontario website. You can also find locums by asking within your FHO group and local community of physicians or joining the Facebook group called Family Physicians Job Opportunities – Ontario to browse through the locums available and post your own ads.

If you need any further assistance, we can provide support in finding locums that are looking for a placement.

2. Agree on the terms in the locum agreement.

Once you have found your locum, get a signed locum/resident physician agreement in place that clearly defines coverage and payment expectations.

Sample locum agreements:

3. Give yourself enough time.

Submit your “Contracted Physician Add-on Application” to the MOH at least two weeks before the locum’s start date to allow time for processing.

The required paperwork can be obtained through the MOH by contacting It will take the MOH about seven business days to review, process, and approve locum applications. The final confirmation will be sent to the locum via email to:

4. Wait for confirmation of status.

Don’t submit billings until the locum has received an official email confirmation from the MOH that they are registered with your FHO. Any billing submitted prior to confirmation will result in outside use.

5. Determine billing details.

Locums are required to submit all billings for locum services rendered through the FHO group number to avoid the claims being processed as outside use. A bill book linking the locum’s 6-digit OHIP billing number with the 4-digit FHO group number (i.e. BXXX-123456) is required to be set up in the EMR.

By submitting the billings through the group, it will generate two main types of payments:

  • Shadow billing payment: 15% of the in-basket services rendered to enrolled FHO patients. This payment is usually paid to the locum’s bank account by the Ministry.
  • Fee-For-Service Payment: this is the payment for all out-of-basket services rendered to all patients and in-basket services rendered to non-enrolled patients. This payment will be paid to the group account by the Ministry.

A typical payment agreement will often include:

  • An hourly rate paid to the locum (e.g. $100-$150)
  • Shadow billing paid to the locum and FFS paid to the locum or kept by the host physician

Please note: payment agreements may vary based on terms decided upon the host physician and locum. We can help assist you in developing a fair and appropriate agreement.

6.  Get ahead of your locum contract renewals.

Locum contract have a maximum term of 1 year. After the contract end date, all locum billings will be rejected. We recommend submitting the renewal paperwork at least one month prior to the original contract end date. The locum renewal paperwork can be obtained by contacting:

7. Group changes.

If you are changing groups and plan to bring a locum with you, please remember that they are not yet affiliated with the new group. The locum must submit a new application under the new FHO group.

At DoctorCare, we help facilitate the completion of all necessary locum contract paperwork for FHO groups managed by us. Have questions about group management initiatives or hiring a locum for your FHO practice? We can help! Contact us today for a complimentary practice consultation.

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