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Physician Financial Relationships

Physician Financial Relationships. Agenda. Physician employment contracts Ownership of physician practices Licensure of physicians Credentialing of physicians. Physician Employment. Who can employ a physician? Integrated delivery system Hospital if they employ hospitalists

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Physician Financial Relationships

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  1. Physician Financial Relationships © 2009 Cengage Learning. All Rights Reserved.

  2. Agenda • Physician employment contracts • Ownership of physician practices • Licensure of physicians • Credentialing of physicians © 2009 Cengage Learning. All Rights Reserved.

  3. Physician Employment • Who can employ a physician? • Integrated delivery system • Hospital if they employ hospitalists • Physician network • Physician practice • Managed care organization © 2009 Cengage Learning. All Rights Reserved.

  4. General Contract Terms • Who are the contracting parties? • Medical school, group practice, physician, hospital, health insurer? • What type of legal arrangement do you want to have? • Employee vs. independent contractor, medical director, supervision, recruitment? • What is the length of term? © 2009 Cengage Learning. All Rights Reserved.

  5. Additional Contract Terms • Are there provisions for termination of the contract? • Can the contract be renewed? • What is the cost and method of payment? • Who will be billing for services rendered? • What are the specific duties and responsibilities? • What is the effective commencement date? • Do you want arbitration in case of disputes? • Which state’s governing law will you use? • What will you do in case of a doctor’s disability or retirement? © 2009 Cengage Learning. All Rights Reserved.

  6. Ownership of Physician Practices • Why would a doctor want to own his practice? • Buy-in • Purchase agreement • Ownership agreements • Control and management • Transferability of interest • Retirement and disability • Dissolution © 2009 Cengage Learning. All Rights Reserved.

  7. Licensure of Physicians • State law regulates licensure of doctors. • National Practitioner Data Bank receives reports of license revocation/suspension, medical malpractice claims, etc. • Healthcare Integrity and Protection Data Bank tracks civil judgments, criminal convictions, exclusions, etc. • Exclusion from federally funded programs is a concern. © 2009 Cengage Learning. All Rights Reserved.

  8. Credentialing of Physicians • Credentialing is the process in which a physician’s credentials are reviewed in connection with an application for medical staff privileges( i.e. treating and admitting patients) at a hospital. • It includes review of state licensure of a doctor and checking the NPDB and HIDPB. • It may also include ongoing review of a doctor’s professional and ethical conduct. © 2009 Cengage Learning. All Rights Reserved.

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