This is the time of year when I’m on the road regularly talking with clients and other hospital professionals at different conferences. One of the things I’m constantly reminded of is how automation is really a must-have in the world of managing physician contracts. Why? Because paying doctors for the work they’re contracted to do for your organization is riddled with potential pitfalls, and automating this process can help you stay clear of them. Whether you’re managing physician time tracking and payments on paper still or not, here are the five potential errors to watch out for when you’re working diligently to get your doctors paid.
1. Time and process related. This type of error might relate to the timing of the submission by the physician. For example, the agreement states the physician should submit their time within 60 days following the end of the billing cycle. Should the physician forget or get behind and walk in with 12 months of submissions, this can present a rather large problem. Another common process error might be the time log is illegible or even submitted twice for the same period.
2. Not a compensable duty. This error applies to the content written by the physician on the time log. For example, the physician agreement specifies a list of compensable duties. The most common error is the organization pays the physician for things that are not part of the agreement. It may be a clear violation, for example, the physician submits that she performed one hour of peer review yet the contract does not specify peer review is covered. It may fit into a gray area, like when a physician submits time for attending a community event and includes her travel time when the travel time specifically is not specified. It’s of utmost importance to be detail-oriented and writing and following your physician agreements to avoid any error.
3. Fair market value. FMV presents an interesting potential pitfall in two ways. It is set at the start of the agreement and if not deemed fair, it is a clear violation. The other pitfall is that the agreement is not followed as written thus is outside of FMV. As an example, there is an annual maximum in the agreement of 50 hours yet the physician is paid for all 75 submitted. These are technical violations, i.e., a monthly maximum is overlooked. Something this small an unintentional can come back to cost your organization big money.
4. Mathematical errors. Errors can occur when calculations are done manually and/or when the math doesn’t make sense. For example, a physician will be paid $500 for 24 hours of cardiac call and $750 hours of 24-hour vascular call. If shifts are counted incorrectly and an over payment or underpayment occurs, it is a technical violation. In other instances the math doesn’t make sense and therefore is not followed as written. A common error is when physicians will be paid up to 10 hours per week, with time logs being submitted monthly. Because weeks don’t fit nicely into months, the math works out that monthly the physician should not be paid more than 43.33 hours.
5. Agreement setup is unclear. This error is when the agreement is silent on important variables. For example, a physician will be paid $5,000 per quarter without reference to a number of required hours or an hourly rate. Physician agreements should be very clear in identifying the number of hours and the hourly rate used in establishing the agreement. Details and specificities in the agreement can help your organization avoid these pitfalls later.
Avoid all these common errors by using automation to assist in operationally managing your agreements. The complexities of today’s agreements require it, especially considering all of the calculations involved and the importance of supporting HCO operators in managing these complexities. Best of all? When you pay your physician partners on-time and accurately, your physician partners are much more likely to stay happy with your organization and remain focused on delivering excellent patient care. Who could argue with that outcome?!