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5 Key Steps to Successfully Managing a Physician On-Call Strategy 

Managing on-call physicians poses challenges for hospitals. Staffing certain specialties 100% of the time is not necessary, which is why on-call services are essential. In addition, hospitals negotiate separate payment terms for on-call physicians. All of this makes managing on-call complex and time-consuming, increasing administrative burden on hospital teams. Here are 5 key steps to optimize your physician on-call strategy.

1. Adhere to Commercial Reasonableness and FMV

First, adhere to commercial reasonableness (CR) fundamentals by establishing legitimate business purposes for the arrangement, ensuring that terms are consistent with market and fair market value (FMV). That includes an ongoing review of duties, effectiveness and need.

2. Determine Call Contract Structure

To ensure compliance with regulatory requirements, on-call contracts must include several key elements, such as specifying the duration of the on-call period, duties and responsibilities, and compensation scheme. The scope of services offered during the on-call period should also be articulated.

3. Ensure Physicians Understand the Nuances of Their Contracts

Before finalizing the contract, it is important to inform physicians of any limitations or restrictions they may have while on-call, such as scheduling appointments or performing procedures. Regardless of contract type, all physicians are expected to follow basic rules, including having periods of inactivity and being available for immediate response during emergencies.

4. Evaluate Your Current Scheduling Tools and Processes

Scheduling processes for physician on-call is often tricky. Why? Because there is the complexity of managing multiple contracts, varying rates for different facilities and days of the week, tracking minimum call time, and ensuring proper approvals. Additionally, the manual nature of scheduling processes and the need for coordination between departments can further complicate the process. Scheduling tools that allow physicians to access, change and swap schedules are important. However, they also create more complexity for the hospital and payment protocols. The data from these systems can ultimately be used for payment but still needs to be reviewed, the right rates applied to the right physicians, and signed off on by various folks.

5. Simplify the Payment Process with Automation

Once your call contracts and scheduling processes are in place, the next big step is the efficient and seamless ongoing management of those contracts and subsequent payments. This is where automation becomes your best ally. By leveraging physician payment automation, you can streamline the entire process, from contract management to payment tracking and reporting. Here are the key areas of your on-call strategy that automation can greatly enhance:

      • Contract Management – By digitizing your contracts, physician payment automation ensures that the right physicians are always being paid according to the right terms of their contracts, including specific rate tables. No more payment errors and less compliance risk.
      • Documentation – Physician payment automation can also streamline and digitize manual, paper-based processes. With automation, the right people can use easy tools to capture shift schedules either through an app or a calendar-based tool. Hospital admin teams can also codify call sheets, greatly minimizing administrative burden for colleagues who manage physician pay.
      • Payment Calculations – Managing minimums, rate differentials, etc., has never been easier with physician automation. For example, one of the difficulties with managing employed physician contracts is that some have minimum call amounts embedded in their contracts, and then get paid for excess call. How do you make sure you are appropriately tracking that minimum call time? Is it annually, quarterly, monthly? How do you reconcile if they don’t hit it? How do you ensure they are paid appropriately once they do hit it? Automation tackles all of this and more.
      • Approvals – Automating the approval process for any kind of physician payment process is crucial, especially for on-call. This is where the right people can easily and digitally sign off and validate the physician actually worked. Ultimately, this can eliminate paying for duplicative shift schedules by allowing your team to manage a digital calendar versus paper or other manual processes.
      • Reporting – Once you have all your call rates codified in a single system, you can do interesting work around benchmarking per diem rates by specialty and by market to see where you have variance and opportunities, and then pinpoint what is really driving your on-call costs. In fact, once you’ve been processing call payments through an automated system, you can then actually take historical dollar amounts and pair it up with the per diem rates. This helps ensure your on-call spend isn’t getting out of control and is achieving your goals. 
Physician on-call is a necessary but sometimes hectic part of a hospital’s operations. Given the complex nature of these types of contracts, it’s imperative that hospitals take great care in both setting up these contracts and managing them for the long term. Hospitals should also consider automation to help them optimize their overall strategy around on call, particularly the payments portion. Automation can reduce compliance risk and administrative burden, while also ensuring proper payments to doctors.

Streamline your on-call payment strategy with DocTime®.

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