Physician administrative agreements are complex largely because of the challenging compliance regulations they must follow. Based on the thousands of agreements we’ve read on behalf of our clients, there is a cycle taking place where the agreements are getting more complicated as the compliance landscape becomes more rigid. This can create a series of problems when it comes to writing and managing these agreements over time. Take a read through the physician contracting errors that we’ve seen throughout agreements that can cause both short and long-term problems.
Using different templates for the same or similar agreement types. Agreement types are known as medical directors, on-call, teaching, etc. Because contracts are managed by so many different people from those responsible to write them (legal), to the administrators and executives who are reviewing time submitted by physicians and ultimately ensuring proper payment, the documents should try to follow similar patterns in the way they are written. Templated agreements will be easier for everyone to understand and ultimately manage correctly over time. When you use a different agreement type for each individual physician, you’re losing time at each step during the process and this leads to greater risk of human error and violation risks.
Not including time log parameters to submit. All agreements, whether they are for employed or contracted physicians, should include parameters that help keep track of the work physicians are completing. In addition, these parameters will keep you more compliant as they create structure. Examples that could be costly if not specifically stated in your agreements are: i) including a template that your physicians can use to submit their time. Our suggestion here is typically to automate this process whenever possible. The risk declines and will cost you less in incorrect payments as well as time. ii) outlining the number of days a physician has to submit their time once the billing period has ended. If the physician only has a certain number of days to submit, there are additionally deadlines for payment which can help bring together the different teams responsible to review and pay physicians.
Lack of standardized duties. The concept of recreating the wheel when it comes to creating your administrative agreements isn’t necessary. Within your organization, there likely are already a number of agreements in place, look through the duties in those existing agreements and see how you can include them in your templates. Over time, you will also be able to start measuring duties being worked by physicians. This data is valuable for you end of year reviews both with individual physicians as well as for your organization as a whole.
Too many layers of approval. Of course, approvals are critical to remain complaint in this process, however, too many layers of approval can be costly, again both in time and because of human errors. When there are too many people in the approval process, time logs can get lost in a long process, one approver may not be as diligent with the approval process because of the crutch of having multiple layers above them. There should never only be one level of approval, but including one person who understands the agreement and works closely with the physician who submitted the time is important, in addition there should be one or two levels of approval higher with a suggested executive as the final approver. Ideally, verifying that the agreement duties and parameters have been met using the final contract is what each approver should be doing. If there is an automated process, this becomes even easier.