Fresh out of training, it’s hard to get your head around compensation. The modest stipend you’ve been making won’t prepare you for what you will earn now. This means you could either underestimate or dramatically overestimate what you think you’ll get. Some practices still base compensation on the physician’s share of collections, which is a pretty easy concept to understand. Increasingly, however, payment even in practices is based on productivity.
As a new physician, it can be hard to understand the concept of compensation claims & physician contracts. There are many questions that come up when you hear the term medical compensation, and in this article, we’ll aim to answer some of the ones you may have
There are six factors that MGMA takes into consideration when they’re reviewing the wRVUs: practice ownership, group type, geographic region, demographics, number of partners, and call responsibilities. These factors play a major role in how much you can get out of your compensation negotiation. It’s difficult to gauge how much you can expect to get paid, but these factors will give you a general idea of your salary range.
Your first-year salary doesn’t determine what you will get later on
The first year salary is not indicative of how much you will get later on, especially if the compensation plan of the practice is focused more on future growth and retention. On the contrary, some practices will actually offer you a high signing bonus, but they may limit your growth in some other ways. You will have to consider your options and think about how you would like to go about your salary situation going forward.
If the majority of your salary and that of your coworkers depends on compensation, it will result in a very competitive work environment. You may have to work harder in these practices than you would in a practice where the salary plan is more lenient. The decision will depend entirely on how you choose to work, as every person has their own idea of a good work environment.
Romanowsky Law specializes in physician contract reviews to ensure that you are getting fair employment – get in touch today to see how we can help.
A non-compete agreement—sometimes referred to as “covenant not to compete”— is a contract agreement between the employer and employee or the business and the partner. The agreement is designed to restrict one party from working in the same profession and area for a certain amount of time, thus becoming a “non-competitor.” In the medical field, there are many trade secrets and other confidential information that has to remain unrevealed to protect the profitability of a practice.
When a breach of agreement occurs, litigation will ensue. To make sure that you win these litigations you need to avoid these three common mistakes:
As an employer, it is better to have a physician contract attorney draft the covenant for you to protect your business and to hold the contract violator accountable. On the other hand, the physician should also review the agreement with their attorney to ensure that the contract is fair and reasonable.
Having an unlicensed attorney draft and review your contract is a surefire way for you to be taken advantage of without a way to legally fight back.
What should I do?
Be vigilant of the time frame and be sure to comply by the court’s regulations and time frame.
For example, if the contract states: “The physician is unable to work in the medical field for two years after the termination of the contract,” the contract is unreasonable, and it can’t be legally enforced.
What should I do?
Consult your contract terms with an attorney prior to the litigation to review its enforceability.
Romanowsky Law specializes in Physician Contracts in the New Jersey & New York area – get in touch today to see how we can help.
If you’ve received a job offer from a potential employer, make sure you don’t sign it before a lawyer has gone over it with you. Regulations surrounding the healthcare industry can be quite strict. This means that physician employment agreements contain things that may not be included in the physician employment contract.
It’s definitely worth your while to consult a lawyer who specializes in physician employment agreements. They may very well save you from coming up with the shorter end of the stick.
Wondering why you need an attorney who specializes in physician employment agreements specifically? It’s simple, really. There are two main reasons why you need a specialized lawyer to review your contract.
First of all, legal professionals who specialize in physician employer contracts probably know a lot about the health care industry in your area. They may even know the hospital or practice that you will be signing on to.
There’s also a chance that your attorney has reviewed and negotiated contracts for other physician clients who were offered jobs at the same place of employment. In such a case, your lawyer will have a better idea of the things that your employer will be willing to negotiate and what they won’t. They’ll also be able to guide you on the things that you should negotiate and what you should compromise on so that you don’t waste too much time.
Second of all, you get to consult your lawyer about various things about your potential employer and the market. You get a professional legal opinion about your potential employer, their reputation, their competence, their management team, and the way they have historically treated their employees. This information can be invaluable and may make or break your decision to sign on with them
It isn’t too difficult to find an attorney who specializes in physician employment contracts. If you have absolutely no idea where to start, just get in touch with the state medical association. It’s important for you to work with an attorney who is licensed to practice law in the state where you’ll be working because there may be specific legal requirements in the area that you’ll have to comply to.
How much will it cost?
The cost of hiring an attorney to review your contract will vary greatly depending on your location. That being said, there are a few factors that may have an effect on how much you are charged. For instance, the fee arrangement may make a difference. Some lawyers charge by the hour and others charged by fixed rates. Some give you the choice.
The extent of the lawyer’s services will depend on what you specify. You may only want someone to review the contract, pinpoint any catches, and give suggestions on things you may want to negotiate while leaving the actual negotiation to you. This is a good way to keep legal fees down. If you want to ensure that you’re getting the best deal possible, however, you may want to hire an attorney to both review and negotiate the contract with your employer on your behalf.
Romanowsky Law specializes in Physician Contracts in the New Jersey & New York area – get in touch today to see how we can help.
As a general practitioner, it might not be the easiest thing to do. There are a lot of things you need to include in the contract, and the salary plan should be agreed upon beforehand. On the other hand, if you’re a healthcare firm and are looking to draft a contract for anything at all, you might find that it’s not easy to make it inclusive and thorough. This is why it’s in your best interest to work with a medical contract lawyer, no matter which side of the coin you’re on.
Physicians, physician groups, medical business, and other attorneys have placed their trust and confidence in our firm for their most vital and sensitive contract issues. Our breadth of experience, regulatory knowledge, and foresight enable us to handle matters involving:
Independent physicians and medical practitioner groups have to worry themselves with a lot of legal issues. Some of these issues include medicine-specific agreements like medical director agreements and physician employment agreements, and some are not. More generalized contract issues include employment agreements, management agreements, leases, and billing agreements.
Without the proper knowledge on how to deal with these issues, it can cost the firm and the physician a ton of money. Listed below are some of the most common types of agreements that every physician has to deal with. A contract lawyer can assist any physician or firm to draft an inclusive and protective agreement that ensure that both parties are treated fairly.
A good medical contract lawyer will be able to draft an agreement that abides by the law and helps to protect the interests of every party involved. This will save the firm from lawsuits and legal complications that can leave a detrimental effect on the firm.
This is a guideline for how these transactions need to be done, and if one party violates the agreement, the other party can go forward with a lawsuit.
A PEA needs to include compensation policy for both the employer and the employee against wrongful acts from one another. The PEA will provide a guideline for each practitioner and what they’re expected to do. This is a tricky thing to do, as there are many factors to include, and each practitioner at each position is will perform different treatments. It means that a PEA needs to be redrafted for each healthcare specialist. Additionally, the PEA will also include the salary for the employee, as well as the payment plan. Some medical firms offer a full shared-profits salary plan while others go by performance or work hour.
Call Coverage Agreements
Medical equipment and workspaces aren’t cheap. This is why there must be a purchase agreement and leases to ensure that the firm is not liable for anything other than their main responsibility to the venue.
These aren’t the only things that a medical contract lawyer can do for a medical firm, as they are proficient at any medical-related legal issues. If you’re having a problem with your medical contract, you should give a medical contract lawyer like Romanowsky Law a call.
Every business should have a legal team to call on in times of trouble. There are so many reasons to do so. That being said, it can be rather expensive to hire a full-time employee in-house, particularly if you are a small business. In such a case, you may find a contract attorney to be a better option so that you can enjoy the resources and protections of a commercial lawyer without breaking the bank.
Lawyers who work for large law firms often have rather high hourly rates, especially when they specialize in commercial transactions and matters pertaining to intellectual property. There is a point when it is a better idea to hire an internal lawyer. Having said that, an in-house lawyer will cost a lot, especially if you are looking for one with enough expertise and experience to handle any legal issues you may run into. Besides their salary, you’ll have to pay for other employee benefits and overhead costs.
There are certainly times to hire a full-time in-house employee and times when it would be better to hire one on contract. Today, we’ll be looking at contract attorneys in particular. Here are the benefits of hiring a contract attorney:
In the case that they are contracted as an independent contractor, however, the company is not required to withhold taxes or offer benefits. Instead, they will compensate the individual based on a contract rate. This is a popular option for companies that only need legal support for a certain duration or for a particular project.
Contract lawyers are often preferred over in-house lawyers or law firms because this allows the company the flexibility of hiring a legal professional with a particular specialization or of coping with additional demands.
When it comes to employment law, your contract lawyer could be your lifesaver. The laws pertaining to state or federal employment can get rather complex and that makes hiring and firing a risky business at times. If you don’t comply with the regulations that you are subject to, you could be facing a lawsuit. Your contract attorney is able to advise you during the process to ensure that your business is protected.
There is a great deal of paperwork that every business has to handle. Contracts and other legal agreements can completely change a situation. A contract attorney will read past all the complicated legal jargon and make sure you are signing a solid contract.
Other matters like litigation and major transactions are usually not handled by contract attorneys. Most of the time, outside counsel will be involved in them. When it comes to litigation, contract lawyers may offer counsel during the process but not take further action. Major transactions like equity funding, mergers, acquisitions, and other such things require more specific expertise that your contract attorney was not hired for.
Another great thing about contract attorneys is that you don’t have to keep them on long-term. They simply serve you for the predetermined duration.
Finally, contract attorneys often have specific skill sets that you may find useful. If you require unique skills, you may be able to find a contract attorney to offer those skills without having to hire a full-time professional.
Romanowsky Law specializes in physician contract reviews to ensure that you are getting a fair employment – get in touch today to see how we can help.
Every medical professional eventually has one payer that is rather difficult to manage. In such a situation, you’ll often find that you can’t use the contract to help you – that is unless you were involved in negotiating it. If the relationship does fall apart, you may have trouble getting the money that you lost. This is why it’s so important to never let a payer have you sign a physician contract that you never had a say in. The professional relationship goes both ways, and you should know how to negotiate terms that both parties can agree on. Here are some things you should know:
Stay away from physician contracts with an indefinite life
A lot of contracts incorporate an evergreen clause, which basically means that the contract renews indefinitely until something happens and results in termination by one or the other party. There may even be contracts that are so hard to terminate that you are never able to, even if you want to.
An evergreen clause on its own doesn’t mean you need to throw out the entire contract. However, it does mean that you should look for a defined number of days needed for either party to effect a chance, an acceptable termination period, and an opportunity for either party to correct a breach of contract within a certain number of days.
Limit the credentialing period
A lot of new doctors have to deal with tons of denials and adjustments on credentialing issues. Sorting out such adjustments can take anywhere from a couple months to an entire year! When you limit the credentialing and enrollment process in your contract, however, you’ve got something working on your side. Make sure the physician contract states the elements required by the payer as well as the forms set to be completed. Include a deadline that requires the payer to review then accept and deny an application within. In the case that the enrollment process is slower than anticipated, make sure the payer is able to guarantee that they will pay claims between the completion of the enrollment process and the closing of the specified period.
If the payer doesn’t agree to process claims between the periods, see if it is possible for the enrollment application to be submitted before the physician’s enrollment. This will keep you safe from losing out, especially during the beginning period of the new physician’s employment.
Have a firm grasp of discounted payment rates
The payment process in the medical industry can be rather challenging to understand. There often aren’t any fixed prices. Instead, the payer often reimburses you on a certain discounted rate. It’s crucial for you to understand these discounted payment rates in order to streamline your payment process.
Discounted payment rates are also often referred to as “allowable rates” because it is the money that your practice is permitted to collect. You have to know how to steer clear of contracts that only state that the payer rates will be set at 115% of Medicare. You need more detail than that. Ask for a payment formula or even a report of the procedure codes that will be used. Make sure the payer is able to produce its rate for each. It’s also useful to request all their payment policies, especially the recognition of procedure codes and the related guidelines.
There are also quite a few states that demand that payers grant physicians’ requests for their rate schedules. Make sure the payer knows to inform you before there are any changes made to the rate schedule. If you are not informed, you should be paid the difference with interest on top.
Make lump-sum reimbursements an option for underpayments
A lot of medical clinics don’t get paid all the money that they are due. When negotiating a contract, try to include the ability to ask for lump-sum reimbursements so you don’t have to waste time resubmitting every single claim.
Define medical necessity
Oftentimes the term medical necessity is understood differently between different parties. A payer may not define it the same way as you would. To avoid any issues related to this in the future, make sure the definition of the term is made clear beforehand.
Romanowsky Law specializes in Physician Contracts in the New Jersey & New York area – get in touch today to see how we can help.
While it’s true that young physicians get paid less than an experienced one, this doesn’t mean that you should just accept any deal. When you are negotiating contract terms, remember that everything can be adjusted to fit both parties’ needs.
Everything that’s agreed upon during the interview should be in the physician contract, including other benefits and work terms. You shouldn’t hold a verbal agreement to be final. Make sure that every important element of your demands is included in the contract before you sign the contract. If a legal issue is to arise, the court typically upholds the terms of the contract, which is why you have to make extra sure that you have those details in the contract.
Now that the obvious has been stated, let’s move on to some other elements of how you should approach a contract negotiation.
Some facilities will allow you to work extra jobs. If you want to work in locum tenens, then you should make sure that the facility allows it.
Also, make sure that you have a malpractice insurance to protect yourself if a lawsuit is to follow your treatment. Your company should detail what the insurance is going to cover you in the case of a malpractice. Covering the cost of CME and other professional fees are additional benefits you can look to negotiate.
Lastly, make sure that the contract length is clearly defined, along with the terms of the contract termination. Covered causes should also be defined. The agreed upon non-compete clauses should be mentioned in the contract and the how disputes are handled should be identified. If you are to go to court for any reason, the contract term could be what saves you from having to pay large sums of money. Once the contract is signed, be sure to review it with your employer once a year.
Romanosky Law specializes in physician contract reviews to ensure that you are getting a fair employment – get in touch today to see how we can help.
Employment contracts are important. They protect the employer and employee’s agreement and ensure that all of the conditions mentioned before the hiring are met by both parties. It’s definitely a big and complicated topic, especially because they’re written in legal language that requires a good understanding of the law to read and write properly.
This post will give you a primer about physician employment contracts, but don’t hesitate to contact a professional if you have any doubts regarding your contract!
If you’re an up-and-coming young physician, it’s more than likely that you aren’t going to earn more than other physicians with similar attributes and knowledge. Expect your compensation to reflect the earnings of other comparable physicians in your geographical area.
While your earnings might be lower than an established physician, it doesn’t mean that you can’t be compensated for your work in other ways. For this reason, you need to review the contract details when it comes to compensation.
The contract items that will affect your future earnings potential, as well as your quality of life, are: the time it takes to earn partnership, work schedules, repayment language, and incentive component structure. When you’re reviewing your contract, you should be asking “When or how do I receive my incentive or bonus?” It’s important to know the industry standard, as some practices or clinics set an incredibly high bar for a bonus incentive.
It’s difficult to gauge whether the offered incentive plan is realistic. If you are offered an incentive or bonus program be sure to ask about how the plan works not only in theory but in practice. Make sure you know whether new physicians have actually received bonuses when similar bars are set so you have a rough idea of how you have to approach your work.
Different practices use different payment models, and these models affect many things in your work environment. Practice dynamics, group-member relations, and long-term earnings prospects, these are the things that depend on how the payment is set up. We have listed common compensation plans and their pros and cons for you down below.
This is a common and most straight-forward model you will find. You have a set level of income, but if you are able to meet the incentive goals, then you will receive bonuses.
The good thing about this model is that it secures your income, but it might not promote productivity. Some practices have an incredibly high bar for incentive bonuses, which means that the physicians will work very hard to earn them, or simply do the bare minimum to get by.
in this model, the after-expenses revenues are split equally among the group’s physicians. This structure is also fairly straightforward and has the advantage of discouraging overutilization of services.
However, it requires that every physician is on the same level of effort. One physician might be doing more than the rest and everybody will get paid the same. Regular performance assessments must be in order for this system to be at its most effective.
This model can be fairly complicated due to its many variables. Physicians are paid as either a percentage of billings or collections and the fixed and variable overhead costs of the practice are shared. They may also receive compensation based on the relative value scale units (RVSUs) assigned to different procedures for patient visits.
In this model, it is important to know the patient mix. A physician serving a patient base that consists mostly of Medicare or Medicaid patients would earn less than a physician who primarily works with commercially insured patients.
While this model rewards extra effort by physicians, it can create a competitive environment that may not be appealing to all physicians. In addition, RVSUs and overhead allocation can be difficult to administer.
While incentive chasing work environment can encourage more productivity, but it will also create a highly competitive atmosphere. Those who thrive in these situations will see their performance rise while those who don’t will see it drop.
It’s of the utmost importance that you understand what your contract says. There’s an example of a young orthopedic surgeon who left training and signed a contract with a listed salary of $500,000 per year.
While that is the amount he gets, but the contract also states that he must pay up for any shortfall or lack of productivity he may have. At the end of the year, the group requested that he return $300,000 because there is a return salary clause in the contract. This wouldn’t have happened had he consulted with an attorney. He would have been briefed on what the contract says, thus saving him a headache by the end of every year.
After their residency, most doctors choose to work at an existing practice group, be it a hospital, clinic, or private practice. They will be given an employment contract which will outline the different obligations, responsibilities, and rights that they hold during their period of employment with that group. It will also mention what the employer is responsible for towards them.
It isn’t uncommon for new physicians to think that they can go over their contract by themselves. Though it is possible, it also often results in a shaky understanding of the legal document you are binding yourself to. You may need to negotiate terms or better understand what you are required to do. Let’s take a look at some legal mistakes new doctors make with their contracts.
It’s important for you to seek legal counsel while you are still in the process of job hunting so that when it comes time to negotiate and make a deal, you’ll already have someone to call.
It isn’t just the stuff you can find out on their company website, either. Find out about what patients think, what past employees think, and what current employees think. Is the practice profitable and doing well? Will it be around for awhile? Do physicians often leave? Do they operate ethically? These are all important things to consider as you are looking for a good practice that operates well, treats their employees well, and treats your patients well. You wouldn’t want to be bound to a place where you don’t agree with the policies or think you aren’t being treated fairly. To be safe, do your homework beforehand so you can be confident in your decision to work there.
It isn’t uncommon for rookie doctors to run into problems regarding the contract, be it how long they are bound to it, how they can renew it, and whether or not they can terminate it. Without reading the contract carefully, you may find yourself in a position where you are bound to work at a certain place for several years without a raise, without certain benefits, or something of the sort. The contract is to protect employers, but it’s to protect you, too. You need to properly understand it and agree with it before you sign and become legally bound to it.
There are three basic rules that smart physicians should remember when signing their first employment contract. First off, do your research. Secondly, get some legal help with a medical contract lawyer like Romanowsky Law. Finally, ensure that you understand and can live with everything written down.
By 2030, New Jersey will have the third largest nurse shortage in the country – a shortage of more than 11,000 nurses. This according to the US Health Resources and Services Administration.
It appears that statistically, because of the recession, nurses were putting off retirement and stayed in the workforce a little longer. Now with the uptick in the economy, nurses are beginning to retire. The problem is not that new nurses are unavailable, but that the nursing schools are understaffed. The shortage of appropriate skilled teachers across the country means the nursing schools are not able to take in as many students as are applying.
According to Professor Dr. Nadine Aktan, nursing schools are turning away qualified applicants in droves because of the faculty shortage. The American Association of Colleges of Nurses says that in 2017 more than 56,000 qualified applicants were turned away from undergraduate nursing programs across the country.
