0:00

The employment agreement will additionally address

0:02

what rights you have to patient records, both

0:07

during the term of employment and afterwards,

0:10

and how your claims for your services that are performed,

0:14

how they're billed in terms of the ownership

0:17

of patient records and access.

0:19

You will typically find

0:20

that the employment agreement will have

0:22

that the patient records themselves are the exclusive

0:25

property of the employer, and you have very limited access

0:29

rights to such information.

0:32

What we typically try to do in representing employees

0:34

with their employment agreements is that we make sure

0:36

that there is, uh, at least access post-termination

0:40

in the event that there's a government investigation, uh,

0:43

and then that there is a, uh, malpractice action that occurs

0:48

so that you have access to those records

0:50

so you can properly defend yourself.

0:51

And also to the extent

0:52

that there are any payer recoupment actions

0:55

that are going on for which you may be responsible,

0:57

it's really important for you

0:59

to have access to that information.

1:00

And while we understand

1:02

that the practice has compliance obligations under HIPAA

1:05

and state law, these are circumstances under healthcare

1:08

operations where the physician can be granted access

1:11

to this record so that they can either defend

1:13

or participate in any of these recruitment actions

1:16

or governmental investigations.

1:18

In terms of the billing of your, your services,

1:22

the employment agreement in almost all cases will provide

1:24

that the money that's generated from the interpretations

1:29

or the services that the physician provides will

1:31

go directly to the employer.

1:33

And through your compensation model,

1:36

you will receive some portion of that benefit.

1:40

Employers often have policies on the timely completion

1:44

of medical records and reports,

1:45

and I believe it's really important for physicians, um,

1:48

prior to signing an employment agreement

1:50

to have the opportunity to read

1:52

and understand what these medical record

1:55

documentation policies provide.

1:57

There are certainly circumstances where

2:00

the policies may require a timely completion

2:03

of medical record that's just not within the physician's own

2:07

practice experience and may not,

2:09

or she may not be able to provide the record completion

2:12

and the timeframe in which the employer is seeking,

2:14

and they may need to be in accommodation

2:16

so that they can comply.

2:18

Um, and then in addition,

2:19

there are oftentimes there are financial penalties

2:22

that may apply, uh, in circumstances

2:24

where the records are not completed in a timely fashion

2:27

or in extreme events

2:29

where the employer can actually terminate the employment

2:32

agreement for the failure to comply with the policy.

2:35

Um, so it's really important for the physician

2:37

to understand, you know,

2:39

what the practice's expectations are

2:41

and policies are regarding the

2:43

completion of these medical records.

2:45

Finally, I wanna touch on briefly indemnification,

2:48

because this is kind of a very complicated subject itself.

2:52

It's not uncommon for an employer

2:54

to include a very broad indemnification provision in an

2:58

Employment agreement that covers a lot of circumstances,

3:01

and it may cover issues of medical negligence.

3:04

It may cover issues where the practice, uh, you know,

3:08

you breached the employment agreement

3:09

or you fail to comply with the policies

3:11

and practices and the employer and their losses.

3:13

Or in this circumstance of, in this slide

3:15

that we're covering, it's really about

3:17

payer recruitment actions.

3:19

And what indemnification does is it obligates the physician

3:23

to hold harmless and reimburse the employer for any costs

3:27

or expenses or losses.

3:29

It may recur as a result of the action

3:32

or an emission by the employee in his

3:36

or her responsibilities to the employer.

3:38

So this could include, for example, the failure to

3:42

document in the record medical necessity,

3:45

or it may be the failure

3:47

to code a particular claim correctly.

3:51

And, you know, you need

3:52

to be understand when you're looking at your employment

3:55

agreement, what your indemnification obligations

3:57

to your employer may mean, including whether

4:00

or not this is an unlimited obligation,

4:02

or whether there's some limit in terms

4:04

of either the duration or the amount that you may indemnify.

4:08

Because, for example, you've only been paid, you know,

4:12

a hundred dollars for the performance

4:14

of an image interpretation, and the employer gets $200.

4:18

You, you want to cap your

4:20

identification obligation if you can, to just the,

4:23

the a hundred dollars that you've been paid in,

4:25

in my hypothetical example.

4:27

Um, you don't want to find yourself in a situation where

4:30

if you can avoid it, where you've agreed to indemnify

4:34

the employer for an unlimited amount of money

4:37

or an amount of money that exceeds the amount

4:39

that you've been paid, particularly

4:41

for these recoupment actions.

4:43

And the the last thing I would want to add

4:44

to this identification issue is

4:46

that you don't wanna be responsible for the acts

4:48

and admissions of the employer,

4:50

or its billing personnel or its agents.

4:53

So, for example, if the, um,

4:55

billing personnel changed the documentation

4:57

or change a code on a particular claim, you should be,

5:00

it should be very clear that that is not your obligation.

5:03

And in fact, the employer's responsible for all losses,

5:05

including any losses that you may incur.