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Fam Pract Manag. 2000 Sep;7(8):66.

Buying and selling patient charts

Q

I'm a family physician whose organization is currently undergoing disintegration. The organization our practice belongs to wants us to buy back our patient charts. However, when we sold our practice to the organization, we were told that the patient charts had no intrinsic value, and the organization didn't pay us for them. Is it legal to sell charts?

Patient charts are considered to be part of the intangible asset value (goodwill) of the practice, which can be bought and sold with a practice. However, in some states nonphysician entities cannot legally own physician goodwill or patient charts. And, of course, even if the entity can own patient charts, patients always have the right to transfer their records under the state's release-of-information laws.

To determine your rights to your patient charts, ask yourself these questions:

  • Is it legal for nonphysician entities to own goodwill in your state?

  • Is there a provision in your contract for buying back goodwill?

  • Did the company pay you for any goodwill that includes patient charts? If so, how was this determined, and is there a buy-back clause that stipulates how the value is calculated?

You may also need a consultant appraisal and an attorney review of the contract to determine your rights.

Average compensation

Q

I'm a family physician resident willing to do obstetrics, and I would like to practice in a rural community. What should I consider to be fair compensation? I've been offered $100,000 to $120,000, but I feel this is low.

Physician earnings do fluctuate regionally, but because employers around the country are seeking physicians, the compensation packages they offer should be competitive on a national basis. A variety of physician compensation surveys show a national average for family physicians of about $140,000. As a family physician willing to do obstetrics in a rural area, you should command at least this much, and $160,000 would not be out of line, depending on the setting.

Compensation for collecting capitation payments

Q

Little effort is required by billing companies to collect capitation payments since they don't need to follow up on unpaid claims. So what is an appropriate way to compensate a billing company for capitation payments received?

It is appropriate for the billing company to receive some compensation, because the company does produce and submit the HCFA-1500 form each time a service is performed.

We have always attempted to negotiate a reduced rate for this service. For instance, for a practice that pays its billing company 8 percent of the fee-for-service receipts the company collects on the practice's behalf, we try to negotiate a rate of 4 percent to 5 percent of capitation revenues for completing and submitting the HCFA-1500 forms.

If the billing company is unwilling to cooperate, we will try to make it responsible for verifying that the capitation payment includes every patient listed on the practice's panel and that the payments are at the appropriate contractual rate for each patient's age.

Faced with that option, most billing companies will elect to give the practice the reduced rate. Unfortunately, that also leaves the practice with the responsibility of verifying the accuracy of capitation payments.

Cesarean section privileges for FPs

Q

I'm a family physician who would like to start doing obstetrics. What can you tell me about cesarean privileges for family physicians who have done ob/gyn fellowships?

In my experience, family physicians with the requisite ob/gyn fellowships who also have good relationships with obstetricians can usually obtain cesarean privileges at most hospitals. However, some larger, urban teaching facilities limit these privileges to ob/gyns only. In some cases, family physicians doing obstetrics must obtain probationary privileges and demonstrate competence before obtaining full, unrestricted privileges.


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Copyright © 2000 by the American Academy of Family Physicians.
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