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Fam Pract Manag. 2004 Jun;11(6):63.

Purchasing tail coverage

Q

I’m thinking about leaving my salaried position and have learned that my current employer won’t provide tail coverage. My contract doesn’t address the issue. Is this typical?

When I left my hospital-owned, employed practice two years ago, I too was told they would not cover the tail. As with your situation, the contract simply did not address it. I was told that covering it was not standard anywhere, and I could not find examples to the contrary. My tail, after four years of family medicine with obstetrics, was going to be $26,000. I did a lot of soul searching and decided to go without it.

Through this experience, I learned that the tail covers both the physician and the practice, unless the doctor specifies that the tail is to cover only himself or herself. If I did not buy the tail and my former practice wanted coverage, the hospital would have to buy its own $10,000 tail. I tried to get the hospital to pay $10,000 of my tail since it would have to pay that amount anyway if I didn’t purchase the policy. But the management was upset that I was leaving and decided not to help me with my tail. (Of course, they proceeded to buy the tail for the hospital anyway.)

You should be aware that there are two types of malpractice policies: claims-made and occurrence. I had the former, which means you are covered for claims that occur while you still have the policy (or a tail). These are the types of policies that require a tail. The state I was practicing in only had claims-made policies. The state I am now practicing in has both types of policies available. I now have an occurrence policy, which means that I will be covered for a claim if I was covered at the time of the incident. No tail will ever be needed. You can also buy “nose” coverage, which is coverage for prior occurrences in addition to new, ongoing coverage, but not every insurance carrier offers this type of policy.

Some physicians can successfully negotiate with practices that recruit them to get their new employer to buy the tail. You might consider doing this should you decide to leave your current position.

Weekend call in a group practice

Q

I recently took a new job and was informed that I had to round on my inpatients on Saturdays and holidays unless the holiday fell on Sunday. Is this normal for a family medicine group practice?

There is no universal standard for weekend call in group practices. In some groups, physicians alternate rounding on all the group’s hospitalized patients, saving colleagues trips to the hospital. In other groups, each physician rounds on his or her patients only, requiring each physician to visit the hospital most days of the week.

To be fair, each physician’s call schedule should be equivalent to that of the group’s other physicians, regardless of the system you’re using. Some typical exceptions to this include physicians who work part time or senior physicians who are granted a reduced call schedule by the group. Physicians with lighter call schedules usually receive proportionately lighter paychecks.

Name changes and claims hassles

Q

I am getting married soon and am planning to change my name. I have heard that I have to be recredentialed with every insurance plan with which I currently participate and that I can expect months of hassles and rejected claims due to confusion about my name. What should I really expect?

Changing your name can be an ordeal, but it does not have to result in payer hassles. One thing you can do to help minimize the trouble is to make sure that your new name is consistent across all the sources you interact with, such as your physician licensing bureau and the Drug Enforcement Administration, in addition to health plans. Medicare carriers are required to process 90 percent of change applications within 45 calendar days of their receipt and 99 percent within 60 days of receipt. Most other payers have similar policies. You should check with your payers for specifics.

The Centers for Medicare & Medicaid Services (CMS) requires that you submit the requested change to your local carrier on CMS’ 855B form, version 11/2001 (the application for health care providers that will bill Medicare carriers, which is available at http://www.cms.hhs.gov/providers/enrollment/forms/). Mark the section where the name change is indicated, and sign and date the certification statement. Following this process is important because change requests received in any other form will not be accepted.


 

Copyright © 2004 by the American Academy of Family Physicians.
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