Clearly define nonphysicians' status, role

Contract Language. By Steven M. Harris, AMNews contributor. April 3, 2006.

CONTRACT LANGUAGE

A column examining the ins and outs of contract issues

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Often, when physicians begin providing ancillary services, they move into the world of contracting independently with nonphysician staff to help provide those services.

Many of my clients have worked with physician assistants, advanced practice nurses and physical therapists to provide services to patients. When structuring contracts with nonphysicians, it is imperative that you carefully consider all legal, regulatory and financial issues associated with providing ancillary services.

The key issues before signing a professional service contract for ancillary services include liability, scope of practice, supervision, documentation and billing.

The issue to consider first is liability, in the sense of defining the status of all parties in the relationship and professional coverage.

Most contracts with nonphysicians for ancillary services identify the professional as an independent contractor of the practice, if he or she is not an employee.

You should indicate in the contract that this person is neither an employee nor an agent of your practice and that the provision of service does not create a joint venture, partnership or other affiliation.

You also should make sure that any individual providing ancillary services has professional liability insurance and that coverage extends to services provided to your patients. Make sure you receive certificates of insurance before any services are performed within your practice.

If you are contracting with a staffing agency, these steps should be a prerequisite before any nonphysician sets foot in your practice. Also, consider contract language that addresses apportionment of liability and damages indemnification.