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When leaving a practice - What do you need to do?

Discussion in 'General Residency Issues' started by Leukocyte, 11.20.11.

  1. Leukocyte

    Leukocyte Senior Member

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    SDN Members don't see this ad. (About Ads)
    So if a physician leaves a group practice, what do they need to do as far as notifications?

    Do you need to call every insurace company and let them know that you have left the practice and change your address with them? Do you have to call Medicare and Medicaid and let them know that you have left?

    What if you do not have a new business/practice location address yet and still between jobs? Do you still call ALL the insurance companies and tell them you left?

    Do you call the NPI center and tell then you left too?

    Thank You.
  2. aProgDirector

    aProgDirector Pastafarians Unite! Moderator SDN Advisor

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    I don't think you need to do any of those things. You certainly can, but I don't think there is any legal or ethical need to do so.

    You must make sure that you don't "Abandon" any patients. All patients must be signed out to a new physician for care. You can put the onus on the patients (if you want), but IMHO it's much more professional for you to find a new doc for your patients (especially any with ongoing problems). At a minimum, you need to give patients 30 days notice. More realistically, it should be 90 days.

    You need to make sure that your records remain available to the next physician.

    You need to make sure that your medmal insurance has a tail, and whom will be paying for it. This can be very expensive, and if you're leaving a group after a short period of time, it may be your responsibility.

    You need to look at your contract to see if there are any other stipulations.

    Before contacting patients, you should review the content of your notice letter with your practice group.
  3. Law2Doc

    Law2Doc 5K+ Member Moderator Emeritus

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    Agree with the above, and would suggest that this isn't an "ask on a forum" type question. It's a matter of contract law. You are party to a contract with your practice group and you are a party to agreements with your insurance company networks. Each have contracts which are going to explicitly state your obligations. Contacts, like snowflakes are all different, and can have a wide range of obligations. There is no "in general, here's what you need to do" advice that will fit all comers. Every contract is going to be a bit different and so no stranger on the Internet is going to be able to provide you useful advice here. You need to get out the agreements and read them. Or hire someone to read them for you.
  4. LoudBark

    LoudBark

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    Each state has its own rules. You need to contact the state medical board where you have your license to specifically ask them to make sure you are not violating any state rules.

    Some states say 30 days notice, some 60 days. Generally, you have to mail a letter to every patient you have ever seen and tell them you are closing your practice. Most state guidelines will also say that in that letter you have to tell them how they can acquire their medical records and that you will be available to refer them to another doctor in the same specialty.

    Some states (Texas for example) even requires doctors who close a practice to place an ad in a local paper stating they are closing or leaving the practice. This again, is state board dependent and you should find out what your state requires.
  5. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    1. Notifying pts: although this varies from state to state, you can probably get away with (working with your former group) sending a letter saying something like ...

    I am leaving group X as of date Y (this date should be at least 30-60 days in the future). After date Y, Doctor Z will be your doctor. Should you wish to change to another doc/group, please fill out enclosed release of info form. I will not be able to provide you any care after date Y. If you need to contact me after date Y, the contact info is ..... Your medical records remain with group X and can be obtained by...


    this assumes that there is a doctor/doctors at your former group who will be taking over your patients and that you are still with the group for the near future. It also assumes you aren't going to be trying to take any of your pts with you to your new situation.
  6. Law2Doc

    Law2Doc 5K+ Member Moderator Emeritus

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    Again state law may provide a minimum threshold (some don't), but your contracts may provide for additional requirements above and beyond what the state may require. You have to read the contracts. No escaping this. And thus no way you are going to get useful advice here.
  7. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    xxx
    Last edited: 11.24.11
  8. Gastrapathy

    Gastrapathy no longer apathetic

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    Dude, you really are insufferable. We get it. You are a lawyer. Hooray. It is, however, possible that there is some relevant experience here and that not all the issues are spelled out in his contract.

    OP, the major issues are
    1) patient notification
    2) malpractice tail
    3) noncompete clause enforcement
    4) ensuring the medical board has a valid new address for you (I know a guy who didn't update within the required interval and actually had a citation as a result).
    5) any contract-related specifics
  9. Law2Doc

    Law2Doc 5K+ Member Moderator Emeritus

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    Dude, I'm just trying to counter bad advice, not show off that I'm a lawyer. You will note that I'm one of the few people on this thread not telling him what the requirements are, I'm telling him that he likely has one or more documents in his possession that are going to govern t he situation, and that no one here can give him useful advice because we are not privy to them. Bad advice is following the state minimum requirements despite having signed a contract that requires more. I think some people on here don't appreciate the number of people that breach contracts every day based on "advice" they get off the Internet, and end up in court without a leg to stand on. For t he same reason SDN doesn't allow people to solicit medical advice, it probably wouldn't want people to solicit legal advice here, for good reason. And sure SOME of the major issues are those you spelled out, but without seeing his contract these very well might not be the only issues the OP faces -- your #5 may dwarf everything else you mentioned in importance, making mention of the rest pretty useless.
  10. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    Most fee-for-service ins contracts don't require very much. Just call up the provider relationship dept of each major insurer and tell them your situation; most will have a simple form to fill out regarding leaving/changing practices.

    The exception is Medicare. You don't want to screw medicare paperwork. Pay someone to help you.


    If you do quickly find a new practice, the new practice can help you do all of this (get your insurance #'s transferred over).

    It's always advisable to read the actual insurance contract/consult with an attorney; but there are not usually major problems with fee-for-service arrangements. Things get a little more sticky with PPO/managed care contracts.
    I am guessing that many of the OP's insurance contracts were primarily with his group, and not him personally.
    Last edited: 11.25.11

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