Are you worried about your patient contract? All of us in concierge medicine worry about legalities. By definition, in concierge medicine the patient contracts directly with physician. Part II in my legal blog series examines the patient agreement, the legal and symbolic cement of your patient relationship. These agreements share certain characteristics and content:
- Short, simple and understandable
- Define physician responsibilities
- Spell-out what’s included in the concierge practice
- Define non-covered services to protect yourself in an insurance dispute
- Define patient responsibilities
- Include payment terms and method of payment
Agreements will vary by state, so be sure a health care attorney in your state reviews your agreement.
Doctors converting to concierge medicine worry about legalities. While you should never drop your guard, remember that the patient who signs the contract is the patient who, by definition, values and trusts you. The contract should reflect your style and remain consistent with your philosophies of mutual respect and trust. Keep your contracts short, simple and understandable. The patient may not trust—or sign a long contract full of confusing jargon.
The patient agreement legally binds doctor and patient together by contract. Most patients feel that signing the agreement affirms your commitment to them, sort of a personal bonding. The agreement says in writing what you the two of you have said all along in a handshake. Keep in mind this agreement does take your responsibilities to new heights—your name is on the line. Encourage the patient to read your clearly-worded agreement, your reference in case questions arise down the road.
You must spell-out your responsibilities and what you include. Most of us provide 24/7 personal coverage. Some of us see our patients in the hospital, at home, after hours, etc. Here’s where you say so. Concierge physicians accepting insurance (80+ percent accept insurance) bill “fees for non-covered services.” Be clear on the contract about what are the non-covered services. Protect yourself in the event of an insurance dispute. Be certain non-covered services are non-covered. Refer to your insurance contacts to verify your coverage recollections. Typically insurance contracts, including Medicare, promise a lot from you. State yourself clearly.
Define patient responsibilities. Patient responsibilities include paying you. What happens if the patient gets behind? Are you still the doctor, and how long will you be the doctor for free? Now the patient wants to return—does she owe a balance for the time away? How much notice do you need for patients to cancel the contract? You get the idea. Numerous specifics will apply to patient responsibilities.
Terms of the contract include:
- Time length of the contract
- Payments in lump sum vs. installments
- Payment by check, credit or debit card
- Automatic debiting vs. invoicing
- Notice of cancellation
- Responsible party–who pays for this particular patient
A good attorney can foresee and prevent your getting burned. Be specific about the terms. Always do what is right for the patient, but have a solid contract to back you up if you wish to stand firm.
You see the importance of the patient agreement. Have the right attorney include the right ingredients. This agreement bonds the relationship between concierge physician and patient, both symbolically and legally. Be yourself. The contract should include certain language defining doctor and patient responsibilities, non-covered services, and payment terms. It needs brevity and clarity. A good patient agreement is your friend; a bad one will haunt you forever.