Infectious Disease Practice Directory: West Virginia

Key Terms in Physician Contracts

Tail Insurance (Extended Reporting Endorsement)

A malpractice coverage add-on that pays for claims filed after a claims-made policy ends, for incidents that occurred while the policy was active. Tail premiums typically run 1.5 to 2 times the annual malpractice premium and are paid as a one-time lump sum at departure. Occurrence-based policies do not require a tail.

RVU (Relative Value Unit)

A standardized measure of physician productivity used by Medicare and most commercial payers to determine reimbursement. Each CPT code carries a work RVU, practice expense RVU, and malpractice RVU. Many physician contracts tie compensation to RVU production thresholds, with bonuses above a defined baseline.

Compensation Formula

The contractual method used to calculate physician pay. Common models include guaranteed salary, eat-what-you-kill (collections-based), salary plus production bonus (RVU or collections above a threshold), and equal-share partnership distributions. The formula directly affects income stability, upside potential, and alignment with practice goals.

Partnership Buy-In

The purchase of an ownership stake in a physician practice entity, typically offered after an associate track of 2 to 5 years. The buy-in price is calculated using business valuation, a multiple of earnings, or a formula tied to practice receivables. True equity buy-ins include voting rights and profit distributions.

Without-Cause Termination

A contract clause that allows either party to end the employment agreement without stating a reason, typically with 60 to 120 days written notice. The notice period, post-termination obligations (non-compete activation, tail insurance responsibility), and severance terms are negotiable. Shorter notice periods favor the employer.

Ryan White HIV/AIDS Program

A federal program providing funding to states, metropolitan areas, and clinics to provide care and treatment for low-income people living with HIV who lack adequate health coverage. Ryan White-funded clinics can receive grants that support clinical operations serving uninsured or underinsured HIV patients.

OPAT (Outpatient Parenteral Antibiotic Therapy)

Administration of intravenous antibiotics in an outpatient setting (home, infusion center, or physician office) for infections requiring prolonged IV treatment. OPAT services billed by the managing ID physician generate professional fee revenue; if the practice provides the infusion facility, additional facility fees may apply.