name, degree(s)

date

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TEMPLATE -- STAFF PHYSICIAN OFFER LETTER - CASUAL

11/1/2017 Revision

Date

Name

Address

Dear Dr.______:

We are pleased to offer you a casual position as a Staff Physician in the Department of ______ofMcGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth). This is a casual position at a rate of$___per hour,effective [date]. Please note that casual appointees typically work less than 20 hours per week and the schedules are normally discontinuous and infrequent in nature. Employees in a casual status are compensated on an hourly rate for hours worked and are not eligible for benefits or leave.

Your appointment as a Staff Physician is subject to approval by the Dean of McGovern Medical School and the President of UTHealth. Upon appointment, you will receive an official Memorandum of Appointment from UTHealth. Therefore, this letter does not create any legal or contractual obligation on the part of either party but reflects the intention of the parties to proceed with the proposed employment opportunity in good faith.Because this position falls within the General Administrative and Professional employee classification, your appointment and any decisions regarding your appointment are at the pleasure of the President in accordance with The University of Texas System Board of Regents' Rules and Regulations.

Your responsibilities will include ______. Your responsibilities and assignments will be under the supervision of ______, who will periodically evaluate your performance.

This offer is expressly contingent upon your resolution of any obligations under a covenant not to compete or similar restriction. Your acceptance of this offer shall serve as confirmation that any such obligation has been resolved. This offer is also expressly contingent upon yoursuccessful completion of UTHealth's employment requirements, including verification of work eligibility and satisfactory completion of a criminal background check, sanctions/exclusions check and health screening, which includes a drug screening. Please ensure that the department has your correct email address and that you are checking this address frequently. Please note that the drug screening will require that you complete this testing within 48 hours of receiving the email notification from our vendor, pre-employ.com.

Your compensation is subject to all deductions required by federal and state laws and, if permitted by law, such other deductions as you may authorize in writing. In accordance with UTHealth policy, if the source of funds for all or part of the compensation stated above is from contracts, grants or other non-state sources, the obligation of the institution with respect to the continued payment thereof is subject to the continued receipt of such funds.

The effective date of this appointment and any continuation of your appointment are contingent upon your holding a current, valid Texas medical license (or other appropriate licensure) and obtaining and maintaining appropriate hospital privileges and UT Physicians credentials. If no current TX license add this sentence: Since it may take up to 6 months to obtain a Texas medical license, if you have not yet applied, please contact the Texas Medical Board ( immediately to request a Physician Licensure Application.

The department contact for privileges and credentialing is ______at XXX-XXX-XXXX or . A benefit to employees with clinical duties includes payment of medical professional liability insurance.

Your employment is conditioned upon your participation in the Medical Service Research and Development Plan (MSRDP). Please execute the attachedAgreement for Participation and Assignment (Addendum A) and return the signed form to us. Before you see patients, you must complete compliance training pertaining to medical documentation and coding. Your acceptance of this offer confirms that you have agreed to comply with all applicable University, state and federal guidelines regarding medical documentation.

All faculty and staff are responsible for compliance with the policies, laws and regulations thatapply to the University and to their status as employees of the State of Texas. All employees are also subject to the relevant provisions of The University of Texas System Board of Regents' Rules and Regulations, UT System policies, UTHealth's Handbook of Operating Procedures, and applicable state and federal laws. The UTHealth Standards of Conduct may be found at: https://www.uth.edu/hoop/standards-of-conduct-guide.htm. Summaries of selected applicable UTHealth policies regarding employment information and ethics standards are attached for your reference.

We look forward to your accepting this offer and joining us in our patient care mission. Please indicate your acceptance of the terms and conditions of employment reflected in this offer by signing below and returning this letter by [month, day, year]. This offer will be rescinded after this date. If you have additional questions, please contact me or our department administrator,______, at [phone number].

Sincerely,

Name, Degrees

Title

cc:______, DMO

Addendum:

MSRDP Agreement for Participation and Assignment

Attachments:

Employment Information Brochure

Ethics Standards Brochure

I accept this offer of appointment and acknowledge and agree to the terms and conditions of employment contained herein:

______

Name, DegreesDate

Information to be returned:

Department of ______

McGovern Medical School

[Address]

  • Signed Offer Letter
  • MSRDP Agreement for Participation and Assignment
  • Updated email address

Addendum A

The University of Texas Health Science Center at Houston

Medical Services, Research and Development Plan

Agreement for Participation and Assignment

______(“Member”), Department of ______, hereby agrees that Member, subject to the terms of the Medical Services, Research and Development Plan ("Plan"), is a member of the Plan.

Member agrees to comply fully with the Bylaws of the Plan, as currently in effect and as may be amended from time to time, and to cooperate fully with the other Members of the Plan and the University, in carrying out the purposes of the Plan. Member further agrees to abide by all rules, regulations, operating procedures, and policies of the University, including Member's departmental policies and policies relating to standards of patient care. Said rules, regulations, procedures, and policies are specifically made a part of this Agreement by reference. Member shall be responsible for keeping informed of the Plan Bylaws and of the rules, regulations, and policies of the University and Member’s department.

In consideration of Member's employment by the University and participation in the Plan, Member hereby assigns to the institutional trust fund established by the University, for the benefit of the Plan, all fees billed, charged or received by Member for professional services during the period that Member is employed by the University. Such assignment does not include salary or employee benefits paid to Member by the University and reimbursement paid by the University to Member for allowable expenses actually incurred in the scope and course of Member's employment with the University. Expenses may not be withheld from professional fees received by Member. Member's assignment is irrevocable during the period of Member’s employment with the University and, unless specifically excluded under the terms of the Plan, extends to all professional service fees from whatever source, regardless of where rendered (including fees for legal consultations, depositions or court appearances). All such fees received by or payable to Member are the property of the University. Member further agrees that all accounts receivable for professional services which are caused to be billed by Member are hereby assigned to the institutional trust fund and are the property of the University. Title to and the right to receive and possess such fees shall pass to the University immediately upon billing for or receipt of such fees, whichever shall first occur.

Member shall bill for all professional services only through the billing office as designated by the University and shall abide by all University rules and regulations regarding billing. Member shall comply with all federal and state laws, rules, and regulations for documentation related to the billing of third party payors for professional services. Member agrees that all monies for professional services received by Member or Member's agent or billing office, whether cash, check or other instrument, shall be immediately turned over to the business office designated by the University and all checks made payable to Member shall be promptly and properly endorsed prior to delivery to the designated office.

The following are examples of actions by Member that constitute breach of this agreement and may render Member ineligible to receive any benefit from the Plan, may result in cancellation of coverage under The University of Texas System Self-Insurance Plan for professional malpractice, and may constitute good cause for disciplinary action, including, but not limited to, restitution of funds with interest and termination of employment pursuant to University policy and the Rules and Regulations of the Board of Regents of The University of Texas System:

  • failure to comply with this Agreement, the Bylaws of the Plan, or the rules, regulations and policies of the University;
  • failure to bill for professional services through the University's designated billing office;
  • failure to immediately deliver fees received by Member for professional services to the University’s designated business office; and
  • retention of cash or checks received by Member for professional services or the deposit of such cash or checks into Member's personal account or any other account not authorized in writing by the University.

Member hereby authorizes the University and its agents or employees to examine any and all records related to professional services rendered by Member that are made or kept by or under the authority of Member, including patient ledgers, billing records, and medical records for purposes of auditing the collection and disposition of fees for professional services, and shall make such records available to the University upon request.

As a condition of Member's participation in the Plan, Member shall be responsible for the payment of ordinary and necessary professional expenses incurred by Member to the extent that Member is not reimbursed by the University pursuant to University policies and procedures and the Plan.

If for any reason Member's employment with the University shall terminate, this Agreement and Member's participation in the Plan shall terminate without recourse. All professional fees and accounts receivable for services rendered prior to termination of Member’s employment with the University are subject to the terms of this Agreement regardless of whether such fees may be billed or received prior to such termination date.

Member understands that participation in the Plan, compliance with the terms of this Agreement and Assignment, and compliance with the Bylaws of the Plan are terms and conditions of employment with the University. The terms of this Agreement and Assignment shall be effective from the date of Member’s employment with the University until the date of termination of employment.

Member

Signature:

Printed Name:

Date: