Medical Director Governance for Florida PIP & Auto-Injury Clinics

An assigned physician organizes the accepted clinic’s governance: roster and credential review, records responsibilities, protocol maintenance, encounter sampling, systematic billing review, adverse-incident processes, and corrective-action follow-up. Provider collaboration is documented separately where needed. MFMD’s monthly review cycle is our service model, not a statutory promise that one monthly check satisfies every duty.

Onboarding establishes the written appointment, responsibility map, document access, review schedule, escalation contacts, and initial list of gaps. MFMD reviews the existing clinical system and itemizes any additional protocol or implementation work in the proposal. Optional Medical Wellness & Optimization Programs add $500/month for the group from agreed activation. Full protocol and workflow development for the selected programs is $1,000 one time; existing or mixed protocols are quoted after review. Implementation and monthly AHCA governance are billed separately.

MFMD reviews the facility’s documentation process, treating-provider responsibilities, referral relationships, record consistency, and escalation of discrepancies. The treating clinician makes patient-specific medical decisions. MFMD does not guarantee payment, resolve insurance disputes, provide legal representation, or supply an NPI for another person’s services.

MFMD requires the clinical record to remain in an EMR with physician review access. When a carrier requires a paper billing package, the facility’s billing staff prints the relevant records and claim documents from the digital system and mails the package to the carrier. This billing process does not permit paper-only clinical records. Claim preparation, submission, and follow-up remain with the facility’s billing team; the appointed clinic director’s statutory billing-review duties still apply.

The Health Care Clinic Act and Florida’s PIP statute address different obligations. A clinic must verify the licensing or exemption conditions applicable to its PIP activity as well as the benefit and billing rules in §627.736. The estimator is a governance estimate; it does not certify PIP eligibility or reimbursement.

AHCA medical direction is $2,000/month. One NP or PA within the agreed usual clinic scope is included, with the applicable collaboration protocol and no separate standard setup fee. Each additional NP or PA adds $500/month. Additional services, specialty responsibilities and protocol work require review; no extra fee is automatically added from a description alone. Individual APP credentialing support is a separate service, not a facility-estimator add-on. The agreed scope is confirmed before engagement.

Choose your services and describe your team and existing clinical documents. MFMD confirms the agreed scope, physician involvement, and activation date after review. A HIPAA-compliant digital clinical platform with documented patient encounters and physician access must be in use before services begin. Appointment software alone and paper-only records do not meet this requirement.

The initial payment is due on the effective date of the Agreement, unless a different due date is expressly stated in the payment schedule. Recurring due dates follow the agreed schedule. Governance begins on the agreed commencement date after the required clinical readiness steps are complete. Signing, payment and clinical activation are separate milestones.

The clinic remains governed through the Florida Health Care Clinic Act. The medical-director framework addresses practitioner licenses and credentials, lawful scope, records, protocols, adverse incidents, systematic billing review, and corrective action under the clinic’s documented operating structure.

For selected encounters, MFMD confirms that the encounter occurred, the appropriate medical or therapy note is authenticated, the documented service or CPT identifier can be reconciled to the superbill, and the rendering professional held the required license, credentials, scope, and Level 2 Clearinghouse eligibility when applicable.

An active governance cycle assigns each exception, records the facility’s response, tracks corrective action, and checks whether the issue recurs. Clinical decisions remain with authorized treating professionals, while corporate and commercial decisions remain with the facility.