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. The AHCA application-phase monthly service is separate from the one-time wellness setup packages.

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.

The active-clinic planning rate is $2,000/month. The AHCA application/pre-opening governance ramp is $1,500/month until the license is issued or day 91 after the agreement is signed, whichever comes first. Optional initial payer credentialing support adds $500/month; together they are $2,000/month while that initial service is active. The agreed cycle may include Florida Medicaid, Medicaid managed-care plans, and commercial plans. Collaboration or supervision for 1 APP is included; each additional APP adds $500/month. The estimate does not price psychiatric/PHP/TMS clinical responsibilities. Any additional implementation is itemized separately before acceptance.

Enter the facility ZIP, choose the applicable services, and describe your team and existing protocols. Review your estimate before providing contact details. MFMD then reviews the operating facts and documents, confirms the assigned physician, initial on-site assessment, scheduled visits, and any required treatment-day arrangements, and issues the agreed scope and start date. An EMR is required and must be in use with physician access before governance begins. You may complete a planning estimate while choosing the platform; paper-only clinical operations are not accepted. No clinical services begin merely because a form was submitted.

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.