Medical Legal Information and Forms

Purpose:
To provide guidance for billing court appearances and other activities associated with medical-legal services, including depositions, legal testimony, and medical chart reviews. A deposition is legal testimony taken out of court and may occur at the attorney’s office or the physician’s office. The attached fee schedule is to provide assistance with determining appropriate fees for services.

1. Provide the attorney the Fee Schedule
2. Page 3 of this form requires the signature of the attorney or authorized signer. 
3. Obtain contact information for billing, and a W-9 from the attorney's office, if this information is missing there could be a delay in invoicing and payment. If needed UWMF W-9
4. Using the fee schedule as a guideline and the Time Tracking Template, record the number or hours that need to be billed to the attorney.
5. Provide the physician the Medical Legal Payment Selection Form
6. Send the signed Fee Schedule, Medical Legal Payment Selection Form, and Time Tracking Template with the total number of hours to Mickie Dickrell at: mmd@medicine.wisc.edu 
7. All invoices are sent via an encrypted email from the Oracle system. 
8. All checks must be payable to UWMF and remitted to:

UW Health
Attn: Deposits (MAIL CODE 1020)
7974 UW Health Court
Middleton, WI 53562

Do not have checks mailed to your office or payable to you. ​​​​​​

Once the invoice has been sent, you can expect the 83% portion to be added to your UWMF paycheck the following month as "other physician payment". Individuals will receive Department compensation plan credit for all fees received.

As a member of the faculty of the University of Wisconsin School of Medicine and Public Health and participant in the University of Wisconsin Medical Foundation, Inc. (the “Foundation”) I understand that the Professional Income I receive must go through the Medical Foundation. The term “Professional Income” is defined in the Foundation Bylaws, as follows:

“Each Medical School Faculty member is required, as a condition of his or her appointment, to commit certain professional income to the Foundation. The professional income required to be included in Foundation receipts consists of all collected fees derived from the diagnosis and treatment of patients by the Faculty member.  Professional income shall also include fees for court appearances, pre-trial legal consultations and all other activities associated with medical-legal services, or other services related to patient care or human health.  In addition, professional services include consultation with respect to the operation, supervision and quality control in laboratories.

“For purposes of this requirement, professional income does not include honoraria, royalties, lecture fees, military pay, or payment for editing scientific publications.  Income received for consultations of a purely scientific or educational nature which do not involve, directly or indirectly, the care of patients or consultations involving human health is excluded from professional income, because human health is a broad term, the Foundation Board or a designated subcommittee or officer may grant exceptions as warranted, in the Foundation’s sole and absolute discretion, and subject to such conditions as the Foundation may establish.  Work for charitable organizations, outside work of Faculty members with part-time appointments, and other unique situations may also be exempted by agreement of the Foundation and the Dean, in the sole and absolute discretion of the Foundation and the Dean, and subject to such conditions as the Foundation and the Dean may mutually establish.  All such outside activities must conform to Medical School and UW-Madison rules and regulations governing the conduct of Faculty and academic staff employees.”

UWMF Bylaws - March 24, 2021

Medical Legal can be paid to the individual in two ways: 

• UW Health payroll: 83% will be added to your UW Health paycheck as "Other Physician Payment" and is subject to applicable payroll taxes and retirement deductions. 
• UW: the funds can be transferred to a UW gift fund account to be used for discretionary purposes.

Please fill out the Medical Legal Payment Selection Form and return to your division accountant, (see also billing procedures).

Individuals will receive Department compensation plan credit for all fees received.

Please note checks must be made payable to UWMF/UW Health, deviance from this can create adverse taxable income issues for the individual.

UWMF tax information UWMF W-9