Collaborating Physician Contracts: Turn 10 Hours/Month into a Six-Figure Side Gig

By ClinX Academy 

TL;DR – A well-negotiated collaborating physician or NP supervision agreement can net $1,000+ per NP each month for <10 hours of oversight. Master the legal nuances, automate chart reviews, and scale across states, and you’re looking at $100 K+ in annual “passive-ish” income.

Why Demand Is Exploding

Keywords used: collaborating physician, NP supervision agreement, remote physician oversight, telemedicine NP collaboration 

Anatomy of a Collaboration Agreement

1. Scope of Practice & State Rules

• Minimal vs. Direct Supervision – Some states (e.g., TX, CA) require chart review quotas; others (CO, WA) allow remote sign-offs.

• Chart Review Percentage – 5–20 % is common. Automate with an EMR report.

• Face-to-Face Requirement – Know whether quarterly in-person visits are mandated.

🔍 Pro Tip: Bookmark your state board’s Advanced Practice page and set a calendar reminder to re-check every January 1 and July 1—laws shift fast.

2. Time & Availability

3. Compensation Benchmarks

4. Liability & Insurance

• Tail Coverage – Confirm whether the NP’s policy extends to you.

• Indemnification – Ensure the company defends and indemnifies the physician for NP actions within scope.

5. Term & Termination

• 30-day out protects you if regulations tighten.

• Include wind-down provisions for outstanding chart reviews and unpaid invoices.

Keywords used: supervising physician requirements, medical oversight contract template 

Compliance Landmines to Avoid

1. Practicing Without a State License – Multistate telehealth = multistate MD licenses.

2. Prescription Authority Overreach – Schedule II oversight varies; tread carefully.

3. Excessive NP Ratio – States cap at 4–7 NPs per MD (or none in full-practice states).

4. Kickbacks – Flat fee is safest; per-script or revenue-share can trigger AKS/Stark scrutiny.

5. Inactive Oversight – Boards have fined MDs for <10 % chart review where 20 % was required.

Step-By-Step: Landing Your First Contract

1. Pick a focus – Urgent care, psych, med-spa? Niche experience wins.

2. Get multistate licensure – Start with IMLC if you’re in a compact state.

3. Update your LinkedIn headline – “Telemedicine Supervising Physician | NP Oversight | Licensed in XX States.”

4. List on marketplaces – Matchwell, PhysicianSideGigs, PULSES supervision board.

5. Pitch deck (1-pager) – Credentials, states licensed, EMR familiarity, response SLAs.

6. Negotiate smartly – Target $1 500/mo per NP for 10 hours of work; slide scale for volume.

7. Automate – Use Google Sheets + Zapier to track chart-review percentages.

Keywords used: physician side gig, passive physician income, NP collaboration job 

Scaling to Six Figures

Hit 6 NPs at $1 500/mo and you’re at $108 000 annual gross with flexible, remote hours.

FAQ Lightning Round

Q: Do I need DEA in every state? 

A: Only where controlled substances are prescribed; tele-psych may require Schedule III–V.

Q: Can I supervise while working full-time hospitalist shifts? 

A: Yes, if your employer does not prohibit outside medical practice and state ratios/time requirements are met.

Q: Who buys malpractice tail when we part ways? 

A: Negotiate “company pays tail” into the contract; add a survival clause.

7-Point Quick-Start Checklist

1. □ Verify state collaboration laws

2. □ Apply for compact licenses

3. □ Draft one-page pitch deck

4. □ Quote retainer & chart-review max

5. □ Use ClinX Contract Red-Flag template

6. □ Schedule quarterly compliance audit

7. □ Re-assess pricing every 6 months

Ready to Master the Business Side?

ClinX Academy’s 30-hour CME curriculum dives deeper into friendly-PC structures, MSOs, payer contracting and more—without the MBA price tag. Explore the course → 

Recommended Reading

• Friendly PC + MSO Model Explained (upcoming post)

• Start-Up Medical Director Roles 101 (upcoming post)

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