PHYSICIAN BUSINESS EXPENSE REIMBURSEMENT GUIDELINES
DEPARTMENT
01
BUSINESS EXPENSE Surgery
02
Anesthesiology
03
Family Medicine
04
Radiology
05
Neurology
06
Oncology
07
Pediatrics
08
Opthamology
09
Immediate Care
10
Medicine
15
OB/Gyn
16
Pathology
19
Psychiatry
20
Neurosurgery
24
Ortho/Rehab
Dues Licenses Professional literature Office supplies Meals Travel Meetings Entertainment Cellular phone Pagers Professional Clothing Medical equipment
Y Y Y Y Y Y Y Y Not > 80% Y Y Y
Y Y Y Y
Y Y Y
Y Y Y Y Y Y Y(Presenting up to $5,000) Y Y = Bus Use Y Y
Y Y Y Y Y Y Dept may pay addtl for Y Y Y Y Y
Y Y Y Y Y Y Y Y Y= Bus Use Y Y Y
Dept unless out of state Dept unless out of state Y Y Y Y Y Y Y Y Y Y
Y Y Y Y Y Y Y Y Y = Bus Use Y Y Y
Y Y Y Y Y Y Y Y Y Y Y Y
Y Y Y Y Y Y Y Y Y (if needed) Y Y Y > 1000 UW's
Y Y Y Y Y Y Y Y Y Y Y Y
Y Dept Y Y Y Y Dept may pay addtl for Y Dept Dept Dept Y
Y Y Y Y Y Y Y Y Not > 80% Y Y Y
Y Per diem unless bus meeting Y -$60 no receipts $2500 dept funded may Y Y Y Y Recruitment (Special Occur) Y Y Y $1600 (new faculty one time/dept matched) Y
Computer equipment Personal communications Gifts
Y
Y Per UW Guidelines
Y
Y
Y
Y
Y
Y
Y > 1000 UW's
Y
Y
Y
Y 6 months or less 6 months or less No limit for individual expenses 6 months or less
Y $100
Y $25-$35 6 months or less $3000 per 1 FTE (exceptions allowed) 6 months or less
** Receipt dates ** Annual Limit
Set by Individual MD, pre-tax salary deduct
$3,000
$1,500
$4,000
No Limit
$12,000
No UWMF reimbursement will be made for any of the following: * Not under Sec 162 of IRS code, relating to ordinary and necessary business expenses. * That have been or will be reimbursed from another source. * Without a receipt or outside the dates of the meeting. * That are directly and exclusively incurred in the production of income that is not related to clinical or academic pursuits. * That are related to financial estate planning. * That are related to spouse travel expenses. * That are related to penalties, fees, or fines at fault of physician. * That are Secretary gifts or other Staff gifts unless indicated above. * That are related to personal communications (ie postage, FedEx, phone calls etc….) unless noted above. * Meals without receipts will follow per-diem rates -see department guidelines for rates.
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION PHYSICIAN EXPENSE REPORT
DIV SOS DEPT SPEC PROVIDER
For use by Finance: Group CME
EMPLOYEE # NAME: ADDRESS: DATE
Direct CME Exp
G/L Acct # Type of Expense 58010 Phys Travel Reimbursement ( See page 2 for detail)
Date
Description
Dollar Amount
58020 58040
Phys Dues-Membership Phys Journals-subscrip & books
58530
Promo & staff relations
76255
Business Auto Reimbursement (36.5 cents per mile)
58090
Other (description)
TOTAL REIMBURSABLE EXPENSES (Attach all receipts with explanations of expenses)
Jan-02
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION PHYSICIAN TRAVEL REIMBURSEMENT
NAME: PURPOSE: [ ] Meeting Presenting [ ] Meeting Attending [ ] Meeting Other DATE(S) OF TRIP:
(Attach proof of presentation)
(Attach proof of attendance)
(Attach proof of attendance)
NAME OF MEETING (CITY/STATE):
ITEM
SUN
MON
TUES
WED
THURS
FRI
SAT
SUN
TOTALS
Airfare Mileage
Personal Car (36.0 cents)
Rental Car Taxi Parking/Tolls Hotel Registration Meals*
Per Diem $40 (no receipts) Breakfast $10 Lunch $10 Dinner $20
Misc:
Business Calls Other
Total
* Meals provided as part of a conference program cannot be reimbursed separately
**PLEASE ATTACH ALL RECEIPTS AND/OR CANCELLED CHECKS TO THE REPORT** I certify that the expenses claimed on this form are true business-related expenses, are documented accordingly, and will not be paid from another source. Signature Date
UWMF Academic Department contact list
Department 01 02 03 04 05 06 07 08 10 15 16 19 20 24 Surgery Anesthesiology Family Medicine Radiology Neurology Oncology Pediatrics Ophthalmology Medicine Ob/Gyn Pathology Psychiatry Neurosurgery Ortho / Rehab Chair Layton Rikkers, MD Susan Goelzer, MD John Frey, MD Patrick Turski, MD Thomas Sutula, MD Minesh Mehta, MD Aaron Friedman,MD Daniel Albert, MD Julian Schink, MD Michael Hart, MD Ned Kalin, MD Robert Dempsey, MD Greg Zdeblick, MD Department Administrator Kevin McMahon 263-1375 Jack Sorenson 263-8115 Bob Drachenberg 263-3402 Greg Zalesak 263-0590 Karen Steiner 263-5361 Marsha Wendt 262-8785 Mary Ruedinger 263-6072 Del Freiboth 263-0590 H4/654 6001 Research Park H6/566 H4/710A Kristi Wisniewski 263-7841 Jeanne Reitter 263-1202 Gretchen Harvey 265-3735 Jeff Charlson 262-0935 Greg Zalesak 263-0590 Kevin McMahon 263-1375 H4/710A B6/319 777 Mills H6/566 K4/316 H4/455B Steve Hegge 263-6073 Chris Helmer 263-0214 Cindy Tiggelaar 263-0413 Jerry Salvo 263-4015 Carol Hassemer 263-9180 Lisa Novinska 263-7767 Asst DA Kristi Wisniewski 263-7841 Other
Margaret Birrenkott 263-9288 E3/358
Jeffery Glassroth, MD Lloyd Withers 263-1710
3/12/2009
c120aea9-c06c-448f-9039-37e5fead1e14.xls\Dept Phone Listing