PHYSICIAN BUSINESS EXPENSE REIMBURSEMENT GUIDELINES
DEPARTMENT
01 02 03 04 05 06 07 08 09 10 15 16 19 20 24
BUSINESS EXPENSE Surgery Anesthesiology Family Medicine Radiology Neurology Oncology Pediatrics Opthamology Immediate Care Medicine OB/Gyn Pathology Psychiatry Neurosurgery Ortho/Rehab
Dept unless out of
Dues Y Y Y Y Y Y state Y Y Y Y Y Y
Dept unless out of
Licenses Y Y Y Y Y Y state Y Y Y Y Dept Y
Professional literature Y Y Y Y Y Y Y Y Y Y Y Y Y
Office supplies Y Y Y Y Y Y Y Y Y Y Y Y Y
Per diem unless bus
Meals Y Y -$60 no receipts meeting Y Y Y Y Y Y Y Y Y Y
$2500 dept
Travel Y funded may Y Y Y Y Y Y Y Y Y Y Y
Y(Presenting up Dept may pay Dept may pay
Meetings Y Y Y to $5,000) addtl for Y Y Y Y Y Y addtl for Y
Recruitment (Special
Entertainment Y Y Occur) Y Y Y Y Y Y Y Y Y Y
Cellular phone Not > 80% Y Y = Bus Use Y Y= Bus Use Y Y = Bus Use Y Y (if needed) Y Dept Not > 80%
Pagers Y Y Y Y Y Y Y Y Y Y Dept Y
Professional Clothing Y Y Y Y Y Y Y Y Y Y Dept Y
Medical equipment Y $1600 (new Y Y Y Y Y Y Y > 1000 UW's Y Y Y
faculty one
time/dept
Computer equipment Y matched) Y Y Y Y Y Y Y Y > 1000 UW's Y Y Y
Personal communications Per UW Guidelines
Gifts Y Y $100 Y $25-$35
** Receipt dates 6 months or less 6 months or less 6 months or less 6 months or less 6 months or less
No limit for Set by Individual $3000 per 1 FTE
individual MD, pre-tax (exceptions
** Annual Limit expenses salary deduct $3,000 allowed) $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 # Direct CME Exp
NAME:
ADDRESS: DATE
G/L Acct # Type of Expense Date Description Dollar Amount
58010 Phys Travel Reimbursement
( See page 2 for detail)
58020 Phys Dues-Membership
58040 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: DATE(S) OF TRIP:
PURPOSE:
[ ] Meeting Presenting [ ] Meeting Attending [ ] Meeting Other
(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 Chair Department Administrator Asst DA Other
01 Surgery Layton Rikkers, MD Kevin McMahon 263-1375 H4/710A Kristi Wisniewski 263-7841
02 Anesthesiology Susan Goelzer, MD Jack Sorenson 263-8115 B6/319
03 Family Medicine John Frey, MD Bob Drachenberg 263-3402 777 Mills Jerry Salvo 263-4015 Lisa Novinska 263-7767
04 Radiology Patrick Turski, MD Margaret Birrenkott 263-9288 E3/358 Carol Hassemer 263-9180
05 Neurology Thomas Sutula, MD Greg Zalesak 263-0590 H6/566
06 Oncology Minesh Mehta, MD Karen Steiner 263-5361 K4/316
07 Pediatrics Aaron Friedman,MD Marsha Wendt 262-8785 H4/455B
08 Ophthalmology Daniel Albert, MD Mary Ruedinger 263-6072 Steve Hegge 263-6073
10 Medicine Jeffery Glassroth, MD Lloyd Withers 263-1710 Del Freiboth 263-0590 Chris Helmer 263-0214
15 Ob/Gyn Julian Schink, MD Jeanne Reitter 263-1202 H4/654 Cindy Tiggelaar 263-0413
16 Pathology Michael Hart, MD Gretchen Harvey 265-3735
19 Psychiatry Ned Kalin, MD Jeff Charlson 262-0935 6001 Research Park
20 Neurosurgery Robert Dempsey, MD Greg Zalesak 263-0590 H6/566
24 Ortho / Rehab Greg Zdeblick, MD Kevin McMahon 263-1375 H4/710A Kristi Wisniewski 263-7841
3/12/2009 c120aea9-c06c-448f-9039-37e5fead1e14.xls\Dept Phone Listing