!#S#!0|18|bold|true|18|19|bold|true|19|20|bold|true|20|57|bold|true|57|59|bold|true|59|60|bold|true|60|78|bold|true|78|81|bold|true|81|82|bold|true|82|121|bold|true|121|122|bold|true|124|144|bold|true|144|164|bold|true|144|164|italic|true|144|164|size|12|164|166|bold|true|168|170|bold|true|356|358|bold|true|468|469|bold|true|595|596|bold|true|683|684|bold|true|920|921|bold|true|1021|1022|bold|true|1093|1094|bold|true|1101|1102|italic|true|1101|1102|size|10|1104|1133|bold|true|1133|1144|bold|true|1144|1165|bold|true|1144|1165|italic|true|1144|1165|size|12|1165|1166|bold|true|1168|1169|bold|true|1236|1237|bold|true|1282|1283|bold|true|1318|1319|bold|true|1326|1327|size|12|1327|1328|italic|true|1327|1328|size|10|!/#S#!1. Direct Hours: •

2. Direct Phone out of office Hours: •

3. Indirect Hours: •

4. Clinical Administration Time Hours: •

Indirect Activities (pick all that apply):«
- Paperwork (e.g. charting and documentation; preparing referrals and requisitions; completing clinical forms, reports and medical certificates of death, excluding third-party requests)»«
- Coordinating and planning care (e.g. chart reviews; reviewing results such as labs, imaging, consult notes)»«
- Conferencing, consulting and meeting with other physicians and healthcare professionals for a specific patient or patients»«
- Conferencing and meeting with family members and/or patient medical representatives»«
- Discussion with, and providing advice and information to the patient or the patient’s representative that is an insured service directly related to pre- or post-direct patient care, via synchronous or asynchronous care communication»«
- Reviewing clinical information or research directly related to the needs of a particular patient»«
- Patient-specific clinical teaching arising from direct patient care»«
- Other:»

Clinical Administration Time Activities (pick all that apply):«
- Proactive patient management (e.g. screenings, chronic disease)»«
- EMR updates requiring physician expertise»«
- Quality improvement initiatives»«
- Other: »

