Travel Checklist and Approval. VCUHS Travel Authorization Form (see instruction form for details)

Transcription

1 Travel Checklist and Approval Attach all documents to this form prior to approval by Program Administrator and Program Director. Do not pay for anything prior to approval. All attached documents are estimates only until approved and incurred. Resident Printed Name: Destination: : Purpose: Initial (or N/A) VCUHS Travel Authorization Form (see instruction form for details) Copy of event agenda with clear notation of start and end date/time of your participation Copy of proposed airline itinerary (if traveling by air) or train tickets (if traveling by train) Copy of map printout from Richmond to final destination with mileage annotated (if driving personal vehicle for entire travel) Copy of any parking fees associated with event (if driving) Copy of hotel price per day Copy of any required registration forms with amounts for event listed Shuttle or cab estimates if provided by the event coordinators Initial I have read and understand the Off Site Conference Policy. I understand I am bound by all VCUHS policies and have referenced those policies as needed. I understand I must retain copies of all ORIGINAL receipts of actual expenses incurred as well as a copy of original boarding passes. I understand I must submit my travel reimbursement form within 60 days of the end of travel or I will NOT BE REIMBURSED. Resident Signature Approvals: Program Administrator Comments: Program Director Comments:

2 Virginia Commonwealth University Emergency Medicine Residency Program Travel Policy Approved By: Joel Moll MD Revision : 11/05/15 Page 1 of 3 The following policy pertains to emergency medicine resident physicians at Virginia Commonwealth University. When conflicts arise with institutional GME policy, institutional policy will prevail. All travelers are required to be familiar with the VCUHS Travel Reimbursement Policy. The Department of Emergency Medicine wants to support resident participation at off site (national, regional, and specialty) conferences. Conference attendance that is paid for directly from the resident s Professional Expense Account (PEA) is covered under the PEA policy. The purpose of this policy is to provide guidelines to residents who have scholarly work (posters, abstracts, national committees, or presentations) accepted at an offsite conference. In order to financially support the greatest number of residents, the following guidelines are in place: 1. All arrangements must first be discussed with the Program Manager (Lisa Rich) and approved by the Program Director (Joel Moll) or his designee. Residents will not be reimbursed for item such as tickets, registration fees, or other travel arrangements without this preapproval. Residents will use the approval packet (Appendix A). 2. All expenses must be planned and approved PRIOR to travel by submitting the Travel Preauthorization form. Do not incur a cost while traveling without PRIOR WRITTEN APPROVAL that it will be covered or you will forfeit reimbursement. 3. The following expenses are the ONLY expenses that the VCU Department of Emergency Medicine Residency Program will reimburse. Do not attempt to submit reimbursement for ANY other expense. a. Travel to and from traveler s house and airport (or conference location if travel is by personal vehicle) b. Airfare c. Travel to and from airport to conference hotel d. Lodging (includes only rate and taxes). e. Per diem (also known as M&IE) paid per GSA/IRS standards f. Registration fee for conference 4. Residents presenting at national conferences will be given preference to residents presenting at regional or local conferences. 5. Travel outside of the continental 48 United States will not be supported by VCU (VCU does not routinely support travel to Alaska or Hawaii) 6. The Department of Emergency Medicine Residency Program will pay for the first presentation of a poster, abstract, or podium presentation. Subsequent presentations will not be funded even if different residents are presenting. 7. The maximum amount of money available toward expenses for any one conference is $1, per person. Reviewer PM PM 5/28/15 11/05/15

3 Virginia Commonwealth University Emergency Medicine Residency Program Travel Policy Approved By: Joel Moll MD Revision : 11/05/15 Page 2 of 3 8. Department will pay registration fees only for the day/event for which the resident is scheduled. Hotel accommodations can be reimbursed for the night before and after the event. For example, if a presentation is scheduled for 2/23, then hotel on the night of 2/22 and 2/23 can be covered. 9. Residents who apply for funding for a second or additional presentations in an academic year will be approved only after other first time presenters have been approved, and if funds are available. 10. When multiple residents attend the same conference they must share double occupancy rooms of the same sex to decrease cost. If a resident could share double occupancy room and chooses a single occupancy, they will only be reimbursed at the double occupancy rate. 11. Residents are encouraged to drive to conferences within 100 miles of VCU Medical Center. They will be reimbursed for mileage at the current IRS per diem rate ($0.575/mile in 2015). A hotel will not be reimbursed unless the resident can show evidence (before travel and in their application) that they will be required to be at the conference later than 7PM or will need to arrive at a conference prior to 7AM. If the resident chooses to take alternate transportation then they will not be reimbursed unless a cost analysis shows that all alternate transportation costs (plane/train ticket, taxi to and from station) are cheaper than all driving costs (mileage and parking). Parking and toll expenses are reimbursable with a receipt (noting the name of facility, bridge, tunnel, or turnpike). Please see VCUHS travel policy for specific details. 12. All original receipts (including for parking) will be returned to the Program Administrator (Lisa Rich) for accounting on return. PHOTOCOPIES OR SCANS ARE NOT ACCEPTABLE. For airline travel, original boarding passes must be turned in as well. 13. All approvals are based on fund availability and projected need for funds in the upcoming year. 14. Rental cars are generally not approved and taxi/shuttle travel to and from event are preferred. a. If Rental cars are required then all associated costs (gas, parking, mileage, taxes, and fees) will have a preauthorized spending limit. Any costs above this limit are paid by the resident. Resident must read and abide by current VCUHS policy for rental car costs. In short, rental cars are not covered unless a cost analysis is performed, submitted, and approved PRIOR TO TRAVEL. 15. Meals are reimbursed at the IRS established per diem rate for the area. Travel days are paid at 75% of the IRS rate. You may use the GSA website for planning purposes (see our attached per diem document for help). Therefore you do not need to save meal receipts as reimbursement is fixed regardless of what you spend. 16. Residents will seek reimbursement only for actual costs attributed to their travel. Submitting receipts or costs that are not incurred by the traveler will result in disciplinary action to include termination. 17. Failure to follow any of these provisions will result in incurrence of personal cost to the resident in the form of no reimbursement or charges owed to the Department. Residents should submit for Reviewer PM PM 5/28/15 11/05/15

4 Virginia Commonwealth University Emergency Medicine Residency Program Travel Policy Approved By: Joel Moll MD Revision : 11/05/15 Page 3 of 3 reimbursement immediately upon their return but NO LATER THAN 60 DAYS AFTER travel for prompt reimbursement of the personal outlay of costs. 18. Travel is a privilege, not a right. Failure to abide by our program, department, or institution policies will result in disciplinary action which may include all of the following (and others): forfeiture of reimbursement, forfeiture of future travel privileges, and termination. Reviewer PM PM 5/28/15 11/05/15

5 Instructions for Completing VCU Medical Center Travel Authorization Form 1. Go to the VCUHS Intranet page ( and click on Accounts Payable link. 2. Download the Travel Authorization Form in Excel format prior to travel. 3. Please fill out the form using the following guidance: a. : Today s date

6 b. Department: Emergency Medicine c. Company: Select 20 MCVP d. Accounting Unit and Account: SKIP THESE e. Employee: Your name f. Employee ID: This is your 6 digit employee number found under Self Serve. It is not your VCU eid nor your Badge ID. g. Title: resident h. Home address: Your actual home address i. Work phone: your cell phone j. Reason for travel: Will mostly be conference k. Method of travel: Check appropriate l. Required Information: Self explanatory VCUHS sponsored event is if the health system is hosting the conference or event m. Travel Description i. If flying then enter your departure and arrival on the departing trip and then reverse it for your return trip. If your ticket is round trip, then enter half of the amount in each line. ii. Hotel Name: Self explanatory iii. s needed: range for hotel iv. Total Nights: Self explanatory v. Car Rental Company: NA unless approved vi. Meals: Write the number of days you will be traveling and at the event (meals reimbursed at per diem rate set by IRS, but you can estimate approx. $50 a day) vii. Ground Transportation: Ignore viii. Private Vehicle, Miles, Rate Per Mile: If you are driving to the event then fill this part out using ix. Other: List registration, parking, taxis etc. in this box. x. Total estimated cost: Self explanatory, will likely be blank until filled in by Lisa. n. Signature of Traveler: Print your form and bring it to Lisa and sign it with her. o. Purpose of the Trip: Explain why you are going p. Description of the Program: Describe the conference q. Benefit to Employee: How will this help you r. Benefit to VCUHS: Explain how helping you helps VCUHS or helps to get the VCUHS name out there. s. How will information be shared with other staff? Indicate how you will discuss this information at our weekly conferences Attached is a copy of a preapproval going to the CORD conference as a sample. Please ensure you have printouts of all estimated itinerary costs (tickets, event registration, hotel, taxi, etc.). Do not book them, just print the estimates.

7 Per Diem Rates (also known as M&IE): Per Diem and Mileage Instructions You are given per diem for all meals and expenses. To calculate per diem you will need to use the link on the accounts payable website to go to the GSA website. On that website type in the zip code of the conference hotel. Find the per diem rate for a full day. (Listed as M&IE). Then click on the Breakdown of M&IE Expenses link (second arrow).

8 On this screen you will need to find the first and last day of travel amount. In our example we see that the M&IE rate is $69 a day. We scroll down to the $69 a day rate and find that the first and last day of travel is given $51.75.

9 Please note: If meals are included as part of your hotel or conference fee then you must subtract out meals that are already covered. So in this example if the hotel provides a free continental breakfast you would subtract $16 from your $69 M&IE rate to get $53 for your per diem that day. Mileage: If you want to know the current mileage reimbursement then go to Accounts Payable. Then click on the IRS Standard Miles Rate Button. Look for the most current reporting period (in this case 2015).

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11 Travel Authorization Form 01/16/15 Emergency Medicine Department 20 MCVP Company Accounting Unit Account John Jingleheimer Schmidt Resident Employee Employee ID # Title 1234 Main Street Richmond VA Home Address City State Zip Work Phone Ext Check Reason for Travel: Method of Travel: Required Information: State Business Airline 1) Is this a VCUHS Sponsored Event? No Conference / Convent Rail 2) Is the event local (within 60 miles)? No Research State Vehicle 3) Are 2 or more VCUHS employees Staff Training / Dev Private Vehicle attending this event? Yes Student Teaching Other 4) Location of Event Out of state Other Travel Description...Departure......Arrival.. City/Country Time City/Country Time AM Richmond VA 04/14/15 1:00 PM Phoenix AZ AM Phoenix AZ 04/16/15 3:00 PM Richmond VA 04/14/15 Hotel Total Nights Name Sheraton Wildpass s Needed 4/144/16 Needed 2 Car Rental Company NA s Needed 9:00 04/16/15 11:15 Total Number of Days AM PM AM PM Estimated Cost $ $ $ Meals Ground Transportation at Destination Other (Registration, Parking, Etc) 3 days (44.25, 59.00, 44.25) Private Vehicle Miles x Taxi to from aiport ($45x2), Registration ($350) Rate per Mile $ $ Total Estimated Cost of Travel $ 1, TRAVELER'S RESPONSIBILITIES Department Certification I certify that the charges to be made are reasonable, will be in accordace with VCU Health System's Regulations, and will be limited to those required in an official capacity. Signature of Traveler 01/16/15 Destination: Phoenix AZ Revised 10/09/2014 / mbt Page 1 of 2

12 Purpose of the Trip: To attend the CORD conference in Phoenix Arizona and present a poster. Description of the Program: CORD Academic Assembly is a conference geared toward educating residents and faculty on best practices in emergency education. I will specifically be presenting a CPC case which involves discussing a unique case with expert faculty and honing presentation skills. Cost of Travel: $ 1, Number of Other VCUHS Employees Attending This Meeting: Approx 4 Benefit to Employee: Learn and practice presentation skills. Network with colleagues. Attend 3 hours of educational lecture on best practices in emergency medicine education. Benefit to VCUHS: Name recognition for VCUHS. How will information learned be shared with the other staff? CPC case will be presented at one our Wednesday education conferences. Lecture material will be discussed at the same time. A completed Travel Authorization Form must be attached to a Travel Reimbursement Request or Travel Advance Request Travel without authorization/approval is at the employee's expense Company 10 Hospital Approvals Needed: Local VCUHS sponsored Local NonVCUHS sponsored Only Manager signature needed also needs Director signature In state & 2 or less people traveling Out of state & 2 or less people traveling also needs Vice President signature also needs Linda Pearson, CFO Out of state & 2 or less people traveling International travel or 3 or more people traveling also needs Deborah Davis, COO also needs John Duval, CEO Company 20 MCVP Approvals Needed: Administrator or Chair International travel also needs Keith Purcell, CFO Company 50 VPHP Approvals Needed: Manager and/or Director Department Vice President _ Expense greater than $300 also needs CEO signature Revised 10/09/2014 / mbt Page 2 of 2

13 Instructions for Completing VCU Medical Center Travel Reimbursement Form 1. Go to the VCUHS Intranet page ( and click on the BOLDED Accounts Payable. 2. Download the Travel Reimbursement Form in Excel format after travel. 3. Please fill out the form using the following guidance: a. Department: Emergency Medicine

14 b. Demographics Use your home address c. Accounting Unit/Accountant/Activity/Activity Category: Leave Blank d. VCUHS Employee: Check box e. Line Item Expenses i. Each line is a different DATE, include all expenses on that date 1. Describe in the text the location (and any other expenses ) 2. Instructions are provided in each box if you hover over the cell 3. If you are uncertain of current per diem rates, discuss with program administrator (and see the per diem document attached). f. Purpose of trip: Discuss why you went 4. Attach all original receipts

15 Travel Expense Reimbursement Form Department of: Emergency Medicine PAYEE INFORMATION MUST BE COMPLETE TO RECEIVE PAYMENT John Schmidt Payee: Employee # Phone 1234 Main Street Richmond VA Street Address City State Zip Accounting Unit Account If Applicable: Activity Activity Category Check Which applies: VCUHS Employee Independent Contractor Other: Location at which expense was incurred. Points between which travel was necessary and method of transportation used. Each day's expense must be shown separately. Miles Traveled Explain: Mileage ($.575) Or ($.56) Auto Rental and Gas Expense Meals Airfare, train Per Diem & Meals Lodging Other Amount public trans Amount (itemize in column 2) 04/14/15 Conference Registration /14/15 Richmond to Phoenix (air) /14/15 Taxi to conference, per diem, lodging /15/15 CORD conference Phoneix /16/15 Taxi to aiport, per diem /16/15 Phoenix to Richmond (air) I Certify that the claimed reimbursement is accurate and was incurred by me on official business for my department. Totals , *See Note Total Additional Sheet The expenses included are only such expenses as were necessary in the conduct of this business. Grand Total $ 1, Purpose of trip: To attend the Council of Residency Directors (CORD) conference in Phoenix. Amount Advanced (Enter as a negative to Acct ) Submit To: Payment Due $ 1, Hopital/UHS and Physicians PO Box Signature of Traveler *Note: Please indicate account to be charged for "Other" expenses. VPHP PO Box Attach copy of completed Travel Authorization Form with this submission for Conferences and Presentations Only submit reimbursable expenses on this form. For scanning purposes please tape receipts onto a piece of paper instead of stapling. Revised 01/08/2014 /mbt