CMSS Design Services by Component Medical Society Services

2013 cms services

EDUCATION DESIGN SERVICES CV TRAINING WEBSITE SERVICES DUES PROCESSING Professional design services are available to all California Medical Societies and Associations regardless of their marketing budget or size. This includes the development, design and production of direct mail campaigns, presentation quality ﬂyers, postcards and brochures, and guidance with any CMS’ annual directory or other unique project.

1201 “J” Street • Suite 275 • Sacramento, CA 95814-2906 • 916.551.2551

Mike Steenburgh

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Executive Director

Frank Navarro

Henry Gardiner Sherry Roberts Jennifer Moller

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916.551.2042

Director of Education

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Cell 209.817.2656

916.551.2046

Project Director

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916.551.2551

Creative Director

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916.551.2053

Administrative Assistant

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916.551.2541

2013 cms services

be provided via webinar if desired). Attendees will receive a high-level overview and fundamental knowledge of ICD-10-CM. This course is ideal to help organizations build awareness and educate stakeholders on the impact of the transition to ICD-10. This course is approved for 3 CEU’s through AAPC. A light breakfast will be provided. Topics covered include: · Impact to Providers · Differences between ICD-9-CM and ICD-10-CM · Documentation challenges · Clinical case examples •

January 23, 2013

Time:

9:00AM – Noon

May 2012

In this issue: Aetna to require additional accreditation requirements in order to be paid for certain surgical pathology services 1 Update on two Anthem Blue Cross issues pending with the Department of Managed Health Care 1 Meet Your CMA Center for Economic Services Advocate: Mark Lane CMA Advocacy at Work

2 2

Urgent survey response requested

Aetna erroneously terminates providers from California network

Document, Document, Document

United Healthcare announces extension of HIPAA 5010 enforcement 4 What’s a COHS?

Save the Date

Act now to avoid the 2013 e-prescribing penalty 5 Payor Updates

Health plan provider newsletters

CMA resources

When you see this icon, that means there are additional resources available free to California Medical Association (CMA) members at the CMA website. To access any of these resources, visit http://www.cmanet.org/ces.

Medical-Legal Library (Formerly CMA On-Call)

In this publication, you will find references to “medical-legal” documents. The California Medical Association’s (CMA) online medical-legal library contains over 4,500 pages of medicallegal, regulatory, and reimbursement information. Medical-legal documents are free to members and can be found in CMA’s online resource library, http://www.cmanet.org/resource-library. Nonmembers can purchase medical-legal documents for $2 per page.

CMA Center for Economic Services 1201 J Street, #200, Sacramento, CA 95814 economicservices@cmanet.org • 916/551-2061

CMA Practice Resources (CPR) is a free monthly bulletin from the California Medical Association’s Center for Economic Services. This bulletin is full of tips and tools to help physicians and their office staff improve practice efficiency and viability. SUBSCRIBE TO CPR OR ANY OTHER CMA NEWSLETTERS: To stay up to date, sign

up for free subscriptions at www.cmanet.org/newsletters.

SPREAD THE WORD: Please forward this bulletin to your coworkers and colleagues.

Aetna to require additional accreditation requirements in order to be paid for certain surgical pathology services Aetna recently notified physicians that, effective August 1, 2012, practices performing in-office pathology testing will be required to be both Clinical Laboratory Improvement Amendments (CLIA) certified and accredited with the College of American Pathologists (CAP). In a letter to physicians, Aetna claims that the change is consistent with the Centers for Medicare & Medicaid Services (CMS) recognition of CAP as an approved accreditation organization for non-hospital anatomic pathology testing.The California Medical Association has voiced concerns with the implementation of this policy and has asked Aetna to explain the need for dual certification. Although CMS may recognize CAP as an approved accreditation organization, CMS does not require both a CLIA certification and a specialty society accreditation to perform in-office pathology testing services. Further, CMA expressed concerns with the ability of physicians to obtain the CAP accreditation prior to the deadline imposed by Aetna. According to CAP, the accreditation process takes approximately 90 days. Additionally, the process of obtaining a secondary accreditation can be very costly for practices. In addition to their contact with Aetna on this issue, CMA is working closely with the American Medical Association (AMA) and several other state and specialty medical societies. Stay tuned for further details. Practices with questions about the letter can contact Tammy Gaul, senior network manager at Aetna at (215)775-6604. Contact: CMA reimbursement help line, (888) 401-5911 or mlane@cmanet.org

Update on two Anthem Blue Cross issues pending with the Department of Managed Health Care DMHC claims audit

As previously reported, on Jan. 12, 2012 the Department of Managed Health Care (DMHC) ordered Anthem Blue Cross to reprocess provider claims, with interest, dating back to 2007. The order is based on 2008 DMHC audits of the seven largest health plans in California. These audits found violations of claim payments above the threshold allowed under California law at all seven health plans. As a result, DMHC assessed administrative fines, required the plans to pay providers the money they were owed and mandated that plans demonstrate CPR • May 2012 • Page 1 of 5

ARE YOU READING CPR?

Our goal is to empower physician practices by providing resources and guidance to improve the success of your practice.

CPR contains the latest in Practice Management Resources, Updates and Information.

SUBSCRIBE NOW

$99 for SJMS Members • $299 for Non-Members WHEN DO I CALL CMA?

To Register Call (209) 952-5299

CMA members can call CMA’s practice management experts for free billing, reimbursement or contract related issues. If you answer “yes” to any of the following questions, it might be time to call for help. CMA Member Since 1995 LLOYD M. KREIGER, MD

Learn more at: www.cmanet.org/aapc

In partnership with

TOPICS COVERED ARE: • General documentation principles • E&M services 1995 and 1997 guidelines • Counseling/coordination of care guidelines and documentation requirements • Split/shared services • Common E&M documentation/coding errors • Tips for preventing E&M documentation/coding errors

DATES: FEBRUARY 12, 13, 19 AND 20, 2013 TIME: 12:15 PM. - 1:45 P.M., PST

The CMA’s Center for Economic Services recovered $ 2.8 million in reimbursements for CMA physicians CMA’s Center

Location: Papapavlo’s 501 Lincoln Center, Stockton, CA Cost:

D AN RS TICE ATO AC ISTR S PR S! MIN IAN GER AD YSIC ANA PH M

CALIFORNIA MEDICAL ASSOCIATION

for Economic Services (CES) is staffed by practice management experts with a combined experience of over 125 years in medical practice operations.

Essentials ICD-10 Workbook

Date:

RESOURCES

“I can point to quite a few claims we had written off as unrecoverable –until the CMA stepped in and got us payment. The CMA has provided us with an invaluable service: Turning zero payment and no prospects into cash in the bank.”

IN 2010 AND 2011 COMBINED, CMA RECOUPED OVER 5.5 MILLION FROM PAYORS ON BEHALF OF OUR PHYSICIAN MEMBERS

The Essentials of ICD-10 is a 3-hour training provided onsite by one of our certified trainers (or can

FREE PRACTICE MANAGEMENT

• Are your claims not being paid in a timely manner? • Are you not being paid according to your contract? • Do you need help with Medicare related issues? • Are your claims being denied after obtaining prior authorization? • Are you receiving unreasonable requests for medical records or untimely requests for refunds? • Are your claims denied for timely filing? • Are you having difficulty obtaining fee schedules and/or payment rules? • Have you been presented with a managed care contract and you’re not sure if the terms are consistent with California law? • Have you done everything you can to resolve an issue with a payor, including appealing?

’s Leadoelkrit to

EKING ICIANS SE ICINE R PHYS ED URSE FO ORGANIZED M CO Y DA A TWO- SHIP ROLES IN LEADER

DAY 1:

GENERAL DOCUMENTATION REQUIREMENTS AND EVALUATION AND MANAGEMENT OVERVIEW

Evaluation

and Management Webinar Workshop Series Evaluation and management (E&M) visits account for more than 50 percent of revenue in most primary-care practices. In recent years, Medicare reimbursement for E&M visits across specialties added up to more than 1 percent of the entire federal budget. Accurate, comprehensive, patient-centered documentation and record keeping is a fundamental part of clinical practice. Understanding the principles and guidelines of E&M coding is essential for everyone involved in billing and will ensure each service is reported correctly. The California Medical Association (CMA) is hosting a four-part series of FREE E&M workshops presented by PalmettoGBA. The workshops are 1½ hour each, spread over four-days and are designed for physicians, nonphysician practitioners and other staff involved in the coding and billing process. Attendees will receive a downloadable workbook from the Palmetto’s Provider Outreach and Education team.

This course will cover the general documentation principles including: Signatures, medical record cloning, addendums, illegible documentation, scribes, and medical necessity/ reasonable and necessary. An overview of E/M services, common documentation and coding errors and helpful resources will also be included in this webinar.

DAY 2:

KEY COMPONENTS IN SELECTING THE LEVEL OF E/M SERVICES: HISTORY

This course will cover: History of present illness (HPI), review of systems (ROS), past family and social history (PFSH). Documentation reminders, frequently asked questions (FAQs), common documentation and coding errors and helpful resources will also be included in this webinar.

DAY 3:

KEY COMPONENTS IN SELECTING THE LEVEL OF E/M SERVICES: EXAMINATION

This course will cover: 1995 examination guidelines and 1997 examination guidelines. Documentation reminders, frequently asked questions (FAQs), common documentation and coding errors and helpful resources will also be included in this webinar.

DAY 4:

KEY COMPONENTS IN SELECTING THE LEVEL OF E/M SERVICES: MEDICAL DECISION MAKING

This course will cover: Diagnosis/management options, type of data, risk assessment. Documentation reminders, frequently asked questions, common documentation and coding errors and helpful resources will also be included in this webinar.

CMA members and nonmembers may register for this FREE series at: www.cmanet.org/events This program is approved for 6.0 AAPC continuing education units (CEU). CEU certiﬁcates will be issued after completion of all events has been veriﬁed.

Access to CMA experts is a free members-only benefit. CMA’s hotline: (800) 786-4262

Riverside

April 6 & 7, 2013 Leadership, except for the amazing few, is a learned art. The Leader’s Toolkit is a Socratic seminar (via a didactic “lecture”) that covers the key elements of leadership in a very concise manner. While there will be some theory, we will highlight actionable behavior, tools, and concepts that you will (or should) use every day.

Sacramento

Sept 20 & 21, 2013

Here Is What We Will Cover: • Strategy: Knowing when to change, change management, strategic planning, strategic execution • Leading Your Team: Non-delegatable responsibilities of the leader, setting boundaries - management philosophy, making decisions • Building Your Team: Hiring (and firing) • Managing Your Time: Setting priorities, managing your time • Managing Your Meetings: Running a Meeting, parliamentary procedure • Managing Your Organization’s Money: assessing your financials from the CEO’s perspective and knowing the correct questions to ask • CMA/CMS Structure: Understanding and leveraging this critical relationship from a physician leader’s perspective • Managing Your Message: Communicating by email, communicating one-to-one, having difficult conversations, negotiating, communications with your customer (aka marketing)

For every segment, the group of 16 attendees will focus on 10 or fewer speciﬁc, actionable items. We will learn from each other, we will learn from the references, we will learn from the presenters’ experience / knowledge, and you will leave with a series of references and highlights in each of these core areas.

San Bernardino County Medical Society Riverside County Medical Association 3993 Jurupa Ave. Riverside, CA 92506 Convention Center/ Sheraton Grand 1230 J Street Sacramento, CA 95814

practice manager Tuesday, January 29 th

RECONSTRUCTIVE

MICROSURGERY:

YOU ARE INVITED TO A COMPLEMENTARY DINNER AND LECTURE/ DISCUSSION

OFFICE MANAGER’S FORUM

CMA - Center for Economic Services Michele provides one-on-one assistance to physician members and their staff on reimbursement and practice operations issues relating to Medicare. Assistance ranges from coaching and education, to direct intervention with Palmetto or regulators.

RUDOLF F. BUNTIC, MD CHIEF OF DIVISION OF MICROSURGERY California Paciﬁc Medical Center Program Director of Hand Surgery Fellowship Buncke Clinic • San Francisco, CA

NOVEMBER 15, 2012

6:00 P.M. REGISTRATION AND RECEPTION • 6:30 P.M. DINNER AND LECTURE 8 P.M. WRAP UP AND DEPART BROUGHT TO YOU BY

Madonna Inn 100 Madonna Road, San Luis Obispo, CA 93405 Complimentary Lunch Included

Michele Kelly, Associate Director,

FROM HEAD

TO TOE

MEETING LOCATION:

11:00AM – 2:00PM 2013 MEDICARE ANNUAL UPDATE WITH CMA’S MICHELE KELLY 3 hour Workshop with Lunch

JANUARY 29TH, 2013: MEDICARE UPDATE 2013 SPECIAL NOTE: THIS IS A 3 HOUR INTERACTIVE WORKSHOP FROM 11:00AM to 2:00PM Join us for our annual Medicare Update workshop for physicians and office staff. This 3 hour seminar will cover relevant information about current, future and proposed changes for the coming year including the following:

Monthly Invitation and Reminder

FREE For San Luis Obispo Medical Association Members! The Monthly Office Manager’s Forum is provided by the San Luis Obispo Medical Association for the benefit of our membership and their staff. Attendance is always FREE to our members. Non-members are welcome and may attend for a month at no cost to experience one of the quality benefits that comes with Society Membership. ($35.00 thereafter)

REGISTRATION REQUIRED PHONE: 805.591.0212 FAX: 805.706.2799

• Part B and Physician Fee Schedule Changes

EMAIL: amy@slocma.org

• Transitional Care Management (TCM) – new CPT codes • Multiple Procedure Payment Reductions • Physician Quality Reporting and Systems (PQRS) changes & deadlines

MADONNA INN RESORT AND SPA

100 Madonna Road, San Luis Obispo 93405 RSVP is requested by November 7, 2012. Please contact Brad Studebaker at 775-846-2670 or at brad@buncke.org

• Value Based Payment Modifer • E-Prescribing Changes • ICD – 10 Update • Plus ALL of your individual Questions!

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what people are saying

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CMSS design services has played a huge role in refreshing OCMA’s image and brand. Through exceptional design work, OCMA has a new set of cutting-edge logos and marketing material that we are truly proud of. CMSS design services has been and will continue to be an invaluable resource to OCMA. Ashley Buchwald

publication material

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Essentials of ICD-10

CES

membership material

Orange County Medical Association

Marketing/Communications Coordinator

CALPAC Success in a new era: CALPAC continues to thrive under state’s new election policies

CALPAC THANKS TO PROPOSITION 11 (2008), district boundaries for the state Assembly and Senate were, for the first time in California history, drawn by a 14-member Citizens Redistricting Commission, rather than members of the Legislature themselves. This historic shift meant that lawmakers were no longer able to protect one another through the creation of gerrymandered districts and so-called “safe seats” for their fellow incumbents.

HAS STRONG SHOWING IN JUNE PRIMARY Adding to the chaos was the fact that the June primary was also the first to implement the top-two system as a result of Proposition 14 (2010). The new rule calls for the top two candidates with the most votes to move on to the November general election, regardless of party affiliation.

Together, these myriad of outcomes that have been California’s Junechanges primarycreated electiona was a landmark event, onewould that brought several unheard of under thechanges previoustorules. For the the Golden first time in state history, it was the way State chooses its leadership. imaginable that two Democrats could be facing off in a November contest to represent a district that, historically, had belonged to Republicans. >>

By: Richard Thorp, M.D. Chair, CALPAC Richard Thorp, M.D.

Chair, CALPAC

CMSS has delivered a fresh new look to our logo and collateral just to name a few. It’s easy to work with Sherry – I send out ideas and she returns with streamlined designs that work immediately and have really enhanced our image. Jessica Kuo, MBA

Associate Executive Director for Membership Development San Francisco Medical Society

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website material

Our Board requested a recruitment information piece, which focused on the “Top 10 Reasons for Joining SBCMS and CMA”. We contacted CMSS’ Creative Director, Sherry Roberts, and she worked diligently with us to create the perfect brochure! Her ability to combine our ideas with her design talent is impressive and on target. We look forward to working with her on future projects.

design services Standiford Helm, MD President, 2012 - 2013 17322 Murphy Avenue Irvine, CA 92614 P 949.398.8100 F 949.398.8120 E shelm@ocma.org

A COMPONENT OF THE CALIFORNIA MEDICAL ASSOCIATION

2013

Cocktail Reception 6:30 PM Dinner & Program 7:30 PM

Luther F. Cobb, M.D., F.A.C.S. for CMA PRESIDENT-ELECT 2013

COBB

SFMS Annual Dinner Thursday, January 31, 2013 CELEBRATING 145 YEARS

HDNCMS_Postcard.indd 1

President-Elect Shannon Udovic-Constant, MD and the San Francisco Medical Society request the pleasure of your company at the