DOCTOR’SLife www.doctorslifetampabay.com
MAGAZINE
Business Lifestyles and Opportunities Vol. 2, Issue 1, 2014 Tampa Bay Edition
ARE YOU
READY FOR
2014
TAX CHANGES?
ICD-10 10-01-2014
What’s Inside Are You Ready for 2014 Tax Changes?
From the Publisher
Doctor’s Life Committed to Great Content for 2014 Page 6
Page 10
Preparing for ICD-10
Page 16
Physician Spotlight Dr. Greg H. Savel
Page 8
Fit Corner
Six Components of Physical Fitness
Page 14
Advertisers
Health Benefits of Florida Wines 2
Social Media Prescription
Page 22
Page 20
Doctor’s Life Tampa Bay
Chillounge Night Ciminelli Real Estate Services Florida RX Card Flex Sedans HomeLife Tropical Realty JW Marriott Panama Lokey Motor Company The Meridian Club Playing Unplugged PNC Bank Rita Shepard SunTrust Mortgage Tampa Testosterone Water Beach Club Hotel
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Issue 1, 2014
A four-year-old hugged me today for making him feel “all better.” Those moments are why I wouldn’t choose any other life. I’ve paid my dues: med school, residency, endless packing and moving. Finally, I’m putting down roots. I wasn’t sure I could do it, until I found the right mortgage specialist. He introduced me to affordable home financing exclusively for physicians. Now I feel all better, too. Because I’m truly where I was meant to be.
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Contact me today to learn more about the Doctor Loan Program1, featuring 100% financing2 and no monthly mortgage insurance.
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Rx Card is an important and valuable “Florida program for the residents of our state. ”
- Dr. Ronald F. Giffler, M.D., J.D. Florida Medical Association Treasurer
common in many health savings accounts (HSA) and high deductible health plans. Another unique component of the program is their preferred pharmacy option. Florida Rx Card has chosen CVS/pharmacy as their preferred pharmacy so that residents who don’t have access to a computer and can’t obtain a hard card, can visit any CVS/pharmacy to have their prescriptions processed through Florida Rx Card. Residents can simply reference “Florida Rx Card” to have their prescription processed through the program. Florida Rx Card is accepted at over 56,000 participating regional and national pharmacies. “We strongly believe that this is an easy and innovative way to help the residents of Florida find affordable prescription options,” states Program Development Director, Brandon Knox.
More Floridians Have Access to Prescription Savings Statewide Prescription Assistance Program Offers a Prescription to High Healthcare Costs he Centers for Disease Control reports that Americans spend more on prescription drugs than people in any other country: some $45 billion in out-of-pocket dollars in the last year alone. With that in mind, the Florida Rx Card is reminding physicians that their patients who aren’t insured or who take prescription drugs that aren’t covered by their health insurance plans, can use the Florida Rx Card to obtain discounts of up to 80 percent off the retail price for brand and generic FDA-approved medications.
Florida Medical Association has been working closely with Florida Rx Card to distribute free discount prescription cards to all Floridians. The goal of the partnership is to provide additional card distribution channels and create awareness so that all residents will have access to this free statewide prescription assistance program. Florida Rx Card was launched to help the uninsured and underinsured residents afford their prescription medications. The program can also be used by people that have health insurance coverage with no prescription benefits, which is
Florida Rx Card has helped residents save over $63 million since its inception in August 2007. You can help by encouraging your patients to print a free card at www.FloridaRxCard.com or www.flmedical.org. Florida Rx Card is also available as an app for iPhone and Android. You can search “Free Rx iCard” in the app store.
Any physicians who are interested in ordering free cards for their clinic/hospital can email Brandon Knox, Program Development Director, at bknox@floridarxcard.com.
IT WORKS! Florida residents have saved over $63 Million through the Florida Rx Card Florida Rx Card offers free prescription assistance cards and is open to all residents of Florida. There are no applications, no waiting periods, and no enrollment forms to fill out. Save up to 75% on rx medications at more than 56,000 pharmacies nationwide. Both brands and generics are included.
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From the Publisher
www.doctorslifetampabay.com
W
e are in full swing of the New Year. The first quarter is just about past us. Doctor’s Life Magazine (DLM) is actively working on content for 2014. Content that places you in the know on a variety of subjects that are relevant and informative as well as showcasing fellow physicians and presenting great opportunities from our advertising partners. Throughout the year, we plan to showcase opportunities, perks and special programs that are made available to you as a physician which you may not be aware of. Some are offered because you belong to a particular organization, like the AMA, and others are provided just because you are a doctor. For instance, the Physician Home Loan Program offered to doctors, both seasoned and new, even in residency. Several banks provide this program. We met with Tony Umholtz, vice president and Certified Mortgage Planner with SunTrust. Tony met with us and explained their program for doctors. They offer up to 100 percent financing for purchasing a home, with no private mortgage insurance and very competitive rates. This is just one of the many opportunities that we discovered for doctors and plan to bring all of them to you throughout the year. In this issue, we covered a range of topics from ICD-10 implementation to the major 2014 tax changes that are affecting most physicians. We sat down with Dr. Greg Savel from the Myrtle Ave Pediatrics in Clearwater for the Physician Spotlight section. After our interview with Dr. Savel, the entire DLM staff wished we were sick and kids again. Myrtle Ave Pediatrics really has something very special and creative buzzing around their practice. DON’T MISS the event PLAYING UNPLUGGED with special guest Randi Zuckerberg; CEO of Zuckerberg Media and sister of Facebook founder Marc Zuckerberg. DLM is a sponsor and the event details are on page 23. Dale Griffin from The Go Agency brings to you his feature, Social Media Prescription, and we discovered that Florida has 16 vineyards that produce some of the healthiest wine, all because of a particular grape grown and used right here in our state. Thank you to Yolanda Roundtree from the Florida Department of Agriculture and Consumer Services for giving us another valuable reason to enjoy a glass of wine… as long as it is from Florida! As always, I hope you enjoy this issue of DLM. I and the entire DLM staff thank you for your readership. Be well,
-Ed
MAGAZINE
Business Lifestyles and Opportunities Vol. 2, Issue 1, 2014 Tampa Bay Edition
ARE YOU
READY FOR
2014
TAX CHANGES?
ICD-10 10-01-2014
TAMPA BAY Tampa Headquarters 1208 East Kennedy Blvd. #1029 Tampa Fl, 33602 813-444-9204 Tampa Bay Publisher Ed Suyak publisher@doctorslifetampabay.com Creative Director Bryan Clapper Editorial Director Ed Suyak Assistant Editorial Director Danielle Topper Advertising Account Executive CJ Cooper Contributing Writers Dale Griffen, RN Cortnie Simmons Yolanda Roundtree Brandon Knox Doctor’s Life Magazine, Tampa Bay is always seeking events, stories and remarkable physicians. Please email the publisher if you have an event, an editorial idea or you know of a doctor or dentist who may have done something extraordinary. We want your suggestions and feedback. publisher@doctorslifetampabay.com
Ed Suyak Publisher publisher@doctorslifetampabay.com
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DOCTOR’SLife
www.doctorslifetampabay.com
Doctor’s Life Magazine, Tampa Bay does not assume responsibility for the advertisements, nor any representation made therein, nor the quality or deliverability of the products themselves. Reproduction of articles and photographs, in whole or in part, contained herein is prohibited without expressed written consent of the publisher, with the exception of reprinting for news media use. Printed in the United States of America.
Doctor’s Life Tampa Bay
Issue 1, 2014
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Physician Spotlight
Dr. Greg H. Savel Doctor’s Life wants to know
How long have you lived in the Tampa Bay area? I’ve been here since 1984 What is your favorite Tampa Bay restaurant? I love what’s happening in the downtown St. Petersburg area. The Birchwood and Z-Grille are two of my favorites. I recently ate at Restaurant BT in Tampa and spent some time talking to BT Nguyen, the Chef and owner… it was an amazing experience as well. Where is your favorite place in Tampa Bay to relax? Photography and motorcycling are my other loves so anywhere I can ride and capture wonderful images. Of course, if my photographic “VISION” for the day isn’t coming together I cannot relax at all. What is your favorite event to attend to in Tampa Bay? Main Sail Art Festival in St. Pete 8
Dr. Greg H. Savel entered MYRTLE AVE. PEDIATRICS in 1991 after graduating from the University of Miami, the University of South Florida (USF) School of Medicine and USF Pediatric Residency. He has been a resident of Florida since 1972. He is the President of Myrtle Ave. Pediatrics, Chairman of PITCH, HOST of Playing Unplugged- Just What the Doctor Ordered and most important, he is the father to his daughter Mackenzie and a loving husband to his wife Carol.
If you had never become a physician, what would’ve been your plan B or second career choice? I’m still proud to call myself a NERD. I’m the guy that everyone calls when their computer or home theater system isn’t working properly. I worked at Radio Shack while in school and might return there. Funny thing, just yesterday I saw a family whose dad is the manager of a local Best Buy… I asked him if there were any part time openings for THE GEEK SQUAD.
Doctor’s Life Tampa Bay
Issue 1, 2014
Why did you become a pediatrician? When I was a teenager my sister earned money by babysitting for many wonderful families in my town. I spent a lot of time helping her take care of the kids and I realized how much I enjoyed children and interacting with them. While in medical school I found myself having issues treating adults that placed their physical health at risk because of bad decision making. I enjoyed much more the interactions of kids and their families so it was an easy decision for me.
country are now coming back with a vengeance. The decision of so many people to not immunize their children based on erroneous facts and data is the major factor of this epidemic. PITCH is making a difference by creating a dialogue in our community between healthcare professionals and those interested in helping increase immunization rates where we live. I’m happy to serve as the chairman of this organization that is trying to and succeeding in making a difference in the health of our community.
I have to say it was one of the more enjoyable interviews I’ve done. After all the research we conducted on you as a physician, your pediatrician office and the viewing of the extremely creative and super fun videos… my entire staff, including myself, wish we were sick and kids again. How important is it to maintain a great team, creative outreach and a fun atmosphere in your practice? On the surface it probably seems like we’re just trying to be different than every other practice. While there is some truth to that statement however what is more accurate in our case is that this is just who we are. The personality you see, the man dressed in this outfit… I could tell you that I do it for the kids but the truth is I do it for me because I’m just this kind of person. I’ve always tried to surround myself with the kind of people who want to have a good time but are serious in their profession. When Sharon (The Doctor Whisperer) came along, she was exactly cut from the same rug. She was innovative, fun, intelligent and understood the way business is done. She had a lot to do with the personality of our practice. Our outward appearance and creativity plays a big role in the success. I want people to see that we’re different but more that we are an amazing place to have their children cared for.
According to the CDC, Childhood obesity has more than doubled and tripled in adolescents in the past 30 Years. What are some of the factors in your opinion, that has manifested such staggering higher percentages of obesity in our youth today? The truth is the increase in obesity comes down to one simple formula… too many calories in and not enough calories out. We live in a world where the food that taste the best and is most readily available often has the least amount of useful nutrition. Society today has become fast-paced and we want everything immediately. Fast food has become the go to meal to save time. The other major factor is we have become a plugged in society. Kids are expending fewer calories due to lack of activity. The percentages of kids who spend hours in front of videogames are computers are staggering. We must find a way to have kids be more active and consume healthier food options. There is no other way to help with this horrendous obesity problem in this country.
The problem is in the amount of hours that are spent by so many children plugged in to some sort of device and plugged out of activity.
What has been the most rewarding accolade with your position as a pediatrician? The opportunity to volunteer and help out worthwhile community organizations. For example I host Playing Unplugged in Largo for the third year in a row while Sharon works tirelessly to raise funds and bring the Pediatric community together. We are asking children to unplug from their electronic devices and come out and play actively with us. We’re expecting 20,000 people at the event this year in April. Sharon has secured Randi Zuckerberg to join us so she can read her new children’s book DOT., it correlates perfectly with our intentions. Also recently I have been asked to be the chairperson of PITCH, Sharon is Vice-Chair. This is the Pinellas Immunization Team for Community Health working toward increasing immunization rates of children in our community. It is been my extreme honor to be asked to be the face of both of these worthwhile causes. How important is it today, for private practice to be involved with the community and how important is it to you personally? I’m honored to be able to give back to the community which has given me everything. I think it is a sad thing when physicians are not willing to give of their time to the very same community that supports them in the first place. I welcome the opportunity to help in any way that I can because it’s a great honor for me. You were recently elected as the Chairman of the Pinellas Immunizations Team For Community Health (PITCH). What exactly is PITCH and why is this coalition so important? We are reaching a crisis in the United States as immunization compliance falls. Diseases that killed humans years ago and have been almost unheard of for years because of immunizations in our Issue 1, 2014
What is the event Playing Unplugged and why is it important to you? As I mentioned above, the lack of activity due to electronic device usage is at the heart of the problem of the obesity issue in this country. While none of us can doubt that technology has advanced our society and the internet can be a useful tool in educating. The problem is in the amount of hours that are spent by so many children plugged in to some sort of device and plugged out of activity. The idea of playing unplugged is all about getting away from those devices and getting back outside. What better person to have than the creator of Facebook’s sister and CEO of Zuckerberg Media, Randi Zuckerberg at our next Playing Unplugged event. The NFL has been behind this for a long time with their play 60 campaign. This campaign is all about promoting 60 minutes of vigorously exercising every single day. A recent study showed that 80% of males and 92% of females who are overweight at age 16 will be obese as adults. Reread that statement a few times and try not to gasp. In 2014, private practices will be faced a period of unprecedented change and challenges, driven by a wide variety of factors. Are you and your team prepared and what is your best attribute for success? There has been a lot of changes and will continue to be even more. I’ve always felt that if you have a great practice, with a wonderful support staff and have ability to understand and embrace change, then you’re going to have a successful practice. Today’s practices need to understand social media and its impact it can have. The truth is that physicians like any other business have to be ready to adapt and change to what is needed in our current society. The formula for success is based on having a good product. I’m happy to say that I am working with 30 of the best people in pediatrics today. We are celebrating 50 years as a practice.
Doctor’s Life Tampa Bay
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Are You Ready for the
2014 Tax Changes? F
ifty-Five Tax Breaks Expired on New Year’s Eve and will continue to impact into 2014. Dec. 31 marked the expiration of 55 tax breaks collectively known as “extenders.” Extending these provisions through the rest of 2014 would cost $54 billion, according to the Congressional Research Service.
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Doctor’s Life Tampa Bay
Issue 1, 2014
What exactly are a few of the changes that will effect higherincome professionals especially physicians? To start expect a higher income tax rate, higher capital gains rate, net investment income tax, a new Medicare surcharge on earned income and a reduced benefit from personal exemptions and itemized deductions.
HIGHER TOP INCOME TAX RATE
Income levels above $400,000 ($450,000 for married taxpayers filing jointly, $425,000 for head of households) are now being taxed at a 39.6% rate as of January 1, 2013. Those amounts are adjusted for inflation after 2013. Taxpayers with $150,000 of income above the threshold amounts will pay an additional $6,900 in tax in 2013 because of the additional tax rate of 4.6%. The threshold levels for 2014 are $432,200, $457,600, and $406,750
Act of 2010, higher-income taxpayers have been required to pay an additional 3.8 percent on net investment income as well as a 0.9 percent Additional Medicare Tax on earned income. In both cases the income threshold levels for being subject to these new taxes are considerably lower than the 39.6 percent bracket and 20 percent capital gain rates. The threshold amount is $200,000 in the case of a single individual, head of household (with qualifying person) and qualifying widow(er) with dependent child. The threshold amount is $250,000 in the case of a married couple filing jointly and $125,000 in the case of a married couple filing separately. For the 3.8 percent net investment
CAPITAL GAINS AND DIVIDENDS
The American Taxpayer Relief Act also raised the top rate for longterm capital gains and dividends to 20 percent, up from the Bush-era maximum 15 percent rate—again, applicable to all net long-term capital gains from transactions made on or after January 1, 2013. That top rate will apply to the extent that a taxpayer’s income exceeds the thresholds set for the 39.6 percent rate ($400,000 for single filers; $450,000 for joint filers and $425,000 for heads of households).
MEDICARE TAXES
Set into motion on January 1, 2013 by the Affordable Care
MEDICAL OFFICE LEASING, SALES, MANAGEMENT, AND TENANT REPRESENTATION SERVICES NEW YORK PENNSYLVANIA CONNECTICUT FLORIDA
income tax, the threshold is adjusted gross income (modified for certain foreign-based income). For the 0.9 percent Additional Medicare Tax, the threshold is measured against compensation earned for the year (including self-employment income).
NET INVESTMENT INCOME TAX
This is most likely the most important change that is affecting physicians. The 3.8% applies to capital gains, dividends, as well as passive-type income from real estate, investments in businesses, and the like. The rules are complex, and many taxpayers will struggle with the extent to which income on their 2013 tax returns will be subject to the new net investment income tax. For income subject to this tax, the effective rate will increase to 23.8% on net capital gain and dividends and 43.4% on short-term capital gain and all other passive-type income.
ADDITIONAL MEDICARE TAX
For tax years beginning after December 31, 2012, the 0.9% additional Medicare tax applies to employee compensation and selfemployment income above the threshold amounts noted above. An employer’s withholding obligation for the additional Medicare tax applies only to the extent the employee’s wages are in excess of $200,000 in a calendar year. For some dual-income couples with combined earned income above the $250,000 threshold but with no one earning more than $200,000, they may find themselves under withheld and subject to an estimated tax penalty as a result. Couples should remember that to prevent a reoccurrence in the future, an employee may request additional income tax withholding, which will be applied against all taxes shown on the individual’s return, including any liability for the additional Medicare tax.
ITEMIZED DEDUCTIONS LIMITATION
The new thresholds, applied in 2013, are $300,000 for married
12
couples and surviving spouses; $275,000 for heads of households; $250,000 for unmarried taxpayers; and $150,000 for married taxpayers filing separately. The Pease limitation reduces the total amount of a higher-income taxpayer’s otherwise allowable itemized deductions by 3% of the amount by which the taxpayer’s adjusted gross income exceeds this applicable threshold. The amount of itemized deductions may be reduced up to 80% under this formula. Certain items, such as medical expenses, investment interest, and casualty, theft or wagering losses, are excluded.
THE PERSONAL EXEMPTION PHASEOUT (PEP)
(PEP) reduces personal exemptions ($3,900 in 2013) for both taxpayers and their dependents by 2 percent for each $2,500 (or part of $2,500) that adjusted gross income (AGI) exceeds the threshold for the relevant filing status. The 2001 tax act phased down the phaseout and then eliminated it entirely for 2010. The 2010 tax act extended the repeal through 2012. The American Taxpayer Relief Act of 2012 (ATRA) allowed PEP to resume as scheduled but raised thresholds above those set under previous law. In 2013, the phaseout will occur over the following income ranges. Thresholds will be indexed for inflation after 2013.
Filing Status Phaseout Begins Phaseout Ends Single $250,000 $372,500 Head of Household $275,000 $397,500 Married Filing Jointly $300,000 $422,500 or Qualifying Widow(er) Married Filing Separately $150,000 $211,250 A family with four personal exemptions in 2013 will lose $15,600 in exemptions, creating $6,178 in additional tax at the 39.6% bracket.
Doctor’s Life Tampa Bay
Issue 1, 2014
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Fit Corner ASK THE COACH
Six Components A
of Physical Fitness
erobic capacity is the first component and is your cardiovascular system’s ability to transport oxygen to working muscles to serve as fuel for energy. Aerobic capacity improves with cardiovascular exercises, like walking, running, bicycling, jumping rope, swimming and dancing. Performing any of these types of activities at an intensity of approximately 60-80% of your total maximum heart rate (220 minus your age) for 30-60 minutes daily will provide you with the first element of fitness.
The second component of fitness is body structure. This is your overall posture, looking for any misalignments of the arms, legs and trunk. Even a small imbalance in the way you regularly stand or sit may lead to pain or injury. Ideal posture aligns your ears over your shoulders, shoulders over your hips, equal leg lengths, pelvic symmetry and neutral joints throughout the body, creating equal pressure on both feet. Any deviations from good posture need to be corrected with the proper stretching, strengthening and muscle releasing exercises. Body composition is the third component of fitness. This is the ratio of body fat to lean body mass (bones and muscles). Weight alone does not tell us about body composition. Body composition measurements are taken with calipers at specific parts of the body to determine the percent of total body fat. There are also scales and devices that measure body fat. In general, the ideal range of body fat is 10-15 percent of total body mass for males and 15-22 percent for females. Balance makes up the fourth 14
component of total body fitness. There are simple balance tests that can be administered to determine your balance level. Even minor balance problems place you at risk for injuries like ankle sprains, muscle strains, falls and fractures. The fifth component of fitness is muscular flexibility. Your muscles should be flexible enough to allow for the full range of motion required by life’s many activities. Muscles can become shortened if not purposefully stretched and by completing the same sport or lifting routine without enough variation. Muscle imbalances lead to many of the most common injuries in people who have strong, but tight muscles in some areas and weaker, unstable muscles/joints in others. The sixth component of fitness is muscular strength. In addition to being flexible, your muscles should be able to exert force and control movement. Strength is improved with weight- resistance exercises. In general, strengthening muscles appropriately uses resistance heavy enough to allow 8-15 slow and controlled repetitions with good form completed in 1-3 sets. Doctor’s Life Tampa Bay
Question: How important is it to have a wellbalanced fitness routine? Answer: A well-rounded or balanced fitness routine is just as important as a wellbalanced nutritional diet. Both together will promote an overall better quality of life. They control proper weight management, more energy, better sex life, combats diseases and health conditions and improves your mood. Tommy Parks Speed and Strength Coach Mississippi State University BA in Exercise Science Professional Baseball for 9 Seasons NFL punter with San Francisco 49ers & NY Jets
Issue 1, 2014
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ICD-10: Where will you be on October 1st? C
By Cortnie R. Simmons MHA, RHIA, CCS, CDIP, AHIMA Approved ICD-10 Trainer and Director of ICD-10 Services and Business Development at Kforce Healthcare
lose your eyes and imagine it is October 1, 2014 and you are laying on a sandy beach in Kauai, Hawaii. There is a beautiful breeze and sunset. The ocean is calm with a beautiful shade of blue. Can you imagine it? Can you imagine that also on this date there is a plan for a new coding system? A system that is going to provide the ability to collect date and report better quality diagnoses and procedure codes for patient care? Can you imagine that this system will allow codes that are specific in detail and that provide significant information about diagnoses like acuity, laterality, and specificity? A system that will provide you with details that allow one code to provide you information about the body system, body part, intent of procedure, the approach, and the use of devices. Can you imagine a system that will replace a 35 plus year outdated and nonspecific structure. Are you imagining it? A system that is anticipated to collect better data and align with other systems across the world. I am not sure if you can imagine it but I can and on October 1, 2014 it will be a reality. This date is set to be the anticipated date for healthcare organizations across the country to implement ICD-10.
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Doctor’s Life Tampa Bay
Issue 1, 2014
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A LITTLE BACKGROUND
I am sure by now many of us have read articles and attended webinars about ICD-10. How many codes? What do the codes look like? I would be remiss if I didn’t take this moment to mention a little about the ICD-10 (World Health Organization developed) system that will be used in the United States starting October 1st. ICD-10 is comprised of both ICD-10 CM and ICD10 PCS. ICD-10 CM will be utilized for the inpatient, outpatient, and physician practice setting. Professional coders as well as in some instances, providers will assign ICD-10 CM codes (as they do in ICD-9 now). ICD-10 PCS which stands for ICD-10 Procedural Coding System will be used in the inpatient setting primarily. Coders in this setting will assign the codes based upon the documentation of physicians that admit patients to acute care facilities. There are around 68,000 codes in the ICD-10 CM system and around 87,000 codes in the ICD-10 PCS system. This is a noteworthy enhancement from the 13,000 ICD-9 diagnosis codes and 11,000 ICD-9 procedure codes that we currently have available for coding. This vast increase is primarily due to the increase in specificity. ICD-10 CM has increased the levels of details on codes with specifics as they pertain to laterality, acuity, site and stage to say the least. For instance providers and professional coders typically assign code 305.1 in ICD-9 for Tobacco Use Disorder. In ICD-10 the detail has increased to around 15 codes and is defined as Nicotine Dependence with options for either unspecified, tobacco or other tobacco products. This is then even further specified to options for uncomplicated, in remission, with withdrawal, with other nicotine-induced disorders, and with unspecified nicotine-induced disorders. I have another great example- there are additional details around injuries that identify the episode of care or encounter of the patient’s treatment/diagnosis in ICD-10 CM. For example: »» Initial encounters defined as when the patient is receiving active treatment/first visit by that physician
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»» Subsequent encounters defined as after the active phase
of treatment and when the patient is receiving repeat or routine care for the injury. »» Sequela is assigned for complication or condition that arises as a direct result of an injury The ICD-10 codes look significantly different as well, foreign to the ICD-9 fan, connoisseur or user. Although this is not a major problem other than the annoyance that all the codes that many professional coders and providers have memorized will no longer apply.
HOW DO WE PREPARE?
With any large implementation, preparation is the key. Henry Ford said, ““Before everything else, getting ready is the secret of success.” That is exactly right for ICD-10 and as we continue to embark on our last 6-7 months to implementation, preparation for ICD-10 is going to be extremely important. ICD-10 will affect various areas in all healthcare environments but professional coders and providers will be most affected. As such education and training will be extremely important.
PREPARING CODERS
Coders have one of the biggest challenges. Coders working in the outpatient or physicians services environment will typically only have to conquer the ICD-10 CM system. However, coders in the inpatient acute care setting will also have to learn and conquer the ICD-10 PCS system. You may be asking, “What is the best way to learn?” It is true that there are a lot of free resources available for ICD-10 for providers and professional coders and I highly suggest taking advantage of these resources, however, I also suggest spending quality time learning the ICD-10 system via other methods such as reviews of the ICD-10 code book and coding courses and classes available to ICD-10 that may or may not be free. Remember free is not always better- sometimes
Doctor’s Life Tampa Bay
Issue 1, 2014
you have to make a financial investment as many people and organizations are doing. Make sure to find the best quality resources that are going to thoroughly prepare you and be able to address your questions and concerns as much as possible. There are a number of organizations that suggest up to 26 hours of education for professional coders. I believe the time will range based on a number of things. For instance, how long has the professional coder been coding? This is important because sometimes it is difficult to teach mature people new behaviors. I was a coding professional for over 15 years and I have been working with ICD-10 for about 3-4 years and I still struggle with being able to remove my perfected 15 year habits from ICD-9. I will be the first to admit that the ICD-10 CM system is not hugely different in concept but there are new rules and additional documentation requirements for ICD-10 CM that do require you to alter your ICD-9 thought pattern. For those coders that have the luxury of having to learn the ICD-10 PCS system for the inpatient setting- this is a totally different story. The ICD-10 PCS system is entirely new and different from what coders are familiar with. This system will require time and practice and an investment. Free tools are great- but you have to dedicate the time and ensure that you are getting the best resources available.
PREPARING PROVIDERS
It is necessary for physicians and other providers to understand the importance of complete classification of diseases and procedures in ICD-10-CM and ICD-10-PCS (depending upon their specialty). The quality of healthcare data will help facilitate and be responsible for setting quality of care and pay for performance initiatives and parameters involved in disease outcome and severity of illness as it relates to resource consumption. Understanding the ramifications of “garbage in = garbage out” as well as how the information is used in healthcare policy development and profiling will help with accepting the need for classification change.
Issue 1, 2014
Effective education for providers is critical to the success of a smooth conversion. Some professional organizations are suggesting anywhere from 2 to 11 hours of education for providers. I find that this information is pretty accurate but should be very specific to provider specialties. Keep it simple- focus on areas per specialty. For specialties around family practice, internal medicine, hospitalists, ER and other cross functional areas it may require more time learning some of the new documentation requirements in multiple areas than it does for specific areas like orthopedics or cardiovascular. I recommend some of the following activities to help with education efforts: »» Education and training sessions specific to specialty and topics requiring new documentation »» Procedure template revision/creation to accommodate incorporation of all key documentation elements for specific procedures (e.g., infusions, transfusions, injections, etc.) »» Super bill revisions and other template updates for ICD-10 codes
IN SUMMARY
I could go on and on about ICD-10 but here is the short and skinny- it makes sense for the most part. Professional coders and billers need help with the appropriate documentation based on what is known about the patient at the time of care. I will admit there are things that I am not clear on why certain changes were made or why some descriptions were updated, however, I do see the value of having better quality codes. Hopefully over the next few years after implementation, CMS will review ICD-10 codes and make decisions for changes based on code assignments that have been utilized and not utilized. In the meantime, don’t take the easy way out and just assign unspecified codes. The data is important and with the move to pay for performance and other quality initiatives, data will be essential.
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n o i t p i r c s e r P
Your Social Media
Relationship Marketing: Is It Working For You? By Dale Griffen, R.N. The Go! Agency USA We’ve all heard sayings similar to: “people, not products, drive sales” or “people do business with people they like.” Customer service and good client relationships have always been important when it comes to acquiring and maintaining clients, but now more than ever it’s so important to cultivate and nurture these people and businesses by using relationship marketing. Why? 20
Dale Griffen
Most consumers want to talk about their experiences, but now their opinions aren’t just shared across the fence, they’re shared online—worldwide, instantly, and not just to their friends, but to anyone that wants to know more about you. Are you just letting it happen, are you getting involved, monitoring what’s being said about you, your company, products, and services and translating it into higher revenue? Relationship marketing is vital in making sure that the positives are emphasized, and any negatives are corrected. It’s all about ensuring customer satisfaction and retention. Let’s take a step back and look at exactly what relationship marketing is. In a nutshell, it’s considered marketing that puts an emphasis on long-term customer relationships by utilizing forms of communication other than advertising and sales promotions, and thereby developing a far more satisfying overall purchasing experience for both the buyer and seller. Relationships of any kind exist for what each person gets out of it. It doesn’t sound very romantic, but think about it, if your significant other didn’t give you the security, affection, love, trust, financial stability, or whatever else you personally need—that
Doctor’s Life Tampa Bay
Issue 1, 2014
relationship wouldn’t work. The same holds true for business relationships, they too are based on the “what’s in it for me” mentality. Are you providing what your client needs? How do you know? Besides person-to-person interactions or speaking over the phone, social media is an extremely effective tool in furthering the client-business relationship. Let’s take a look at how Facebook, LinkedIn, Twitter, YouTube, Yelp, FourSquare or any other platform can help you develop better relationships with your current and future clients, other professionals, and leaders in your industry. As we mentioned, people share their experiences, opinions, and even suggestions—good or bad. Now, they’re doing it online, with 757 million daily active users on Facebook, 400 million daily Tweets, and over 259 million LinkedIn members, 45 million users on Foursquare, and 117 million monthly visits to Yelp. People are talking! The benefit for you is that since these platforms are public, you have the ability to join in on the conversation. Better yet, if you are proactive, you can develop relationships with these people that are lasting and beneficial to your bottom line. Remember, when you’re in a relationship with someone, they are much more likely to be loyal to you and tell their friends about you. A loyal customer is your best sales person! Logically, some of the keys to a good personal relationship are; taking an interest, listening, meeting basic needs, having positive interactions, and good problem solving skills. Are you doing this with your business relationships? Let’s look at each of these in terms of social media. Are you posting on social media with the goal of helping people to solve problems rather than gain sales? A great quote is, “People don’t want quarter-inch drills—they want quarter-inch holes” by Ted Levitt. This means that people do not necessarily pay for a “product” or “service,” they pay for the solution to a problem. In fact, what we do in business is rent those products and services to our clients to get jobs done in their lives. Have you developed good “listening skills” online? One of my favorite true stories involves a famous steak house. A man had a same-day round trip flight from New Jersey to Tampa for a business meeting. While waiting to take off in Tampa that evening, as a joke he tweeted: “Hey @Mortons - can you meet me at Newark airport with a porterhouse when I land in two hours? K, thanks. :)” And guess what? They did. You may have heard of this very true story—it generated a lot of press, and a LOT of business for the steakhouse, not to mention some very loyal customers! (Read more here: bit.ly/MortonsCRM ). What can you do to be sure you’re “listening?” Obviously, part of listening includes handling in-person complaints, suggestions, and compliments. But as we mentioned, people may be more comfortable simply posting these things online. How can you catch them?
HERE ARE A COUPLE OF IDEAS!
• Go to Google and search for, and set up, alerts. Enter all of the keywords and key phrases that describe you and your business, things like your name, company name, specialty, location, ZIP code, and even specific search queries that people may enter to find a business like yours. (You may even want to set up alerts for your competition to see what they’re up to!) • To find conversations on Twitter that you might want to be involved with, go to twitter.com/search-advanced. Enter the criteria you are looking for, for example if you sold cars, you might search for the key phrase: “I need a new car” and your ZIP code. You’d be surprised at how many entries there are there. Responding to that tweet could have excellent results! Take a look, and see how you might modify it for your business! Another great tool is TweetDeck, a very inexpensive tool to help you manage your social media. • On LinkedIn there are a plethora of groups that you can join that are dedicated to your specific niche. Find the groups that are right for you by typing in your keywords and start some discussions, or get involved with some current discussions! It will elevate your status as an expert in your field. It’s a great networking platform that can be dialed in to your target audience and location. • Look in on Foursquare and Yelp to see that your information is there, and updated—then check in from time to time to see what people are saying.
People share their experiences, opinions, and even suggestions—good or bad. Now, they’re doing it online, with 757 million daily active users on Facebook, 400 million daily Tweets, and over 259 million LinkedIn members, 45 million users on Foursquare, and 117 million monthly visits to Yelp.
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Be active in posting on Facebook, LinkedIn, and Twitter, putting up information that is informational and helpful to the reader. Post tips and articles that are related to your area of practice, and pepper in promotional posts only now and then. You want to make sure you have an active social “voice,” but don’t forget the importance of social “listening.” Remember that social media is PR, not sales. Emphasis on the word “social.” When someone “likes,” shares, or comments on any of your posts on social media, be sure to respond to them. Just like in a real-life networking setting, if someone “liked” or commented on your tie or shoes and you didn’t respond, they would walk away. The same holds true on social media. Remember, just like any relationship, there’s work involved. The social media channels are free to use, but as we’ve said before, “time is money.” It’s crucial to develop a marketing plan for your social media activities and stick to it. One last quote from Zig Ziglar: “Every sale has five basic obstacles: no need, no money, no hurry, no desire, and no trust.” When you develop a good relationship with someone and earn their trust, you can show them much easier that they do need, can afford, and want what you’re offering! We’d like to develop a relationship with you! Follow The Go! Agency USA online and if you have any questions or need any help with your social media marketing campaigns, let us know!
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s e n i W a d i r o l F THE HEALTH BENEFITS OF MUSCADINE GRAPES
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By Yolanda Roundtree Florida Department of Agriculture and Consumer Services
he next time you sit down for dinner, don’t forget the bottle of wine — Florida that is. Most Florida wines are made from muscadine grapes — a variety of grapes that contain the highest level of antioxidants ever tested in a natural product. Muscadine grapes are fat free, high in fiber and high in antioxidants. The health benefits of wine have been studied for years and research has indicated that moderate drinking can reduce heart attacks by 50 percent. According to Dr. Serge Renaud, a French scientist and pioneer in alcohol research “Antioxidants in wine help prevent damage to blood vessels, help prevent heart disease... as many of 400 other chemicals in wine raise the level of HDL in blood. HDL is the good cholesterol that helps prevent heart attack and stroke.” You never thought that having a glass of wine with dinner had a purpose other than helping to wash down that last savory bite of chicken, beef or fish. However, the health benefits of drinking wine are greater when wine was consumed with meals instead of consumed by itself, according to Dr. Mauizio Trevisan from the University of Buffalo. “Drinking with dinner assures that the protective effects of alcohol are strongest in the evening, when fats from the dinner meal circulate through the bloodstream and carry over to the next morning, when most heart attacks take place.” According to M.D. News Magazine, recent tests show that resveratrol from muscadine grapes can block cancer cells from attacking organs, thus preventing the spread of the disease once it starts. Programs at the Strang Cancer Prevention Center in New York City showed that resveratrol was very effective as an inhibitor of the growth of COX, a compound present in breast cancer and other cancers. Compounds that inhibit
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COX offer promise as a cancer prevention agent by making cancer cells vulnerable to the body’s natural defenses. Initial studies showed that resveratrol inhibits tumor growth at three different stages — initiation, promotion and progression. Growing research also notes that additional benefits are in the grapes themselves. “If you don’t drink wine, try some jams or a muffin made from muscadines,” says Dr. Betty Ector, nutrition researcher at Mississippi State University. “They’re an even better source of resveratrol. One half serving (two fluid ounces) of unfiltered muscadine juice, one serving of muscadine jam, one medium muffin, or onetenth serving of muscadine sauce contains about the same amount of resveratrol as four fluid ounces of red wine.” Florida has 16 unique vineyards throughout the state that produce wines from a variety of muscadine grapes and other Florida agriculture products.
Doctor’s Life Tampa Bay
Issue 1, 2014
AFRICA
ASIA
EUROPE
LATIN AMERICA
MIDDLE EAST
NORTH AMERICA
&
DISCOVER T
Panama
he JW Marriott Panama Golf & Beach Resort sits in the heart of Cocle, Panama, in the luxury community of Buenaventura. The premier hotel offers the ultimate in beach vacationing as well as high-end amenities and services aimed at pampering every guest.
The Panama resort features 109 rooms and nine suites on four floors along with four meeting rooms with 3,918 square feet of flexible space, a number of onsite restaurants and bars, full-service spa, 18-hole golf course, state-of-the-art fitness center and outdoor pool and whirlpool. Tamarindo features international cuisine with a focus on locally sourced ingredients and is open for breakfast, lunch and dinner. While Prime 19 focuses on serving juicy steaks for lunch and dinner in a relaxed atmosphere, Tai Kai offers Japanese plates in a casual
dinner setting. El Faro reaches out to guests in the pool and beach areas with lunch and dinner options. Solera Pool Bar features a swim-up wet bar serving the most thirst-quenching concoctions around, and Bar-a-lago provides a variety of top-shelf liquors and a wide assortment of wines. The Panama resort will surround guests in opulence when they experience the luxurious Panama beach accommodations with Spanish colonial dÊcor, hardwood floors and soft, inviting hues. Rooms feature private balconies and gardens, and some have ocean views. Down duvets and Egyptian cotton linens on one king or two double beds ensure a sound night’s sleep, while marble bathrooms with soaking tubs, premium bath products, plush bathrobes and terry slippers pamper all guests. High-speed Internet access, 42-inch LCD TVs, iPod docking stations, inroom coffeemakers and irons and ironing boards are among high-end luxuries travelers can expect from the JW Marriott.
Imagine a private island with a spectacular two-mile, white sand beach and the only footprints are yours. Such a place really exists. Just 13 beachfront units and several private rental homes. No cars, no crowds, no hassles. It will win your heart.
Elegant cuisine and as much or as little as you want to do. Daily Snorkeling Trips Bone, Reef, Deep Sea Fishing Off-Island Excursions New Spa Services
The Meridian Club on Pine Cay Turks and CaiCos islands For inFormation 649.941.7011 reservations@meridianclub.com meridianclub.com
s o c i a C & A PRIVATE ISLAND s k r Tu HIDEAWAY
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ome call it “Cast Away meets Wolfgang Puck” where “shoes are optional” (Hideaways Collection), while others call it “an authentic tropical getaway” (Andrew Harper) and bestow awards (Trip Advisor Readers Choice), but regardless of how it’s defined, it’s clear The Meridian Club staff enjoy hosting guests on this private hidden gem. Beautifully positioned on a two-mile stretch of talcum-powder beach - considered by many as the finest in the Caribbean - The Meridian Club is an environmentally-sensitive private island resort ideally suited for those seeking an unspoiled, upscale but unpretentious retreat. With no automobiles, televisions, radios or telephones, guests unwind and enjoy the island’s natural beauty. Soothing trade winds ensure comfortable temperatures and low humidity while surrounding waters teem with marine life. Underwater visibility often exceeds 100 feet and there are miles of coral gardens within a five minute boat ride. Ashore, Pine Cay remains a pristine natural haven with vast open space and seven freshwater ponds, a perfect habitat for the abundant local fauna and flora. Aside from the obvious – bask in the sun on a deserted beach – guests can enjoy a variety of activities such as snorkeling, kayaking, paddle boarding, biking, playing basketball or tennis, and the most popular … taking golf carts out to explore the island. Culinary Adventures Mornings begin with freshly brewed coffee, fresh-baked pastries and breakfast on a private screened porch, with the option to join other guests at outdoor tables on the pool terrace. In the afternoon visitors have the option of a tasty buffet lunch, often off the grill, or a more adventurous picnic lunch (prepared upon request.) The club offers only the freshest seafood - locally caught ocean fish, lobster and conch prepared in various styles. There are other options, such as steak, chops, rack of lamb, duck and Cornish hen, and the award-winning chef prepares vegetarian meals upon request. With an new pastry chef this season, the club is excited to continue the tradition of fine desserts, beautifully presented with coffee or cordials.
Spa Offerings The Sand Dollar Spa, staffed by a Balinese masseuse, offers specialty spa techniques, including massage, hot stone treatment, manicures, pedicures, and facials. Balinese massage is a highly evolved, distinctive form employing a combination of gentle stretches, deep tissue kneading, acupressure and aromatherapy oils to stimulate the flow of blood, oxygen and “qi” (energy) around your body, bringing relaxation and a sense of wellness. An ancient technique, related to the Ayurveda, the Indian holistic medical system, this type of massage is known to help with a wide range of ailments, including migraine, muscle and joint pain, sleep disorder, anxiety and depression, as well as allergies and breathing problems such as asthma which often are worsened by stress. The use of oils is calming and sensual and leaves guests feeling tranquil and serene. Fishing With great fishing only 20 minutes off shore and a boat ride that in itself is an memorable excursion, many who visit Pine Cay come for the fishing or include fishing in their visit to the island. From deep sea fishing to fishing in the flats, there is always something interesting for any level fisherman. Some take their catch back to our chef and have it prepared for the next meal, while others enjoy “catch and release” for the sport of it. Whatever your pleasure, if you plan to fish during your Caribbean vacation, many say Pine Cay is the best option. For more information, call The Meridian Club at 866.746.3229 or visit www.meridianclub.com.
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Benz contribution Financial Services at participating dealers December 02, 2013. Not Destination everyone will qualify. Sport:1Advertised 39 months payment based license on MSRP of $39,225 lessdealer the suggested contribution resulting in a payments total grossequal capitalized cost of $37,854. Dealer may vary and could affect yourthrough actual lease payment. Includes Charge andC250 Premium Package. Excludes title,lease taxes, registration, fees, insurance, prep and dealer additional options. Total monthly $14,001. Cash due at Dealerincludes contribution maycapitalized vary and could affect your$795 actual lease payment. Destination Charge and Premium 1 Package. Excludes title,Total taxes,payments registration, fees,Atinsurance, prep for andany additional Totalthe monthly payments $14,001. duetoat signing $2,899 cost reduction, acquisition fee andIncludes first month’s lease payment of $359. No security deposit required. equallicense $17,695. lease end, dealer lessee pays amountsoptions. due under lease, any officialequal fees and taxesCash related signing includes $2,899 capitalized costand reduction, acquisition fee andmiles, first month’s lease payment of $359. No security deposit required. payments equal(and $17,695. At lease pays any amounts due under lease, anyinofficial feesshown. and taxes the scheduled termination, excess wear use plus$795 $0.25/mile over 32,500 and $595 vehicle turn-in fee. Purchase option at lease end forTotal $23,535 plus taxes any other feesend, andlessee charges dueforunder the applicable leasethe agreement) example E350related Sport:to the scheduled termination, excess wear and use plus $0.25/mile over 32,500 miles, and $595 vehicle turn-in fee. Purchase option at lease end for $23,535 plus taxes (and any other fees and charges due under the applicable lease agreement) in example shown. 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Total monthly equal Cash due to at the signing includes $3,325 capitalized costand reduction, acquisition and miles, first month’s lease payment of $579. No1 security required. Totalregistration, payments equal $19,753. At lease end, lessee pays any amounts due under the lease,payments any official fees$15,633. and taxes related scheduled termination, excess wear use plus$795 $0.25/mile over fee 22,500 and $595 vehicle turn-in fee. No security deposit required. payments equal(and $19,753. At lease lessee pays any the amounts due under the lease, any and taxes related to the scheduled termination, wear to andavailability use plus $0.25/mile overto22,500 miles,See anddealer $595 for vehicle turn-in fee. Purchase option at lease end forTotal $39,120 plus taxes any other fees end, and charges duefor under applicable lease agreement) in official examplefees shown. Subject to credit approval. Specific vehiclesexcess are subject and may have be ordered. details. Please Purchase at lease forsafely $39,120 (and any other fees and charges due under the applicable lease agreement) in example shown. Subject to credit approval. Specific vehicles are subject to availability and may have to be ordered. See dealer for details. Please always wearoption your seat belt,end drive andplus obeytaxes speed limits. 069337-01 always wear your seat belt, drive safely and obey speed limits. 069337-01