“Customer Service: Improving the Patient Experience by Seeing it Through Their Eyes”

This presentation focuses on how to improve patient experience, which begins with understanding the difference between patient satisfaction and patient experience. Presented by one of CMA’s practice management experts, Mitzi will discuss what has happened to service in a medical practice, how to improve the patient experience, having transparency with your patients, and effectively communicating, connecting, and building trust with patients and their family members.

Speaker: Mitzi Young is the Associate Director, Practice Strategy for the California Medical Association, Center for Economic Services. Mitzi brings over 29 years of experience in the health care industry. In Mitzi’s current role, her focus is Practice Management and Operations. She focuses on the dayto-day operations of CMA’s member practices. Mitzi recommends areas of improvement within a physician practice to achieve financial health, education, staff morale, and development of new internal systems. Mitzi presents seminars on practice management and health care regulations.

Mitzi started her career working for a third-party administrator as a claim and eligibility processor for San Bernardino County hospital’s medically indigent adult program. She went on to further her education and worked as an operations and business manager for specialty practices and for ambulatory surgery centers overseeing all personnel and business operations. She brings with her a vast knowledge of medical billing and collections, contracting, accreditation, and personnel and business management. She understands the needs of physicians and their staff, the challenges that face medical practices, and is very passionate about advocating on behalf of providers on succeeding in the ever-changing challenges of the healthcare landscape.

September 13th, 2023: 11:00AM to 1:00PM

Learn from HPSJ staff and public health partners how to engage HPSJ members in your practice for lead testing, oral health fluoride varnish application, childhood immunizations and more. Additionally, the staff will present information regarding the transition to the new payment system, transportation for members and share claims updates.

Cma Practice Resources

REMINDER: MEDI-CAL’S ANNUAL TWO-WEEK CHECKWRITE DELAY BEGINS JUNE 22

The California Department of Health Care Services (DHCS) recently announced the details of its annual “checkwrite” delay. DHCS will delay certain payments for two weeks in June so that those claims are paid out of the 2023-2024 fiscal year budget. This checkwrite delay will impact providers who render services through Medi-Cal funded programs.

Medi-Cal fee-for-service payments scheduled with a warrant date of June 22, 2023, will be held until July 6, 2023. Payments to the following programs will be held during this time period:

• Medi-Cal o Child Health and Disability Prevention (CHDP) o Family Planning, Access, Care and Treatment (Family PACT)

• Abortion

Medi-Cal funded fee-for-service payments scheduled for June 29, 2023, will be held until July 6, 2023. Payments to the following programs will be held during this time period:

• Abortion

• State-Only California Children’s Services

• State-Only Genetically Handicapped Persons Program

• Medi-Cal o CHDP o Family PACT

Payments made to the Every Woman Counts (EWC) program will be excluded from the hold.

CIGNA TEMPORARILY DELAYS MODIFIER 25 POLICY; AGREES NOT TO ENFORCE FOR CERTAIN LINES OF BUSINESS

As a result of advocacy by the California Medical Association (CMA) and other state specialty societies, Cigna has again delayed implementation of its policy requiring the submission of medical records for all Evaluation and Management (E/M) claims billed with CPT 99212-99215 and modifier 25 when a minor procedure is billed. The policy, originally scheduled to become effective May 25, will be delayed until June 11.

Cigna has advised CMA that the policy, when implemented, will not apply to fully-insured products regulated by the California Department of Managed Health Care or the California Department of Insurance (also referred to as CHC-CA and CHLIC). For these products, Cigna will continue to allow reimbursement when modifier 25 is appropriately billed with an E&M code without the need to submit medical records.

Unfortunately, Cigna’s large population of selffunded, Administrative Service Only business in California – representing over 70% of the total lives in the state – will remain subject to the modifier 25 policy.

CMA has stressed to Cigna and regulators that there is no reliable means to identify which patients have a fully insured vs. self-funded product so practices can know whether the policy applies. Absent clear identification of the product type for each patient, the exemption for fully insured products is meaningless.

CMA continues to discuss their concerns with Cigna, advocating for a more collaborative approach to identify alternative methodologies for cost containment that do not bluntly penalize physicians using the modifier appropriately.

Practices with questions or concerns are encouraged to contact Cigna Customer Service at (800) 88Cigna (882-4462).

Practices can also contact CMA at (888) 401-5911 or economicservices@cmadocs.org.

Dea Extends Telehealth Flexibilities For Controlled Substances

The ability to prescribe controlled substances based on telehealth patient visits was set to expire when the federal COVID-19 public health emergency ends on Thursday, May 11, 2023. The U.S. Drug Enforcement Administration (DEA) recently issued two proposed rules establishing new post COVID PHE policies for controlled substance prescriptions based on telehealth visits, one for buprenorphine and one for other controlled substances.

After receiving a backlash of opposition from the California Medical Association (CMA) and others in organized medicine, and more than 38,000 letters, DEA has issued a temporary rule that will extend the same policies that have been in place during the COVID-19 public health emergency for an additional 6 months, until November 11, 2023.

There will also be an additional one-year grace period for pre-existing telemedicine relationships. That means, if a patient and a practitioner have established a telemedicine relationship on or before November 11, 2023, the same telemedicine flexibilities that have governed the relationship to that point are permitted until November 11, 2024.

According to DEA, the goal of this temporary rule is to ensure a smooth transition for physicians and patients who have come to rely on the availability of telemedicine for controlled medication prescriptions, and allow adequate time for providers to come into compliance with any new standards or safeguards that DEA promulgates in the final rules.

CMA applauds this extension, which will allow patients to continue to receive safe and effective care via telemedicine. CMA submitted comments on the proposed regulations, urging DEA to ensure that any new rules will not limit access for our most vulnerable patients.