S a n M at e o C o u n t y
April 2015
in s id e
S a n M at e o C o u n t y M e d ica l A ss o ciat i o n
Volume 4 Issue 4
Physician D Subsequent encounter C43-C44 Malignant neoplasms of skin A Initial encounter R97 Abnormal tumor markers Q35-Q37 Cleft lip and cleft palate
E40-E46 Malnutrition
N17-N19 Acute kidney failure and chronic kidney disease
Z68 Body mass index
S Sequela
M15-M19 Osteoarthritis
ICD-10
X71-X83 Intentional self-harm
F30-F39 Mood disorders
Y21-Y33 Event of undetermined intent S00-S09 Injuries to the head T33-T34 Frostbite H40-H42 Glaucoma L20-L30 Dermatitis and eczema P09 Abnormal findings on neonatal screening E08-E13 Diabetes mellitus D50-D53 Nutritional anemias B15-B19 Viral hepatitis K35-K38 Diseases of appendix W65-W74 Accidental drowning and submersion J09-J18 Influenza and pneumonia
Billing, cash flow and ICD-10
Proper medical record keeping
Time to go shopping... ...for a better deal on workers’ compensation.
There has never been a better time to shop the sponsored workers’ compensation plans offered through the San Mateo County Medical Association/CMA. That’s because workers’ compensation insurance rates in California continue to move upward. The Insurance Commissioner recommended an increase of 6.7% in pure premium rates for 2015 compared to the average premiums charged as of July 20141. Your plan may experience a higher or lower rate increase than recommended by the Department of Insurance. Don’t just sit back and accept higher rates! Call Mercer to see if you can get a better deal through the San Mateo County Medical Association/CMA. Working with Mercer as the program administrator, the Association sponsors best-in-class insurance plans at competitive premiums. By becoming involved with the sponsored plans you will receive valuable protection for your practice and employees while supporting the good work of your Association! Take control of your workers’ compensation costs. Call 800-842-3761 now for your free, no-obligation quote. Or visit www.CountyCMAMemberInsurance.com for more information and to download an application or premium indication form.
Sponsored by:
Scan for more info! Mercer Health & Benefits Insurance Services LLC • CA Ins. Lic. #0G39709 Copyright 2015 Mercer LLC. All rights reserved. • 777 South Figueroa Street, Los Angeles, CA 90017 CMACounty.Insurance.service@mercer.com • www.CountyCMAMemberInsurance.com 800-842-3761 • 71354/71372 (4/15)
1Source: Workers Compensation Insurance Rating Bureau of California, http://www.wcirb.com/sites/default/files/documents/insurance-commissioners-decision-01012015_1.pdf
S a n M at e o C o u n t y
Physician Editorial Committee Russ Granich, MD, Chair Uli Chettipally, MD Sharon Clark, MD Edward Morhauser, MD Gurpreet Padam, MD Sue U. Malone, Executive Director Shannon Goecke, Managing Editor
April 2015 - Volume 4, Issue 4 Columns President’s Message: ICD-10 is coming, but are we ready for ICD-11?......................................... 4
SMCMA Leadership
Vincent R. Mason, MD
Vincent Mason, MD, President; Michael Norris, MD, President-Elect; Russ Granich, MD; SecretaryTreasurer; Amita Saxena, MD, Immediate Past President
Rest in peace, SGR........................................................................................ 6
Alexander Ding, MD; Manjul Dixit, MD; Toby Frescholtz, MD; Edward Koo, MD; Alex Lakowsky, MD; Susan Nguyen, MD; Michael O’Holleran, MD; Kristen Willison, MD; Douglas Zuckermann, MD; David Goldschmid, MD, CMA Trustee; Scott A. Morrow, MD, Health Officer, County of San Mateo; Dirk Baumann, MD, AMA Alternate Delegate
Editorial/Advertising Inquiries San Mateo County Physician is published ten times per year by the San Mateo County Medical Association. Opinions expressed by authors are their own and not necessarily those of the SMCMA. San Mateo County Physician reserves the right to edit contributions for clarity and length, as well as to reject any material submitted. Acceptance and publication of advertising does not constitute approval or endorsement by the San Mateo County Medical Association of products or services advertised. For more information, contact the managing editor at (650) 312-1663 or sgoecke@smcma.org. Visit our website at smcma.org, like us at facebook.com/smcma, and follow us at twitter.com/SMCMedAssoc. © 2015 San Mateo County Medical Association
Sue U. Malone
Feature Articles Billing, cash flow, and ICD-10. . ................................................................. 7 Marion Webb
Improve care and communication with proper medical record keeping. . ............................................................ 10 Marvin Firestone, JD, MD, FCLM and Dan Tennenhouse, MD, JD, FCLM
Of Interest Upcoming SMCMA events. . ....................................................................12 Membership updates, classified ads, index of advertisers. . ................14
President’s Message by Vincent Mason, MD
ICD-10 is coming, but are we ready for ICD-11? I remember the first time I heard about the International Classification of Diseases and Related Health Problems, ninth revision (ICD-9). I was in my second year of medical school, heading off to start my clinical rotation the following year. There was no Internet, no electronic health care system, and no discussions of telehealth or telemedicine as we know them today. Life seemed simple but was about to become complex, thanks to ICD-9 and billing codes and CPT codes. It all sounded cumbersome and laborious to me—yet another thing to deal with in medicine. I didn’t understand the history of the ICD.
The International Classification of Diseases and Related Health Problems is the international standard for defining and reporting diseases and health conditions. In medical school, I believed only the medical system in the United States was affected by ICD-9. Now I know that more than 100 countries use the system to report mortality data, a primary indicator of health status. ICD has been translated into 43 languages, and approximately 70% of the world’s health expenditures (USD $3.5 billion) are allocated using ICD for reimbursement and resource allocation. The International Statistical Institutes adopted the first international classification editions, known as the
International List of Causes of Death, in 1893. It was revised every ten years. The revisions contained minor changes, until the sixth revision, when the classification system expanded to two volumes. It included morbidity and mortality conditions, and its title was revised accordingly to the International Statistical Classification of Diseases, Injuries and Causes of Death. Upon its creation in 1948, The World Health Organization (WHO) was entrusted with the ICD. The seventh revision was limited to essential changes and amendments of errors and inconsistencies; the eighth was somewhat more radical than the seventh, but left unchanged the basic structure of the classification and the general philosophy of classifying diseases, whenever possible. During these revisions, the use of the ICD for indexing hospital medical records increased rapidly throughout the world. Interest in ICD continued to grow. By the 1970s, a number of specialist bodies had expressed interest in using the ICD for their own statistics. The ninth revision retained the basic structure of the ICD, although with much additional detail at the level of the fourdigit subcategories, and some optional five-digit subdivisions. For users not requiring such detail, care was taken to ensure that the categories at the threedigit level were appropriate. Work on ICD-10 began in 1983, and the new revision was endorsed by the Fortythird World Health Assembly in May 1990. The latest version came into use in WHO Member States starting in 1994. The tenth revision allows more than 155,000 different codes and permits tracking of many new diagnoses and procedures, a significant expansion on the 17,000 codes available in ICD-9.
4 San Mateo county physician | april 2015
Amazingly, the United States is the last major industrialized nation to make the switch to ICD-10. On January 1, 1999 the ICD-10 (without clinical extensions) was adopted for reporting mortality, but ICD-9-CM was still used for morbidity. The Final Rule by the CMS requiring the replacement of ICD-9 with ICD-10 was published in January 2009. At that time, the compliance date was set for October 1, 2013. In 2012, the Department of Health and Human Services announced a one-year delay of ICD-10 implementation, which pushed the date back to October 1, 2014. On March 31 of last year, the U.S. Senate voted 64-35 to delay the implementation by at least one year. The current transition date is October 1, 2015. The adoption of ICD-10 will lead to improved efficiency and lower administrative costs. By enabling providers to reveal much more detail about diagnoses and procedures, ICD-10 will result in fewer miscoded and rejected claims, leading to more accurate, timely payments. The National Healthcare Anti-fraud Association cites that billions of dollars are lost annually through healthcare fraud. The expanded detail in the ICD-10 codeset limits manipulation attempted to secure higher reimbursement. While we prepare to transition ICD-10 this October, the rest of the world will be preparing for ICD-11. The eleventh revision is expected to reflect progress in health sciences and medical practice, enabling collaborative web-based editing, open to all interested parties. (To assure quality, it will be peerreviewed for accuracy and relevance.) It is expected to be compatible with electronic health applications and information systems and should be free to download online for personal use. It is expected to arrive in 2017. ■
Executive Report by Sue U. Malone
Rest in peace, SGR The sustainable growth rate (SGR) formula is no more. Thanks to new legislation adopted earlier this month, Medicare patients and the physicians who care for them no longer will be threatened by the flawed payment formula that left the Medicare program unstable and threatened access to care. Following years of advocacy by the nation’s physicians standing up for their patients and their practices, the U.S. Senate on April 14 voted 92-8 to pass H.R. 2, the Medicare Access
and CHIP Reauthorization Act. Two weeks earlier, the U.S. House of Representatives adopted the legislation in a landslide vote of 392-37. President Obama signed H.R. 2 into law on April 16.
In addition to addressing Medicare payment, the legislation outlines several provisions that should be beneficial for physicians, including: •
Medicare’s current quality reporting programs will be streamlined and simplified into one merit-based incentive payment system, referred to as “MIPS.” This consolidation will reduce the aggregate level of financial penalties physicians otherwise could have faced.
•
Protections are included so that medical liability cases cannot use Medicare quality program standards and measures as a standard or duty of care.
•
Incentive payments will be available for physicians who participate in alternative payment models and meet certain thresholds.
•
Technical support will be provided to help smaller practices participate in alternative payment
H.R. 2 was adopted on the eve a 21 percent cut to physicians’ Medicare payments was set to take place. Instead, the bill provides positive annual payment updates of 0.5 percent, starting July 1 and lasting through 2019. Claims that were held for the first half of April will be processed and paid at the rates that were in place before the 21 percent cut was scheduled to take effect.
6 San Mateo county physician | april 2015
models or the new fee-for-service incentive program. While the bill supports physicians who choose to adopt new payment and delivery models, it also retains Medicare’s fee-for-service model. Participation in new models is entirely voluntary. In California, both Senators Boxer and Feinstein supported H.R. 2. In fact, 52 out of 54 Members of the California Congressional delegation voted to support physicians. Here in San Mateo, we asked our members to contact their legislators and urge them to support this legislation. This is an incredible achievement in one of the most dysfunctional Congresses in history. Please be sure to contact your Congressional representatives to thank them for their support. Simply go to www.FixMedicareNow.org, click on physicians then email. ■
President Obama signs the bill H.R. 2 Medicare Access and CHIP Reauthorization Act of 2015, Thursday, April 16, 2015 Photo: Carolyn Kaster, AP
Billing, cash flow, and ICD-10 by Marion Webb
W
ith its October deadline approaching, ICD-10 implementation is at the top of the list of physician concerns for 2015. For many physicians, especially for those working out-ofnetwork, knowing how to maximize recovery of pay will be a key consideration. In this article, we will address how you can prepare now to improve collections, and we will provide helpful tips and resources for getting on track to maximize your revenue. Current ICD-9-CM diagnosis codes do not provide sufficient clinical specificity to describe the severity or complexity of various diseases, according to Physicians Practice. ICD-10 will add more than 68,000 codes, compared to ICD-9’s maximum of 13,000 codes. The new codes will be different in their organization, structure, detail and composition and seek to improve operational capabilities of clinics and practices. Physicians will be able to better determine the severity of illnesses and therefore quantify the level of care more accurately. The codes will also create an electronic trail of documentation, which will help doctors receive proper payment and ensure that their reputation remains in good standing, wrote Mike Patel, CEO of Meditab Software, in an article published on the Advance Healthcare Network website. With the importance and significance of this transition, Patel said, it’s crucial that providers are amply prepared.
Increasing your cash flow early While some organizations continue to wait to see if the compliance date of October 1 will truly stand, some experts caution that waiting for the final date could put your revenue at risk. Robert Wergin, MD, president of the American Academy of Family Physicians, expressed confidence that the Oct. 1 deadline will stick. “This time, it looks like the real thing,” Dr. Wergin told Medscape. He agrees that doctors’ anxiety remains high over what it will take to implement the new coding system and what it will mean for doctors in terms of income. “There is concern that the technology won’t work when the systems start up,” he said. He also noted that providers might not get paid right away. The best way to prepare for any delays, the experts say, is to increase your cash flow early. Marion Webb is a writer based in San Diego. This article was previously published in Physician Magazine, a publication of the Los Angeles County Medical Association.
Five way to increase your cash flow now 1. Clear existing blockages With the move by health plans to increase deductibles, more patients face higher outof-pocket costs. Rather than waiting to be reimbursed, by tapping into the payers’ systems, practices can assess the status of a patient’s deductible and accurately predict out-of-pocket expenses at the time of their visit. They then can obtain authorization right away to charge a patient’s credit card once the insurance claim is settled.
2. Use new technologies Using new technologies such as lockbox services, remote deposit, electronic funds transfer, sweep accounts and online bill payments for all expenses allows practices to get payments into their accounts faster. Combining claims into one outsourcing solution and a single electronic database rather than tracking them separately also helps improve cash flow.
3. Coordinate care in your practice In the old days, long wait times were seen as a sign of a physician’s popularity, but today any obstructions in a practice’s scheduling process will likely leave patients to seek care elsewhere. To keep your clients coming back and keep your reputation as an efficient and effective practice intact, you want to optimize care, which will ultimately translate into optimized cash flow.
april 2015 | SAN MATEO COUNTY PHYSICIAN 7
Five way to increase cash flow now (continued)
your
4. Identify errors early Post-service revenue cycle management opportunities abound, giving you tools to identify and correct errors before you submit a claim to your insurer. Also, training your staff to monitor claim denials to spot trends and fix problems at their source is key. Common preventable causes of claim denials include lack of insurance company-required referrals or prior authorization, inaccurate demographic or insurance information, claims that weren’t filed in a timely manner, and incorrect modifier, procedure and diagnosis codes.
5. Rule out fraud With large sums of cash coming in, it’s critical that you hire honest employees. It takes only one dishonest worker to disrupt your cash flow. Consider paying vendors with a business credit card instead of checks. Banks offer business credit cards to medical practices for internal use as well as credit card merchant processing for payments. Segregate banking duties among staff so no one person has access to all bank accounts. Ask your bank to send account statements directly to your accountant and limit online banking access. Put strong cash controls in place and log all funds collected on site and total them at the end of each work shift. Invest in periodic audits of internal controls performed by an accountant or an auditor who specializes in detecting fraud. ■
Tips to ensure ICD-10 readiness and maximize income Here is a checklist of 14 tips from the experts to get on track with ICD-10 compliance and maximize revenue along the way. Experts include Patel as well as Robert Tennant, Health IT policy director for the Medical Group Management Association, and such online sources as Physicians Practice and Peoriamagazines.com. Create an impact chart. Practices should create an impact assessment chart and capture key information in a spreadsheet including the area impacted, needed changes in workflow, how the new system will impact assigning of code, vendor information and contingency plans. Training. To maintain their certifications, all medical coders must take a minimum number of ICD-10-specific CEUs before the compliance date. To ensure that your staff is adequately trained, the experts suggest conducting a gap analysis to determine your team’s knowledge of medical terminology, pharmacology, pathophysiology, anatomy and physiology and review samples from different types of medical records to see whether the current level of documentation contains enough detail for ICD-10 coding. Physicians also have a learning curve, and those with specialty tools will be in the best position to make sure they aren’t negatively impacted financially. Test, test, test! Make sure your staff is up to speed and practices with active claims by coding them in the old system and the new to see if they are getting the right information. Clear documentation. Ensure that your patient records are clear and complete in order to submit accurate claims and avoid delays in payment. Cost-effective resources. Visit the Centers for Medicare and Medicaid Services website as a resource. cms.gov/Medicare/Coding/ ICD10/index. html?redirect=/icd10 Software. In addition to impacting practice systems and electronic health record software ,the move to ICD-10 may require that practice software needs to be updated or replaced. To do this takes time and resources. Regulations. Know and identify all other regulations and changes so you won’t get behind as you approach ICD-10 implementation. Filtering. Filter out the codes you will be using the most for greater efficiency. Communicate. Ensure clear communications with payers and clearinghouses to ensure that the system is ready to go, and ask if they are ready for the transition as well. Payers. Find out if payers have adopted contractual changes regarding coding specificity that could affect how you process claims. Extra expenditures: Plan for unforeseen expenses in time and resources such as training of staff, IT upgrade costs, business process analysis of health plan contracts and documentation, and cash flow disruptions due to the ICD-10 transition.
Continued on page 11
8 San Mateo county physician | april 2015
5 reasons to join the San Mateo County Medical Association Whether you are a solo physician looking for resources and support to help your practice succeed, or a large practice member interested in supporting organized medicine and shaping public policy, your membership in the San Mateo County Medical Association and California Medical Association is a valuable investment in your future
grow your practice
SMCMA offers a referral service to the general public and makes thousands of referrals annually to SMCMA members, exclusively on the basis of specialty, geographic location, board certification, and languages spoken.
Keep up-to-date on the latest news with our complimentary membership magazine, newsletter, membership directory, and website. Network with your peers at our social events.
have a voice
Ensure you have a voice and vote on key issues affecting the practice of medicine and gain leadership and legislative advocacy experience.
Give back to your community and help improve public health by volunteering for Community Service Foundation programs, San Mateo Hep B Free and Walk with a Doc.
resolve payment and billing problems
stay connected
give something back
SMCMA works directly with commercial and government payers to resolve reimbursement or other disputes on your behalf.
april 2015 | SAN MATEO COUNTY PHYSICIAN 9
Improve care and communication with proper medical record keeping We are all required to keep adequate patient records. So what’s an “adequate” record? If you believe “adequate” means long and detailed, you’re wasting your time. Let’s assume your partner is ill and you will substitute for a few days. One of your partner’s patients comes to see you with an urgent problem, and you review the medical records. Will your partner’s records be adequate? They will if they show you all of the following information without forcing you to hunt through pages of irrelevant material: 1. The patient’s important disorders such as: diabetes, heart disease, stroke, osteoporosis, rheumatoid arthritis, prostate cancer, etc. This may appear in a separate problems list. 2. All the patient’s current medications. This may appear in a separate “Medication Record.” It should include: dose, frequency, route, number prescribed, refills, and any special conditions for use such as PRN 3. A recent history and physical examination, if applicable. 4. Current diagnosis, if made, that relates to the urgent problem. This includes a differential diagnosis if one was written. 5. Treatment given on the last few visits, including every medication prescribed. 6. Additional treatment planned, if any. 7. Warnings like: allergies, noncompliance history, substance use disorder, presence of immunocompromise, etc. The above elements of the patient record need not all appear in the note for the last visit, but must be relatively easy to find. Does your partner’s record contain enough of the above information for you to provide the patient with safe care? If not, the record is inadequate. Is the record too lengthy and packed with irrelevant or defensive information?
by Marvin Firestone, JD, MD, FCLM and Dan Tennenhouse, MD, JD, FCLM That would be a poor record because you may not be able to quickly find the information you need for safe patient care. When you document for your own patients, ask yourself if your record contains everything another clinician who sees the patient after you would need in order to provide the patient with safe care.
Do patients have a right to obtain copies of their records? This is a common misconception. Language in the code sections (California Confidentiality of Medical Information Act and HIPAA) say that patients can request copies of their own records in writing, and the physician is obligated to provide them within 15 days. This includes legal representatives of the patient such as parents, guardians, and conservators. What isn’t usually mentioned is that the code sections also contain exceptions. If the physician believes that giving the record to the patient would not be in the patient’s best interest, the physician can instead provide a summary of the record. The summary must include basics like diagnoses, medications, diagnostic study results, and prognosis. However, a summary should not include information that could be confusing or misleading to the patient such as a differential diagnosis, or comments likely to make the patient angry such as suspicions of substance use
10 San Mateo county physician | april 2015
disorder or non-compliance. It also should not include names of confidential sources of information about the patient such as a family member. Patient records should be kept to provide good patient care, and should not be watered down so the patient can read without negative repercussions for the physician. If the patient is an unemancipated minor, and a parent or legal guardian is requesting a copy of the record, the physician need only note in the record that it could have a detrimental effect on the professional relationship with the patient, or not be in the patient’s best interest to release a copy to the parent or guardian, and the reason why. A copy of the record does not need to be released. For emancipated minors, it is the minor who has the power to authorize or request release of records, not the parent or guardian. If the patient is being treated for a mental health disorder, and is requesting a copy of the record, the mental health professional need only note in the record that it could have a detrimental effect on the professional relationship with the patient, or not be in the patient’s best interest to release a copy to the patient, and the reason why. A copy of the record does not need to be released. Mental health records also include all alcohol and drug abuse records. With regard to mental health records, there is also a provision for the patient to require that the provider permit inspection by, or provide copies to, a licensed physician, psychologist,
marriage and family therapist, clinical social worker, or professional clinical counselor. If so requested, copies of the record must be provided. However, the recipient of the record may NOT permit inspection or copying of the medical record by the patient.
off-label use. From a liability standpoint, this may be equivalent to writing a prescription. You should do it only when there is strong support in the medical literature. If you purchase the medication from outside the country to give to the patient, you are violating Federal law.
The above limitations do not apply to release of copies of records to attorneys who are requesting them pursuant to a subpoena or to the patient’s written authorization. However, attorneys must NOT permit inspection or copying of the medical record by their clients.
Off-label prescribing is common during pregnancy or for children where no research has been published on the safety of the medication for that population. However, if alternative medications exist that have been shown in the literature or by common experience to be efficacious and relatively safe (i.e., the benefits warrant the risks), the alternative medications should be prescribed instead.
What about prescribing off-label? What are the rules? The law does not prohibit prescribing offlabel. All you need is a reasonable basis for believing the medication is indicated such as: (1) supporting medical literature, or (2) this off-label use being common practice in the medical community. However, if common practice for that offlabel indication has not been successful, do not prescribe it. As long as the benefits warrant the risks, off-label prescribing is appropriate. Do not experiment with an off-label use in the absence of supporting medical literature or lack of common practice for that indication. Initial experimentation should take place in a controlled setting with an experimental license and an extensive written informed consent. Recommending medications not approved in the U.S., that the patient must obtain from outside the U.S., is also
Tips to ensure ICD-10 readiness and maximize income (continued from page 8) Outsourcing vs. in-house billing. If billing is handled in-house, the cost of keeping employees on staff may be higher than the cost of hiring a thirdparty biller. Here are some questions to consider in making the decision: What are some of the financial benefits in hiring a third-party biller that your practice currently does not get? How will your practice pay for
Where statutes expressly prohibit use of a medication for that indication, you may not prescribe it off-label. An example is anabolic steroids or growth hormone to enhance athletic performance. When you prescribe medication off-label, you should document the indication since it will not be obvious from the medication’s FDA-approved labeling. Otherwise, anyone else taking over the patient’s care, and other members of the health care team, may not recognize your reason for prescribing the medication. It is not necessary to document in the patient’s record the source of your information about why off-label use is appropriate for that indication. When you prescribe off-label, you should explain to the patient that the medication is not FDA approved for that indication. This is part of the informed consent
the third-party biller and what hidden expenses will come up (postage or processing fees)? Also, ask yourself how will billing services be affected as your practice continues to grow, given that many revenue cycle management firms are paid a percentage of collections? Turnover: Ask yourself if your billing department has a high turnover rate. If the answer is 20% or more, you may have inefficiencies that either need to be addressed in-house or may lead you to consider outsourcing.
disclosure you are required to give when prescribing. Patients often check their medications on the Internet. Off-label uses are usually not listed. This can make the patient suspicious, and as a result, the patient may not take the medication. It may also undermine the patient’s confidence in you. It is good practice to explain that the indication may not be found on Internet, but is supported by the medical literature and/or common experience. In addition to prescribing for indications that are not FDA approved, off-label use also includes dosages outside the FDAapproved dosages, and other deviations from the approved labeling. The legal requirements for these forms of off-label use are the same. ■
About the Authors Marvin Firestone, JD, MD, FCLM, and Dan Tennenhouse, MD, JD, FCLM, are presenters at the Western Institte of Legal Medicine in San Mateo. Both hold degrees in medicine and law and are experts in the field of medical law. Learn more at www.wilm-ed.org. These issues and many more are addressed in the Western Institute of Legal Medicine course Medical Record Keeping. The next course will be offered June 19-20, 2015, in Foster City. A special discount is available to SMCMA members. Registration and course details can be found at www.wilm-ed.com.
Hire counsel: Because payment disputes are possible, providers should proactively address ICD-10 issues in their current negotiations. The attorneys at Epstein Becker & Green suggest that any provisions addressing group changes that address ICD10, and those referencing “revenue neutral” requirements and provisions dealing with policy and manual compliance, should be carefully considered in contract reviews. Finally, the attorneys also recommend a clear, fair dispute resolution provision for ICD-10 conversion. ■
april 2015 | SAN MATEO COUNTY PHYSICIAN 11
superlative customer service = successful practice Professional patient relations, telephone techniques and etiquette are essential in today’s competitive medical environment. Managed care and capitation mean increased patient volume of visits at decreased reimbursement rates. Under managed care, it is important to control utilization of office visits. Appropriate screening of telephone calls, requests for appointments and advice given will assume greater importance. Quality of care and patient satisfaction is still paramount. Interactions with patients must be handled appropriately to minimize the risk of increased malpractice claims. Instructor Debra Phairas will use a variety of techniques to illustrate the principles taught. These include skits of typical telephone conversations and role playing to demonstrate how to handle patient situations and calls effectively using the wrong, then the right way. This course is intended for all staff that encounter patients either in person or by telephone. It is a basic course, not intended for managers.
save the date! san mateo county medical association
2015 annual meeting
thursday, june 18, 2014 the candy store
a classic car museum
12 San Mateo county physician | april 2015
smcma educational program Date and Time Wednesday, May 20, 2015 12:00 - 2:00 p.m. Location San Mateo County Medical Association 777 Mariners Island Boulevard, Suite 100 Cost SMCMA members & staff: $99 / non-members: $249 Lunch will be included Registration Please print the registration form (www.smcma.org/calendar-smcma-events) and return with your payment to: San Mateo County Medical Association 777 Mariners Island Boulevard, Suite 100 San Mateo, CA 94404 fax (650) 312-1664/smcma@smcma.org
april 2015 | SAN MATEO COUNTY PHYSICIAN 13
classified ads Primary Care Practice for Sale - Belmont 8+year old practice in Belmont, CA. Well-located and pleasant office. Prime location in San Francisco Bay Area presents great growth opportunity. Asking for $195k or best offer.
650 346-9341 imcapractice@gmail.com \ 650 346-9341
Private, independent, medical practice in Redwood City A qualified, energetic MD is needed to help a large established and still growing general practice with a broad range of medical services. This is an opportunity for a family practitioner, internist or general physician to join a group of five other MD’s in a busy urban environment in a comfortable old world office space. Negotiable.
Physician volunteers still needed for Walk with a Doc Walk with a Doc is a free program of the SMCMA Community Service Foundation that encourages physical activity in people of all ages and fitness levels. Community members walk side-by-side with physician volunteers who can answer their general health-related questions along the way. Now in its fourth year, Walk with a Doc has grown to include thirty walks at 15 locations throughout San Mateo County. Our first walk for the year took place on March 7 at Ravenswood Open Space Preserve in East Palo Alto. The program’s success relies heavily on the participation of our enthusiastic physicians. Walks take place at 10am on Saturday mornings (excluding holiday weekends) and will continue through October 24. Physicians are welcome to join us at any walk, but volunteers are especially needed on the following dates: July 18: Burgess Park, Menlo Park July 25: Windy Hill Open Space Preserve, Portola Valley August 1: Red Morton Park, Redwood City August 15: Pulgas Ridge Open Space Preserve, Redwood City August 22: Twin Pines Park, Belmont / August 29: Beresford Park, San Mateo September 19: Ryder Park, San Mateo September 26: Washington Park, Burlingame October 3: Spur Trail, Millbrae / October 10: City Park, San Bruno To sign up, contact us at (650) 312-1663 or smcma@smcma.org, or sign up on our website at smcma.org/walkwithadoc.
Email CV to serena1asma@gmail.com RETIREMENT The following SMCMA member has recently retired from practice:
Lefkos Aftonomos, MD
In Memoriam Beth Boles, MD February 1, 2015
Tracy Zweig Associates INC.
A
REGISTRY
&
PLACEMENT
FIRM
Physicians
Nurse Practitioners Physician Assistants
John Salzer, MD February 21, 2015 Alfred Stitch, MD January 21, 2015
Index of Advertisers Cooperative of American Physicians............. Inside Back Cover The Magnolia of Millbrae...................................................................... 5 Medical Insurance Exchange of California (MIEC)...................13 Mercer..........................................................................Inside Front Cover NORCAL................................................................... Outside Back Cover Tracy Zweig Associates.........................................................................14
14 San Mateo county physician | april 2015
Locum Tenens Permanent Placement V oic e: 800-919-9141 or 805-641-9141 FAX : 805-641-9143 tzwei g @ tracyzwei g . co m www. tracyzwei g . co m
Proud to be endorsed by the San Mateo County Medical Association
Our
beats in
Our heart beats in California ‌ and has for almost 4 decades. Since 1975 NORCAL Mutual has served healthcare professionals throughout the Golden State. Strength, stability and innovative products are just a few reasons why physicians continue to look to us for their medical professional liability insurance. We provide you: Industry-leading claims and risk solutions support 24/7 Full access to our interactive risk management library Flexible coverage options tailored to your needs California is important to us. So is your peace of mind. See how homegrown strength can help protect your practice.
Visit heart.norcalmutual.com or call your agent/broker today. 844.4NORCAL (844.466.7225)
Š 2015 NORCAL Mutual Insurance Company