Download - February 2015 | Physician Magazine

FEBRUARY 2015

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A PUBLICATION OF PNNwww.PhysiciansNewsNetwork.com

R E P O R T I N G O N T H E E C O N O M I C S O F H E A L T H C A R E D E L I V E R Y

T H R E E I P A s C O M B I N E R E S O U R C E S T O F O R M T H E N E W A L L I E D P A C I F I C I P A

Billing, Cash Flow & ICD-10PLUS: Smart Ways to Cut Your Income Taxes in 2015

The Executive Master of Public Health Program in Health Policy & Management

For more information, call us at (310) 267-5600 or visit us on the web at www.emph.ucla.edu

Today’s turbulent healthcare environment places a premium on fundamental analysis and innovative management. Get the analytical, financial, business, and leadership tools you need to move your practice forward.

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The piece that makes a difference.

FIELDINGSCHOOL OFPUBLIC HEALTH

FEBRUARY 2015 | W W W. P H YS I C I A N S N E W S N E T WO R K .COM 1

Volume 146 Issue 2

Physician Magazine (ISSN 1533-9254) is published monthly by LACMA Services Inc. (a subsidiary of the Los Angeles County Medical Association) at 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 90017. Periodicals Postage Paid at Los Angeles, California, and at additional mailing offices. Volume 143, No. 04 Copyright ©2012 by LACMA Services Inc. All rights reserved. Reproduction in whole or in part without written permission is prohibited. POSTMASTER: Send address changes to Physician Magazine, 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 90017. Advertising rates and information sent upon request.

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COVER STORY

10 BILLING, CASH FLOW & ICD-10

ICD-10 implementation is at the top of the list of physician concerns for 2015. For many physicians, especially for those working out-of-network, 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 pro-vide helpful tips and resources for get-ting on track to maximize your revenue.

6 Independent Practice Associations Combine Resources to Form the New Allied Pacific IPA

8 Prescription for Home Ownership

20 Five Smart Ways to Cut Your Income Taxes in 2015

FROM YOUR ASSOCIATION

4 President’s Letter | Pedram Salimpour, MD

22 United We Stand | At Work for You

24 CEO’s Letter | Rocky Delgadillo

206

The Executive Master of Public Health Program in Health Policy & Management

For more information, call us at (310) 267-5600 or visit us on the web at www.emph.ucla.edu

Today’s turbulent healthcare environment places a premium on fundamental analysis and innovative management. Get the analytical, financial, business, and leadership tools you need to move your practice forward.

The UCLA Executive Program in Health Policy & Management

v Ranked among the Top Ten Healthcare Business Programs for Physician Executives by Modern Healthcare

v Executive format with convenient weekend classes

v Two-year, fully-accredited MPH degree in Health Policy & Managment

v Diverse cohort structure and team-based learning environment

v Dynamic healthcare and professional network centered at world-renowned UCLA and spanning the enterprising Southern California marketplace.

The piece that makes a difference.

FIELDINGSCHOOL OFPUBLIC HEALTH

SUBSCRIPTIONSMembers of the Los Angeles County Medical Association: Physician Magazine is a benefit of your membership. Additional copies and back issues: $3 each. Nonmember subscriptions: $39 per year. Single copies: $5. To order or renew a subscription, make your check payable to Physician Magazine, 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 90017. To inform us of a delivery problem, call 213-683-9900. Acceptance of advertising in Physician Magazine in no way constitutes approval or endorsement by LACMA Services Inc. The Los Angeles County Medical Association reserves the right to reject any advertising. Opinions expressed by authors are their own and not necessarily those of Physician Magazine, LACMA Services Inc. or the Los Angeles County Medical Association. Physician Magazine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. PM is not responsible for unsolicited manuscripts.

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LACMA’s Board of Directors consists of a group of 30 dedicated physicians who are working hard to uphold your rights and the rights of your patients. They always welcome hearing your comments and concerns. You can contact them by emailing or calling Lisa Le, Director of Governance, at [email protected] or 213-226-0304.

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Are You ICD-10 Ready? Get Your “ICD-10 Action Guide” FREE!

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4 P H YS I C I A N M AG A Z I N E | FEBRUARY 2015

FOR THE FORESEEABLE FUTURE, the Af-fordable Care Act has laid the groundwork for the changes in how healthcare is delivered and, just as importantly to patients and their access to doctors and hospitals, how that healthcare is paid for. Within the last year about 6.8 million Americans who did not previously have access

to health insurance got that through the man-dates of this new law. And whether each of us was in favor of the specifics of this concept or cautiously wary of its mandates, to-day we know that with all the good that it will bring many families, there will be serious challenges. Among those challenges is a shortage of physi-cians due to an aging population and a sudden increase in the number of patients who would like access to their doctors.

Kaiser Health News reported that approxi-mately 10,000 baby boomers are becoming

eligible for Medicare each day. This immediate heavy increase of new patients now qualifying for healthcare is challenging a primary care sys-tem already struggling to keep up with demand, overall contributing to an already present physi-cian shortage. California today ranks 24th in the country in the number of doctors per 100,000 residents. And there are parts of Southern Cali-fornia that have fewer doctors per 100,000 peo-ple than the state ranked 49th in the union.

A survey completed in late 2014 by the Phy-sicians Foundation found that 81 percent of

doctors described themselves as overextended or at full capacity—even before this sudden in-crease in workload. Another 44 percent of phy-sicians said they planned to cut back on the amount of patients they see, retire from their practice or close their practice to any new pa-tients.

And the challenges get still more pervasive. While the ACA’s overarching goal was to make healthcare more accessible, some insurance companies are limiting the number of doctors into their physician panels as a way to cut costs. Consequently, patients are finding it difficult to find doctors within their insurance networks, and when they do find a doctor affiliated with their insurance plan they often find it difficult to get appointments to see their doctor in a timely manner. Today, nearly one in five Americans lives in a region designated as having a short-age in primary care. The Association of Ameri-can Medical Colleges projects the shortage will grow to about 66,000 in little more than a de-cade as fewer residency slots are available and more medical students choose higher-paying specialty areas—by choice but often by necessity because of their educational debt burden. This is not just a stress on individual doctors, who we can argue are accustomed to stress, this is a stress on the healthcare system.

Los Angeles County physicians are dedicat-ed to working through the physician shortage in order to keep the ACA a benefit and not a burden. We have to stay active, vigilant and en-gaged. We all are busy. And by the measures stated above, we will get busier. But if we do not engage with policy makers and others to come up with solutions for the issues facing us and our patients, others will do that for us. Ev-ery profession and every professional ought to remain master of their own destiny. Doctors are no exception.

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Kenneth Sim, MD, chairman, Board of Directors Allied Pacific IPA and co-chairman, Board of Direc-tors, Network Medical Management, told PNN that in October 2014, Allied Physicians merged with Pa-cific IPA and now all three IPAs have come together. The goal is to consolidate resources and create a vi-able entity that will enable independent physicians to remain in private medicine and be competitive in the market where economies of scale and access to new technologies are the key.

“The market is changing so fast that every time you look around something new is happening. Busi-ness models are evolving, there are mergers, acqui-sitions, everything is changing so quickly,” Dr. Sim said. The government is driving the changes and this is nothing new, according to Dr. Sim, but the will-ingness of physicians to come out of their individual silos and work together to survive is new.

From the Health Maintenance Organization Act that President Richard Nixon signed into law in 1973, to the Affordable Care Act of today, the pres-sure is to contain costs while encouraging better management of care for the patients. But you can no longer do it without having the resources to take advantage of the new technologies that will bring healthcare to the level consumers expect in all other industries, Dr. Sim said.

In the past Allied Physicians IPA, Pacific Physi-

cians IPA and Physicians’ Healthways IPA competed with each other for patients. No one wanted to talk to each other, Dr. Sim noted. This is no longer a vi-able model going forward. “Instead of competing we decided to come together and collaborate so we can survive together.”

New technology and innovation will be key, but individual doctors do not have resources or even time to learn about them, let alone implement them. Yet it is technology that will be the biggest game changer and differentiator. Information technology implementation, population health management and home monitoring are the biggest challenges, Dr. Sim said. There are ideas and products out in the market, but most physicians don’t know about them and don’t have time to find out. As a group, he said, there will be opportunities and resources to address that lack.

“Patient care in the future will require greater investments in technology and other innovations. Consolidation is a way to free up economic resourc-es that can be better invested in doctors and in the clinical management systems that take better care of patients. This is smart. This is the future: Dr. Sim’s is a novel and innovative model of exceptional clinical care that has proved scalable,” Pedram Salimpour, MD, president of the Los Angeles County Medical Association, told PNN.

ALHA MBR A-BASED ALLIED PHYSICIANS IPA (Independent Practice Association) com-

pleted a merger with two other groups, Physicians’ Healthways IPA and Pacific IPA, which

resulted in a new entity under the name of Allied Pacific IPA that has 2,000 physicians serving

over 250,000 members in San Gabriel Valley. There are 500,000 members in seven counties in

Southern and Central California.

“Instead of competing we

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Five main benefits of home ownership:• TAX BREAKS | Mortgage interest and property tax

deductions can translate into some impressive tax savings for homeowners. These expenses are usu-ally completely tax-deductible on both the federal and state income tax returns, as are several closing costs. This is of particular benefit to new home-owners, as the bulk of the monthly payments in the first few years goes toward paying down the interest on the new loan. Of course, it is best to consult your tax professional for specifics based on indi-vidual income bracket and other deductions.

• BUDGET STABILITY | Home ownership is a great way to hedge against inflation. While rental rates increase year after year based on current market conditions, buying a home allows homeowners to fix their payments for up to 30 years. This means that monthly housing expenses will be capped even when inflation takes hold and price for rent, gasoline, and other consumer goods increase.

• BUILT-IN INVESTMENT | Owning a home can be a wise financial decision. Over time, real estate has proven to be a sound investment, particularly as the mortgage principal is paid down and both equity and home values increase. Oftentimes, homeowners can sell their current homes and

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• CAPITAL GAINS INCENTIVES | Homeowners who have lived in their homes as their primary residence for two of the past five years have added benefits when they decide to sell. Single taxpay-ers can exclude up to $250,000 profit and mar-ried taxpayers can exclude up to $500,000 profit from capital gains tax. There is no need to buy a replacement home, nor any age restriction.

• AUTONOMY | It is not economically advanta-geous for renters to upgrade their homes, either cosmetically or structurally. Homeowners, on the other hand, have both the freedom and the incen-tive to upgrade their living environments. These improvements can result in increased equity and, as any home owner can attest, they help to turn a house into a home.

Homeowners who missed the last refinancing boom have been given another chance. Interest rates are the lowest the country has seen since mid-2013, and remain close to their lowest level in 50 years. Whether you’re a first-time home buyer or current homeowner it’s a good idea to speak with an experi-enced mortgage professional to determine if the pre-scription of homeownership is right for you.

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BILLING,CASH FLOW& ICD-10BY MARION WEBB

With its October deadline approaching, ICD-10

implementation is at the top of the list of physi-

cian concerns for 2015. For many physicians, es-

pecially for those working out-of-network, know-

ing 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 get-

ting on track to maximize your revenue.


LAYING THE GROUNDWORK FOR A SUCCESSFUL TRANSITION

Current ICD-9-CM diagnosis codes do not pro-vide sufficient clinical specificity to describe the severity or complexity of various diseases, accord-ing 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 clin-ics 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 Pa-tel, CEO of Meditab Software, in an article published on the Advance Healthcare Network website. With the importance and significance of this transition, Pa-tel said, it’s crucial that providers are amply prepared.

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3-4 characters in length

14,025 diagnosis codes

3,824 procedure codes

3-5 characters

Outdated technology

Generic, non-specific codes

Not used by other countries

ICD-10

3-7 characters in length

68,000+ diagnosis codes

71,924 procedure codes

3-7 characters

Current technology

Specificity improves accuracy and depth of data

Allows data exchange


1 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.

2 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.

3 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.

4 CLEAR DOCUMENTATION: Ensure that your patient records are clear and complete in

order to submit accurate claims and avoid delays in payment.

5 COST-EFFECTIVE RESOURCES: Visit the Centers for Medicare and Medicaid Services

website as a resource. cms.gov/Medicare/Coding/ICD10/index.html?redirect=/icd10

6 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.

7 REGULATIONS: Know and identify all other regulations and changes so you won’t get

behind as you approach ICD-10 implementation.

8 FILTERING: Filter out the codes you will be using the most for greater efficiency.

9 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.

10 PAYERS: Find out if payers have adopted contractual changes regarding coding

specificity that could affect how you process claims.

11 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.

12 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 third-party 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 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?

13 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.

14 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 ICD-10, 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.

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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 rev-

enue 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.

ICD-10 codes will create an electronic trail of documentation, which will help doctors receive proper payment and ensure that their reputation remains in good standing.


Consultants advise doctors to keep three months of cash flow in reserve to prepare for any delays in pay as ICD-10 implementation gets closer. While some groups continue to push for additional delays, saying the mandate comes at a time when physicians are already dealing with several other technology requirements and risk penalties, several experts recommend that physicians who aren’t ready to comply put themselves at a financial risk.

INCREASING YOUR CASH FLOW EARLYWhile some organizations continue to wait to see

if the compliance date of Oct. 1 will truly stand, some experts caution that waiting for the final date could put your revenue at risk. Robert Wergin, MD, presi-dent 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. Wer-gin 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.

Five Ways to Increase Cash Flow Now:

1 CLEAR EXISTING BLOCKAGES: With the move by health plans to increase deductibles, more patients face higher out-of-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.

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.

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EFFECTIVE REVENUE RECOVERY TECHNIQUES BY SHANA NISSANOFF, CHIEF EXECUTIVE OFFICER OF ECURE (EMERGENCY CARE UNDERPAYMENT RECOVERY EXPERTS)

THE NUMBER ONE MISTAKE

made by medical practices is to

fail to implement a claims audit-

ing process. Even if the practice

sends out a perfectly scrubbed

bill, health insurers will still in-

appropriately deny, delay and

significantly reduce payments.

They may even request refunds

for claims they have overpaid.

By implementing claims auditing

processes, a physician’s practice

can ensure that health insurances

pay appropriately. It’s a two-step

process. Appropriate documen-

tation for patients to sign must be

front-loaded, and denial letters

to health insurers should contain

a legal framework rebutting the

specific denial at hand. This pro-

tects your rights for claims being

underpaid. (continued)

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The first step in ensuring proper payment is to make sure that you understand as a physician or healthcare provider if you are a contracted provider.

Often a healthcare provider thinks they are not contracted and find out later, unbeknownst to them, that their contract was assumed or sold to another carrier, or a “Silent PPO.”

If you happen to be contracted, then you are bound by the terms of your contract. If you are not, then you are not bound by any terms of anyone’s con-tract; rather, the carriers are actually bound by the terms of the law in the state of California. Those legal rules differ for elective cases and for emergent/urgent cases.

In a nutshell, if you are contracted, then based on the benefits that are allowed to the patient in the patient’s benefits contract, you will collect only the amount that has been agreed on be-tween you and the carrier.

Because there are so many insurance companies and so many different plans within each insurance com-pany, this is almost impos-sible to follow except on a case-by-case basis.

If you are not contracted with a carrier for an elec-tive case, then the patient is ultimately responsible for the care they received, unless you verified benefits with the carrier and they told you otherwise. The car-rier, as a general rule, needs to pay for only the ben-efits documented in the patient’s benefit plan. How-ever, when a physician goes into the emergency room or consults on a patient in the hospital, and he is not a participating provider in that particular healthcare plan, then that healthcare plan’s benefits do not pre-vail.

What does prevail is called “usual, customary and reasonable” (UCR) reimbursement. If the payment isn’t paid in full by the carrier (minus the co-pay and deductible), then you, as a non-contracted provider, can have a claim directly against the carrier for your underpaid balances.

The UCR reimbursements are based on a very specific law that entails many factors, including what other physicians in the geographical area bill out, what that specific provider who performed the proce-

dure typically bills out, what specific circumstances are involved, the physician’s experience and specialty and many other factors that are non-tangible. Hence, if at any time a commercial carrier such as an HMO or a PPO does not pay a provider his usual, custom-ary and reasonable reimbursement and reduces it to a different number called the “allowable,” then the provider has the ability to seek further payment.

Once the physician figures out if he is bound by the participating plan’s contract or not, then the next step is to streamline the claims management revenue cycle — your practice’s internally designated work flow that includes the steps you take to prepare, sub-

mit and collect the claim correctly.

The documentation in your notes needs to be all-encompassing. It needs to specify exactly what was done in the text of the note. Furthermore, you cannot rely on billers to read the note and make a decision on your behalf as to what the CPT code should be. It is incumbent on you to fig-ure out what you did and look up the CPT code that

clearly reflects the evaluation, management or proce-dure that you performed in order to be able to submit appropriate claims and not receive a denial.

The carriers are always looking at the CPT codes and then comparing it to actual documentation. If the documentation itself does not reflect the description in the CPT code, they will deny the bill, or worse, consider it fraudulent billing and request a refund if they have already paid it. Again, you cannot rely on any biller to code for you.

The next step is to streamline your claims audit and appeals procedures, i.e., your practice’s internal controls that detect health insurance payment errors and manage submitted claims, and perform the ap-propriate collection efforts to ensure that the health insurer’s processes adjudicate and pay your claims accurately. In other words, the first time an EOB (ex-planation of benefits) comes back to the biller with an explanation as to how the carrier paid that claim, if it was not paid in full, then it needs to be evaluated and deciphered as to why it was not paid in full. Was the entire bill offset because of the patient’s deduct-

Often a healthcare provider thinks they are not contract-ed and find out later, unbe-knownst to them, that their contract was assumed or sold to another carrier, or a “Silent PPO.”

CONTACT US AT:

844.834.8141

[email protected]

15525 Pomerado Rd #E6San Diego, CA 92064

DATA REVIEWWe collect, sort, and organize all of your past unpaid or under-paid out-of-network emergency room claims within the last three years.

ANALYSISWe determine how much was underpaid, why it was underpaid, and what portion is recoverable. This is done through a line-by-line examination of your claims by our team of experts.

RECOVERY Our team of experts is trained extensively in medical collec-tions law and recovery tech-niques. They work tirelessly to recuperate the money owed to you through appeals, phones calls, and if neces-sary, subsequent legal ac-tion against the carriers. We expand on the work already done by your existing staff and billing company to create a mutually beneficial relation-ship between our company and yours.

We start where your billing and collection company stops.

We work to recover your money from insurance plans. We put YOUR money back in your pocket at no cost to you!

ecurehealth.comWe generate an average of $100,000 per year per doctor for claims that were already written off.


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ible? Did the patient meet their out-of-pocket maxi-mum allowable for the year, in which case the carrier should have paid 100 percent of the claim? Did the carrier just indiscriminately decide to pay you as a non-contracted provider the contracted rates that they usually contract with other providers who otherwise get volume discounts for signing those contracts that you are not entitled to?

Until you can deter-mine why the bill was not paid appropriately, you will not know how to ap-peal it correctly. This docu-ment will explain how to simplify your claims audit and appeals process and reduce the administra-tive burden, demystify the health insurance claims appeal process and ex-plain what to do when the insurance carrier flat out denies the appeal.

Physician practices are entitled to fair reimburse-ment and appropriate payment for the procedures and services they provide when they have coded and documented the procedure or services appropriately.

A BILLER IS NOT A COLLECTOR OR AN APPEALS SPECIALIST

Most practices either hire billers internally or send the billing to an outsourced company. Most provid-ers pay a percentage of claims, on an average 5% to 10% of what is collected. Most providers think that the biller is incentivized to collect as much as he pos-sibly can as he is on a percentage basis, and the more that he collects for you, the provider, the more he will keep in his pocket.

This is far from the truth. A biller’s job is to bill. His job is not to collect.

The more claims he bills out correctly, the more bills will eventually be paid. His job, and his incentive, is to bill correctly as many claims as possible one time for each claim.

If the bills go out correctly and they get paid inap-propriately, he still gets his percentage of those pay-ments. If he spent time, effort and energy trying to collect monies that were underpaid or not paid, he

would make far less at the same percentage rate than he would just finding more clients to keep on billing out initial billings.

For example, if a doctor has a $1,000 bill and the biller takes 5%, it will take him about five minutes to bill out the $1,000. If only $100 was collected, he will collect $5, which is 5% of 100. Five dollars for five minutes equates to $60 an hour. If he now

tries to collect the balance of the billings that he has done, which is now $900 ($1,000 minus the $100 collected) with no guaran-tee that he will ever see a penny of that $900 from that insurance carrier, he may spend two to three hours trying to collect it.

Even if he collects the full amount, which is rare, then he would have spent three hours of his time — at $60 an hour, or $180 — but he is only making 5% of the $900, which equates

to $45. This is not economically advantageous to a biller to try to even collect your monies. Therefore you must understand that there is significant differ-ence between a biller and biller’s incentives and a collector and a collector’s incentives.

A collector usually charges anywhere from 30% to 50% of what he collects. There is a reason for his high percentage: It takes so much more time, effort and energy with higher risks of not collecting from the carriers, as the bills have already been billed out correctly, and initial payments have been made.

A practice needs to understand that after the bill-ing is done, the next step is to either send it to an in-house collector or outsource it to a collector that is separate from the biller.

The provider will have to expect that the percent-age he will give to this collector will be substantially higher than the biller would be getting because oth-erwise there would be no reasonable incentive for the collector to collect these monies and spend long hours on the phone, sending letters of appeals, etc.

Even after the collectors have pursued claims against the carriers, they too fail in many ways. The carriers understand that for out-of-network emergen-cy services, they are obligated by law to pay the usu-

Most providers think that the biller is incentivized to collect as much as he possibly can as he is on a percentage basis, and the more that he collects for you, the provider, the more he will keep in his pocket. This is far from the truth.


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al, customary and reasonable rates for these services. They rarely ever do. They understand the econom-

ics. They understand that most practices have billers that just bill and never appeal. For those practices, there is a statute of limitations as to how long before those claims can never be pursued again by law. There is a small percent of practices that actually send their claims that were not paid on the initial billing out to collectors who then appeal those decisions appropri-ately citing case law and attaching supportive docu-mentation to their appeal for the appropriate payments.

There are times when the insurance companies will pay these, but again, most of the time they will not pay the bill in full as they realize that, as the ex-ample above, the $900 underpaid claim will never be taken to court. Therefore they effectively have nothing to worry about. A lawyer will cost a physician any-where from $250 to $500 an hour, and it will take anywhere from 10 to 100 hours to try to collect and litigate for $900. The math here does not work either.

WHAT TO DO WHEN YOU ARE NOT PAID YOUR FULL BILL

So what is a physician/provider to do when the car-rier underpays the biller, does not pay or continues to underpay the collector? The first answer is to complain to the Department of Managed Care, which has an ombudsman who reviews these billings with appropri-ate documentation and makes a determination that is binding on the carrier. Over the past several years of reviewing the percentages of the Department of Man-aged Care’s decisions, it appears that about 50% of the time they do find in favor of the provider. They too are not always correct, but this is an avenue that needs to be addressed by the provider and by the collector.

An alternative to the Department of Managed Care, which can take up to 18 months to get a re-sponse, is to sell the outstanding accounts receiv-able to companies that actually purchase them at a somewhat discounted rate, or purchase them based on a percentage of what they collect in the future. By doing this, the physician has absolved himself of any and all costs associated with collections and has monetized his zeroed-out balances and dead accounts receivable. These companies consolidate claims from multiple providers, and as an example, they take a thousand providers that have $900 bal-ances, and now have a case that they litigate against the carrier for $900,000. In this situation the econom-

ics actually makes sense. They create a mini class ac-tion lawsuit against the carrier, and the attorney fees and costs now are economically beneficial and rea-sonable to the litigated case at hand.

One of these companies is ECURE out of California. They will purchase and take assignment of claims and consolidate them with other providers in order to cre-ate an economically beneficial case against the carrier.

Once this actually happens and the company that purchased the accounts receivables is successful in either settling or winning a case in the courts of California, the carriers usually will start paying those providers appropriately, understanding that their legal fees are going to exceed the cost of paying the pro-viders appropriately from the get-go. This is the only way to turn the tables on the carriers and have them follow the rules and force them to follow the rules of the law.

For more information contact ECURE at (844) 834-8141.


FIVE SMART WAYS TO

Cut Your Income Taxes in 2015 BY DAVID DENNISTON, CFA

TODAY’S WORLD IS an incredibly tax-unfriendly environment for physicians. And

by increasing your taxes due to the provisions of the Affordable Care Act, Uncle

Sam is out to get even more! The good news is that there are several steps that you

can take to be proactive and keep more money in your pocket. Here’s how you can

minimize your tax burden and improve your specific situation.

FEBRUARY 2015 | W W W. P H YS I C I A N S N E W S N E T WO R K .COM 2 1

Pay Yourself First | Start contributing to your 401(k) plan (or 403(b) plan if you work for a nonprofit) as well as a 457(b) and a Health Savings Account (HSA) if they are available. Contributing boosts your retirement sav-ings and lowers your income taxes as well. This money comes right out of your paycheck, withheld by your employer.

By contributing to your 401(k), every dollar you put in gives you a discount on your federal income taxes. For example, if you are in the 35% bracket, and you contribute $10,000, you have just lowered your taxes by $3,500. That’s like a 35% rate of return on your money today that can grow tax-free until you withdraw it someday, when it will be taxed likely at a lower rate.

Be sure to contribute at least up to the maximum match your employer provides. If your employer matches dollar-for-dollar, this is like an automatic 100% return. Even if your employer matches 50 cents or 25 cents on the dollar, that is still a 50% or 25% return just for contributing.

Get close as you can to maxing out your contribu-tion. If you are under 50 years old, the maximum you can put in the 401(k) is $18,000 in 2015. If you are over 50 years old, you may do an additional catch-up contribution of $5,500 for a total of $23,500.

Set Up a Business or Moonlight as a Consultant | The American tax code is set up to benefit one person: the business owner. There are many potential write-offs, including using a home office, which allows for many deductions. For instance, you could remodel your basement as a tax-deductible home office, and deduct 100% of all costs, such as utilities, insurance and depreciation, related to the office. Keep in mind, you don’t have to be the business owner; it can be your spouse.

Avoid Tax-Inefficient Funds | You can control capital gains and dividends when you own individual stocks and exchange-traded funds,, because you can sell them anytime. Unfortunately, it is much more difficult to control them with mutual funds. Mutual funds will dis-tribute capital gains even when you haven’t sold any-thing, a phenomenon called “phantom capital gains.” As assets come into a fund, the portfolio manager will buy stocks or other securities. Then, when investors re-deem their money, the manager will have to sell stocks or other securities, creating taxable distributions. This can be bad news for tax efficiency. If you are in a “hot fund” that had capital gains from unsold positions that the manager bought years earlier (before you invested in the fund), and investors start pulling out dough, you could be left with a big tax bill. You could actually lose money in a mutual fund and still get caught with a big capital-gain distribution. Be very careful which mutual

funds you invest in. Some managers are incredibly tax-efficient, but many are not.

Harvest Capital Losses | The idea of tax harvesting is to purposely create capital gains or capital losses to maximize your tax advantages. Of course, the govern-ment has no ceiling on the amount it can tax you for capital gains. However, it does it have a floor on capi-tal losses: $3,000 per year. Net losses above $3,000 must be carried over into the following year. Perhaps you have no carry-forward losses and you have real-ized some capital gains. Instead, you may have some capital losses that you can harvest to offset the gains and perhaps even create a loss for the year. It’s simply a matter of selling one or more losers while holding onto your winners.

Be Charitable | By donating to charity, you can get a tax deduction by unleashing your giving spirit. If you can get your itemized deductions above the amount of the standard deduction, you can have a higher tax write-off than many Americans. Remember your state income taxes are counted towards your itemized de-ductions, as well as mortgage interest. By adding some charitable giving to the mix, most of us can easily exceed the standard deduction limits and be able to itemize instead. There’s no minimum to the amount of charitable gifts you can report. However, if your contri-bution entitles you to merchandise, goods, or services, including admission to a charity ball, banquet, theat-rical performance, or sporting event, you can deduct only the amount that exceeds the fair market value of the benefit received. For a contribution of cash, check, or other monetary gift (regardless of amount), you must maintain as a record of the contribution a bank or credit-card record or a written communication from the qualified charity containing the name of the organization, date of the contribution, and the amount.

As a physician, you’ve made a commitment to helping others and your community.

Now you need to make a similar commitment to your finances.

You can fight back at Uncle Sam through focusing on reducing your taxes by contributing to your retire-ment, setting up your own business, harvesting losses, avoiding tax-inefficient funds, and being charitable.

By being proactive with your tax situation, you can then do the things you’ve long dreamed of doing and be well down the road to financial independence.

About the Author: Dave Denniston, Chartered Financial Analyst (CFA), is a professional wealth manager and financial advisor located in Bloomington, MN. He is also the author of 5 Steps to Get out of Debt for Physicians, The Insurance Guide for Doctors, The Tax Reduction Prescription, and his upcoming book The Freedom Formula for Physicians. You can contact him at (800) 548-1820, at [email protected], or visit his website at www.DoctorFreedomBook.com to get a copy of The Freedom Formula for Physicians.


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The California Medical Association (CMA) recently submitted comments to the California Department of Health Care Services (DHCS) on the state’s next 1115 Section Medicaid Waiver, telling DHCS that increasing reimbursement rates is absolutely impera-tive prior to implementation of any new program reforms. Cali-fornia’s current Medi-Cal rates often do not even come close to the cost of providing care.

California is in the last year of its current Section 1115 waiv-er, which was approved by the federal government so California could expand Medi-Cal coverage in accordance with the Afford-able Care Act in 2010 and implement a variety of delivery reform projects like the duals demonstration project.

The state’s current five-year waiver is set to expire October 2015. CMA has participated in a number of work groups de-signed by DHCS to receive feedback on what new projects the state would implement in the next waiver. The state convened work groups in order to explore ways to implement incentive payments to providers participating in the Medi-Cal program and how to increase and maintain the physician workforce in the state of California.

CMA commented that the 10 percent provider reimbursement cut authorized by AB 97, on top of California’s already abysmally low provider reimbursement rates, which have not been adjusted for increasing costs in two decades, and the discontinuation of the Affordable Care Act’s pay bump for primary care providers, makes it very difficult for physicians to accept new Medi-Cal patients—placing roadblocks for patient access to care.

CMA made it clear that increasing rates is a prerequisite to implementing incentive payment reforms. CMA called for the state to conduct an independent, third-party assessment on re-imbursement rates, stating that such an assessment is a critical component in determining both the baseline rates and the level of incentive payments required.

CMA also commented on workforce development, calling for the funding of new residency programs and the expansion of Song-Brown and Steven M. Thompson Physician Corps Loan Repayment Programs.

DHCS is expected to enter into negotiations with the Center for Medicare and Medicaid Services on the new waiver in the spring of 2015.

CMA TELLS DHCS Medi-Cal Payments Must Be Raised BEFORE IMPLEMENTING ANY NEW REFORMS

CMA Elects New Chair for Board of Trustees

The California Medical Association (CMA) has elected David H. Aizuss, MD, David H. Aizuss, M.D. as the new Chair of the Board of Trustees. This is the first time in twenty years a Los Angeles County Medical Association (LACMA) member has been elected CMA chair.

A board-certified ophthalmologist who practices in Los Angeles, Dr. Ai-zuss exclusively places focus on direct

patient care. He has served as vice chair of the CMA board since 2011 and was a former president of the LACMA and the California Academy of Eye Physicians and Surgeons.

“I am honored to have been elected. The association is dedi-cated to serving its members and advancing the public health of the citizens of California,” said Dr. Aizuss. “CMA is the single most effective voice for physician advocacy in our state Legislature and before state regulatory bodies.”

Pedram Salimpour, MD, president of LACMA, applauded the electoral results. “We are proud to have one of our own serving on such a highly regarded board,” Dr. Salimpour said. “Dr. Aizuss is one of the most highly respected clinicians and physician leaders in California, and I take very personal pride in that he has been a close associate of my family’s for many years.”

“I am proud of the physicians who put their reputations and pocketbooks on the line in the interest of their patients. To have such a compassionate and dedicated physician as the new chair of CMA strengthens our voice in our advocacy for the patients our physicians serve,” stated Rocky Delgadillo, chief executive officer of LACMA, after hearing of the electoral results.

AMA Asks Feds to Decouple EHR Certification from Meaningful Use

The American Medical Association (AMA) has sent a letter to the National Coordinator for Health Information Technology, Karen B. De-Salvo, MD, urging that the certification of elec-tronic health records (EHR) be decoupled from meaningful use certification requirements. “Un-fortunately, we believe the meaningful use cer-tification requirements are contributing to EHR system problems, and we are worried about the downstream effects on patient safety,” the letter said.

“Many physicians find these systems cum-bersome, do not meet their workflow needs, decrease efficiency, and have a limited, if any, in-teroperability,” the letter said. ”Most important-ly, certified EHR technology can present safety concerns for patients.”

AMA believes there is an urgent need to change the current certification program to bet-ter align end-to-end testing to focus on EHR us-ability, interoperability and safety.

The letter was also signed by 35 medical so-cieties and specialty societies.

© 2015 NORCAL Mutual Insurance Company

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.

MEDICAL PROFESSIONAL LIABILITY INSURANCE FOR PHYSICIANS BY PHYSICIANS

Visit heart.norcalmutual.com or call your agent/broker today. 844.4NORCAL (844.466.7225)

© 2015 NORCAL Mutual Insurance Company

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.

MEDICAL PROFESSIONAL LIABILITY INSURANCE FOR PHYSICIANS BY PHYSICIANS

Visit heart.norcalmutual.com or call your agent/broker today. 844.4NORCAL (844.466.7225)


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CEO’s LETTER

THIS FEBRUARY, LACMA is excited to continue to serve, expand and provide new offerings to its rising numbers of distinguished physician members.

As part of our ongoing outstanding series of events and efforts to keep physicians on the cutting edge of knowledge and learning during this time of change in the health sector, we are thrilled to highlight three programs you don’t want to miss this February.

Kicking off our February series on Feb. 7 is a seminar on “Disruptive Behavior and the Medical Staff’s Response” presented by the California Public Protection and Physician Health Inc.

Speakers Tom Curtis, an attorney with Nossaman LLP, and Karen Miotto, MD, chair of the UCLA Medical Staff Health Committee, will discuss key is-sues every member and staff of physician health committees in hospitals, medical groups, county medical societies and specialty societies need to be aware of when addressing disruptive behavior.

Curtis has more than 35 years of experience representing clients in the healthcare sector on a wide range of issues. Dr. Miotto is an expert on issues pertaining to well-being and emotional health of physicians. She frequently talks about the rising stress of practicing in the changing health environment and the alarming rise of physician burnout to physician leaders and groups.

On Feb. 11, LACMA is proud to present another event, the “Ambulatory Care Centers Committee Panel Discussion,” which will focus on such topics as accreditation of surgery centers, reimbursement of claims and physician intimidation.

This event will take place from 7-9 p.m. in Beverly Hills at a location that will soon be announced on the LACMA events website.

Our distinguished Women Physicians Action Committee is proud to pres-ent a topic that is near and dear to every woman’s heart—namely how to best manage finances and plan for the now and the future to ensure financial

stability and security. The experts on money issues will delve into accounting, financial planning and contract

negotiation issues specifically as they pertain to female physicians. Whether you’re a female physician working in your own practice, are employed or have

employees, this seminar will pave the way to your successful financial planning for 2015.As always, you will find more information and registration details on LACMA’s website in

the events section. In our efforts to continually serve you better, we are currently researching a new address

in the downtown area of LA as our lease expires.I look forward to seeing many of you during an upcoming event and am excited about the

many opportunities as well as challenges that will present themselves during this new year.

Rocky DelgadilloChief Executive Officer


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THE DISTRICT 2 ALLIANCE celebrated its

75th anniversary in style with an event

held in a doctor’s beautiful garden and a

delicious catered dinner and wonderful

entertainment enjoyed by 115 physicians,

spouses and friends of medicine.

Success in achieving camaraderie across the full medical specialty spectrum and turf lines was dramatically evident. The Pasadena Symphony Quartet performance was a special bonus.

California Assemblyman Chris Holden and California Representatives in the U.S. Congress Adam Schiff and Judy Chu provided congratula-tory certificates. A hand-painted scroll from LA Supervisor Mike Antonovich wowed the crowd as it was presented by Helen Chen, MD, radiolo-gist at City of Hope Cancer Center in Southern Pasadena and a former intern with Holt Rose, MD, cho-emcee of the event. Lois Matthews, Huntington Hospital Board, praised District 2 president Halaine Rose and her active all-volunteer organization.

At the party, the D2 Alliance in honor of its diamond anniversary, raised $5,000 for HMRI migraine research led by Mike Har-rington, MD, and $3,200 for the District 2 Alliance MD student scholarship fund.

Co-emcee Dr. Holt Rose commended D2 Alliance—greater Pasadena region—for working vigorously to educate colleagues and other voters to preserve the Medical Injury Compensation Reform Act by voting “No on 46.”

A presentation by Gordon Sasaki, MD, and Halaine Rose, plus Halaine’s archival photo books, gave insight into the stellar record of Alliance D2 in health education, legislative advocacy, physician and patient support.

Special thanks to Joanne and Gordon Sasaki, MD, Cathy and William Caton, MD, Halaine and Holt Rose, MD, for financial and diamond input, Team 75 -- hosts Nancy and Dave Rhodes, MD, co-emcee Vivien and Willaim Foran, MD, Marilyn and Eden Henderson, Georgiana Wu, Sara Gaspard, MD, Jan and Dave Moritz, MD, and Debra Fallon.

DISTRICT 2 ALLIANCE

75th Diamond AnniversaryBY HALAINE ROSE

Dr. Helen Chen (second from right) presents painted scroll from LA County Board of Supervi-sors honoring 75 years of health, education and community service of D2 Alliance to current president Halaine Rose (center) and former presidents (left to right) Betty Falk, Joan Dietrick and Carole Roback.


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TO PLACE A CLASSIFIED AD VISIT WWW.PHYSICIANSNEWSNETWORK.COM OR CONTACT DARI PEBDANI AT [email protected] OR 858-231-1231.

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• Physicians• Nurse Practitioners • Physician Assistants

LOCUM TENENSPERMANENT PLACEMENT

800-919-9141 • 805-641-9141FAX: 805-641-9143

email: [email protected]

PRACTICE FOR SALE/LEASE

OB-GYNECOLOGY PRACTICE FOR SALE

at Los Angeles suburb. Please write to [email protected]

TRACY ZWEIG ASSOCIATES, INC.

• Physicians• Nurse Practitioners • Physician Assistants

LOCUM TENENSPERMANENT PLACEMENT

800-919-9141 • 805-641-9141FAX: 805-641-9143

email: [email protected]

OPPORTUNITY OFFERED

PHYSICIAN – FAMILY MEDICINE

Located in Vista, California, Vista Community Clinic is a private, nonprofit outpatient community clinic located in North San Diego County serving people who expe-rience social, cultural or economic barriers to health care in a com-prehensive, high quality setting.

POSITION: Full-time, Part-time and Per Diem Family Medicine Physicians.

RESPONSIBILITIES: Provides outpatient care to clinic patients and ensures quality assurance. Malpractice coverage is provided by Clinic.

REQUIREMENTS: California li-cense, DEA license, CPR certifica-tion and board certified in fam-ily medicine. Bilingual English/Spanish preferred.

CONTACT US: Visit our website at www.vistacommunityclinic.org Forward resume to [email protected] or fax resume to 760 414 3702.EEO/AA/M/F/Vet/ Disabled

OFFICE SPACE FOR LEASE

MEDICAL OFFICESPACE AVAILABLE• Panorama City• Arleta • Highland Park • Pasadena • Inglewood • Compton

• West Covina• Pomona• Ontario• San Bernardino• Riverside• Colton

1,000-7,000 SQ.FT.FOR DETAILS, CALL:323-653-3777

TURN-KEY OFFICE CARMEL VALLEY

Class A medical office building avail-able in prime location in Carmel Val-ley, San Diego. Full or Part Time oc-cupancy for medical or allied health professional. Dedicated free park-ing garage for patients/clients. Fully equipped and furnished. Suite 1000 sq feet with 2 large treatment rooms, breakroom, photography and recep-tion area. Rates dependent on use. Contact [email protected] or 619-218-8980. PRACTICE SERVICES

CME PROGRAM ACCREDITATION

ASSISTANCEIf you need assistance getting your CME program accredited in your hos-pital, medical group, IPA and/or ACO, contact [email protected].

Place Your Classified Ad Today!

PhysiciansNewsNetwork.com


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Cooperative of American Physicians ................................3

Fenton Law Group.........................................................25

Kinecta ............................................................................5

Mercer ..........................................................................C4

Nelson Hardiman ..........................................................19

NORCAL ......................................................................23

Office Ally .....................................................................C3

RPM Mortgage ................................................................9

UCLA ............................................................................C2

TO PLACE A CLASSIFIED AD VISIT WWW.PHYSICIANSNEWSNETWORK.COM OR CONTACT DARI PEBDANI AT [email protected] OR 858-231-1231.

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• Full or part-time positions

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PLEASE CONTACT US FOR MORE INFORMATION:Phone: 1-877-878-3289 Fax: 1-877-817-3227

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Today! PhysiciansNewsNetwork.com

THE 28TH ANNUAL “HIV/AIDS

ON THE FRONT LINE” CONFERENCE

UC Irvine Student Center,

Irvine, CAWednesday,

April 22, 20158:00am-5:00pm

This activity is approved for a maximum of 6.5 AMA PRA Category 1 credit

Topics Include: HIV Update, Global Epidemiology, Hep C, Retention & Care, STD’s, Acute HIV Care, Incarcera-tion & HIV, and Prevention

For more information & to register, please

visit:

WWW.HIVCONFERENCE.ORG Blanca Guardado (714) 456-7734

CME

scorescore

TOP10REASONSFOR JOINING LACMA AND CMA

Working together, the Los Angeles County Medical Association and the California Medical Association are strong advocates for all physicians and for the profession of medicine. Of the many reasons for joining LACMA and CMA, 10 stand out.

LACMA/CMA IS THE VOICE OF PHYSICIANS

1Legislative AdvocacyLACMA and CMA are distinguished by their successes. Dual membership provides for unparalleled legislative advocacy to end abusive practices. In addition, LACMA has sued health care plans on behalf of members to stop intimidation tactics.

two FREE Reimbursement Assistance

Tired of fighting with payors? CMA’s Economic Services experts have recovered nearly $8 million for members since 2010!

3 FREE Jury Duty AssistanceLACMA can help you: • Reschedule your date • Relocate for your convenience • Reduce number of call-in days from 5 to 1!

27% in AVERAGE SAVINGSThrough an exclusive partnershipwith Medline, LACMA saves members a guaranteed minimum of 10% on their medical supplies and equipment. Find out how one member saved $31,000 for his practice!

4

Benefits & DiscountsAimed at meeting both your professional and personal needs, LACMA offers you additional discounts and savings on Auto & Home Insurance, UPS services, Staples office supplies, Financial Planning, HIPAA Compliance Kits, and more!

five

FREE CME & Educational ResourcesCMA develops toolkits, guides, webinars, and resources on all things related to today’s changing healthcare landscape—all FREE with membership. In addition, LACMA provides access to important and local CME-accredited events.

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8FREE Networking & Referral Events• Socialize and network with members of the medical community• Find or create opportunities for your practice• Engage with legislators and policymakers

Unlimited Access to Legal ExpertsSave time and money by consulting with a CMA legal expert before hiring a lawyer. Services include HIPAA Compliance, ACOs, Buying and selling a practice, Upkeep of medical records, and much more!

9 State-of-the-Art CommunicationInformation is power. LACMA and CMA produce several publications full of valuable information including the award-winning Physician Magazine, Physicians’ News Network, and CMA Practice Resources, full of tips and tools for your practice.

tenAccess to your Physician AdvocatesWhen you join LACMA and CMA, you hire a professional staff that serves as an extension of your practice. We are here to help you reach your goals and connect to the resources you need most. Whatever you need—be it help with a problematic payor, or details about your member discounts—just call the member helpline at (800) 786-4262 or visit www.lacmanet.org

LOS ANGELES COUNTY MEDICAL ASSOCIATION707 WILSHIRE BLVD, SUITE 3800

LOS ANGELES, CA 90017

PHONE: (213) 683-9900FAX: (213) 226-0353

For more information on member benefits and resources, visit www.lacmanet.org/Membership

RIGHT NOWis the best time to join LACMA and CMA

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Mercer provides a wide range of health insurance options and guidance tomembers of the Los Angeles County Medical Association. We connect you withthe top group insurance carriers and help you choose the coverage that best fits yourneeds and budget. We offer flexibility and value so you can provide quality health, dental,life and disability plans to your employees.

Small Group (2 to 50 employees) coverage is available for all business forms that includeat least one non-spouse W-2 employee in addition to the owner(s). Tax form verificationof your status as a small group is required. We can help you to determine whether yourbusiness structure and enrollment will qualify for small group coverage if you are not sure.

Plus, members who purchase their group health insurance through Mercer, the Association’s sponsored insurance program broker and administrator, are eligible to receive Mercer Select H&B KnowHow. Developed by Mercer, a leader in human resource consulting, outsourcing and investments, Mercer Select H&B KnowHow is a tool that helps provide employers with important human resources information suchas the latest health and benefit requirements for California, and it provides the formsneeded for compliance.

For more information, contact a Mercer Client Advisor at 800-842-3761, or visitwww.CountyCMAMemberInsurance.com.

Are you aware that small groups can change theirhealth insurance at any time throughout the year?

70829 (2/15) Mercer Health & Benefits Insurance Services LLC • CA Ins. Lic. #0G39709Copyright 2015 Mercer LLC. All rights reserved. • 777 South Figueroa Street, Los Angeles, CA 90017 • [email protected] • www.CountyCMAMemberInsurance.com

Sponsored by:

MERCER Project 70829, LACMA, (2/15)

Full Size: 8.375” x 10.875” Bleed: .125”Folds to: N/A Perf: N/AColors: 4c = processStock: N/APostage: N/AMisc: N/A

Health InsuranceGroup

LACMA Feb 2015 Medical Ad - 70829_FEB 2015 AD 1/8/15 3:59 PM Page 1

Download - February 2015 | Physician Magazine

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