Saturday, December 16, 2017

OCMA Blog

Physician Advocate Tip of the Month: Verifying your patients' eligibility and benefits

March Tip:

Verifying your patients' eligibility and benefits in 2014 may save your practice thousands of dollars

The beginning of a new year means calendar year deductibles and visit frequency limitations start over. Remember, with open enrollment there may be changes to patients' benefit plans, or they may even be insured through a new payor. Physicians are urged at this time of the year to be diligent in verifying patients' eligibility and benefits to ensure that you will be paid for services rendered.
 
And don't forget that under the ACA, patients receiving premium assistance through federal tax subsidies are given a 90-day grace period in which to pay their portion of the premium. During the first 30 days of the grace period, the plans must pay for services incurred. However, during days 31-90 of the grace period, plans are allowed to suspend the patient's coverage
 
Don't get stuck with unnecessary denials or an upset patient. Do your homework before the patient arrives by obtaining updated insurance information at the time of scheduling, if possible, and making copies of the insurance card at the time of the visit. 

Receiving practice management guidance from Mitzi is a FREE OCMA member benefit!

Contact Mitzi to schedule a one-on-one consultation to discuss your practice management needs: 

Mitzi Young
Physician Advocate, CMA Center for Economic Services
888.236.0267
myoung@cmanet.org


Physician Advocate Tip of the Month - What you need to know about "the grace period"

February Tip:
What You Need to Know About "The Grace Period"

 Federal law allows Covered CA enrollees who receive financial subsidies to keep their health insurance for three months, even if they have stopped paying their premiums. This is known as the "grace period."

CMA made significant progress through their advocacy efforts to help ensure that physicians are not on the hook for unpaid claims in months two and three of the three-month grace period. Instead, coverage will be suspended during those two months. CMA has prepared an easy-to-understand fact sheet to help physicians and their staff understand what the grace period means for their practices and their patients. Click here to download a copy of the grace period fact sheet.

 Upcoming: OCMA Exchange Seminar  

Mitzi Young, OCMA/CMA Physician Advocate, will be hosting an exchange seminar at OCMA on Thursday, February 27. The seminar will focus on how the California health benefit exchange will affect physician practices. Attendance for this seminar is free for OCMA members. For more information and to RSVP, visit https://caexchange.eventbrite.com.


Receiving practice management guidance from Mitzi is a FREE OCMA member benefit!


Contact Mitzi to schedule a one-on-one consultation to discuss your practice management needs:

Mitzi Young
Physician Advocate, CMA Center for Economic Services
888.236.0267
myoung@cmanet.org


May Tip of the Month from OCMA Physician Advocate, Mitzi Young

May Tip:

"The Health Exchange is coming...get ready now!  With the implementation of the Patient Protection and Affordable Care Act (ACA), two thirds of California's uninsured will be covered by private insurance through a health insurance exchange purchasing pool. The exchange's goal is to start pre-enrollment in October 2013.

We have developed a toolkit to educate physicians on the exchange and ensure that they are aware of important issues related to exchange plan contracting. The toolkit is available free to OCMA /CMA members only at www.cmanet.org/exchange."

Receiving practice management guidance from Mitzi is a FREE OCMA member benefit!

Mitzi Young
Physician Advocate, Center for Economic Services
888.236.0267
myoung@cmanet.org


Practice Management Tip of the Month from OCMA Physician Advocate, Mitzi Young

April Tip:


"A reminder that as of April 1, 2013, Medicare reimbursement for physicians will be cut by 2 percent.

With no solution on the horizon to the budgetary woes in Congress, physicians should be prepared for the 2 percent reduction in reimbursement from the Medicare program. The 2 percent Medicare cuts are part of the $1.2 trillion in cuts required by the Sequestration Transparency Act. Medicaid is exempt from the cuts."

Receiving practice management guidance from Mitzi is a FREE OCMA member benefit! 

Contact Mitzi to schedule a one-on-one consultation to discuss your practice management needs:

Mitzi Young
Physician Advocate, CMA Center for Economic Services
888.236.0267
myoung@cmanet.org 


How Should You Deal With Negative Online Reviews?

"Had to wait 1 1/2 hours."
"The staff was horrible, rude and unprofessional."
'The doctor misdiagnosed my problem."

In the past, a physician's reputation and practice were built by word of mouth. Today, word of mouth is no longer limited to people talking face-to-face. Websites, such as Yelp.com, AngiesList.com, HealthGrades.com, RateMDs.com and Vitals.com, allow anyone with access to a computer to share his or her opinion about a physician with the public at large.

Physicians tend to focus on the negative comments, but not all comments are negative. A recently published study in the Journal of Internal Medicine found that an overwhelming number (88 percent) of online reviews for physicians were positive. The following is an excerpt of the study:

We identified 33 physician-rating websites, which contained 190 reviews for 81 physicians. Most reviews were positive (88%). Six percent were negative, and six percent were neutral. Generalists and subspecialists did not significantly differ in number or nature of reviews. We identified several narrative reviews that appeared to be written by the physicians themselves.

The CAP Hotline has received an increasing number of calls from physicians asking how to respond to negative comments. So what can a physician do in response to a negative online opinion? Some physicians fear that negative comments may harm their reputation and want to seek legal remedies to battle unsubstantiated online libel and defamation. This may not always be the best solution to the problem. Lawsuits are time consuming, expensive, and may not produce the outcome desired by the physician. Courts may view negative statements made online at review websites as opinion, not fact.

Physicians should accept that rating websites are here to stay, at least for the foreseeable future. An occasional unfavorable review must be seen as a cost of doing business in the age of social media. If a physician desires to respond to a negative comment, much caution and thought should be put into the method and type of response. Some websites, like Yelp.com, have sections in its "Support Center" for business owners which discuss how to respond to comments.

Whether to respond is a personal choice and should be given careful consideration. A response may be made publicly or in private to the individual. All responses should be kept simple, polite, honest, professional, and compassionate. If the criticism is true, it should also describe what changes are being made to prevent this from occurring in the future. You may end your reply by showing that you care by stating: "Thank you. We appreciate all feedback."

What other steps can be taken to address patient opinions?

  • Go online and see what is being said about your practice.
  • Assign a staff member to regularly monitor these sites.
  • Update incorrect demographic information.
  • Personalize your comments with a clear professional photo.
If a comment is not appropriate, consider taking another approach. CAP provides free Patient Satisfaction Surveys to its members. In today's environment, a satisfied patient is an important part of a successful practice and it is better for the feedback to come directly to you and not to the Internet.

If you are a CAP member, we encourage you to take advantage of this free opportunity, by calling 800-252-7706 to request a packet of 100 surveys.

If you are not yet a member of CAP but are interested in learning more about the myriad benefits of membership, including superior medical professional liability coverage, contact Membership Development at 800-356-5672 or request an online quote at www.CAPphysicians.com/join.

Ann Whitehead is a Senior Risk Management & Patient Safety Specialist for the Cooperative of American Physicians, Inc.

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