Saturday, December 16, 2017

OCMA Blog

Physician Advocate Mid-Year Report: 127,000 Reasons to be Member

127,000 REASONS TO BE A MEMBER


The California Medical Association's (CMA) Center for Economic Services' (CES) reimbursement specialists have recouped $127,168 on behalf of physician members of OCMA since the beginning of 2014!

Mitzi Young is OCMA's Physician Advocate from CMA's CES team. Since the start of 2014, Mitzi has met with over 43 physician practices to assist with practice management needs and perform complimentary practice assessments. 

Your Personal Physician Advocate
Meet Mitzi Young, staff member and CMA Center for Economic Services (CES) Physician Advocate for the OCMA. Mitzi is dedicated to handling your practice management issues and is only a phone call away!

Mitzi brings 21 years of practice management experience and expertise in the health care industry. She has worked in numerous health care settings including county organized health programs, surgery centers and specialty health care practices. 
 
Mitzi understands the needs of physicians and their staff, the challenges that face medical practices, and is very passionate about advocating on behalf of doctors in the ever-changing healthcare environment.

 

When do you call Mitzi?

  • When you have questions about Covered California
  • When your claims are not being paid in a timely manner
  • When you are not being paid according to your contract
  • When your claims are being denied after obtaining prior authorization or verifying eligibility
  • When you receive unreasonable requests for medical records or untimely requests for refunds
  • When you are having difficulty obtaining fee schedules and/or payment rules
  • When your claims are denied despite timely filing
  • When you've been presented with a managed care contract and you're not sure if the terms are consistent with California law
  • When you've done everything you can to resolve an issue with a payor and have been unsuccessful
  • When you need help evaluating your practice
  • When you need ANY practice management guidance

Would you like a FREE Practice Assessment?

Find opportunities to increase revenue through the billing process, accounts receivable and collections. Increase efficiency with patient scheduling, appointments and check-in process and discuss all of your practice-related concerns. Contact Mitzi to schedule your member-only practice assessment.
 
Receiving practice management guidance from Mitzi Young 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

Not a member?

Join today!  
Contact Mark Morones, Director of Membership:
(949) 398-8103
mmorones@ocma.org


Physician Advocate Tip of the Month: Identify Covered California patients who are in months two and three of the Grace Period

July Tip:

Identify Covered California patients who are in months two and three of the Grace Period using the following verification codes:

Plan Name 

Eligibility Code

 Anthem Blue Cross  "Inactive pending investigation"  
 Blue Shield of California   "Pended" 
 Health Net  "Eligibility suspended"

 

What are your options if a patient presents with inactive coverage? Download "Surviving Covered California: Tip Sheet #4" (a member-only resource) at www.cmanet.org/exchange.

Would you like a FREE Practice Assessment?

Find opportunities to increase revenue with the billing process, accounts receivable and collections and discuss all of your concerns. Increase efficiency with patient scheduling, appointments and check-in process. Contact Mitzi to schedule your member-only practice assessment.
 
Receiving practice management guidance from Mitzi Young is a FREE OCMA member benefit!
Mitzi Young
Physician Advocate, CMA Center for Economic Services
888.236.0267
myoung@cmanet.org


MICRA lawsuit measure assigned proposition number

Via the California Medical Association-

The unprecedentedly broad and diverse coalition working to defeat the trial lawyers’ MICRA lawsuit measure is now officially the “No On 46” campaign, following the assignment of proposition numbers to qualified ballot measures by the Secretary of State’s Office on Monday.

If approved by voters, Proposition 46 would increase health costs, reduce access to care and threaten patient privacy, all to make it easier and more profitable for lawyers to sue doctors and hospitals. In addition to increasing the overall number of medical lawsuits and the cost of health care across the board, Proposition 46 contains a number of unrelated provisions designed to mislead and deceive voters – including a little-discussed mandate relying on a massive expansion of a government-run prescription drug database, which third-party analysts say cannot be implemented as written and will leave personal medical information vulnerable to privacy breach.

For these reasons, health providers, education groups, labor unions, business organizations, working men and women, and community clinics have all announced their opposition to Proposition 46.

On Monday, two additional groups – the State Building and Construction Trades Council of California (SBCTC) and the California NAACP – joined the “No On 46” campaign, pointing out the devastating effects it would have on California.

“This initiative will cost state and local governments hundreds of millions dollars and raise health costs for everyone,” said Robbie Hunter, President of the SBCTC. “That hurts job creation and will negatively impact California’s future.”

According to California’s independent Legislative Analyst, the proposed measure could increase state and local government health costs by “hundreds of millions of dollars annually.”

“This measure is terribly flawed and will reduce access to quality health care for underserved communities,” said Alice Huffman, President of the California NAACP. “At a time when we’re working hard to cover as many Californians as possible under the ACA, Proposition 46 takes us in the wrong direction. Proposition 46 will disproportionately hurt minority communities. It’s bad medicine for California.”

These two organizations join the growing list of California public entities and private organizations that have announced their formal opposition. For a complete list, please visit the campaign website, www.noon46.com.


IMQ Expands Peer Review Services

Does your medical staff need help with peer review? The Institute for Medical Quality is expanding its services to include Clinical Case Review of individual cases and Judicial Review services in addition to our existing Comprehensive Peer Review services.
 

Through off-site patient chart review, an IMQ Clinical Case Review consultation provides an objective evaluation of the clinical practice of one or more physician members of a hospital medical staff, physician group, or ambulatory care practice through peer review of selected cases. IMQ's involvement is especially helpful when an organization will benefit from expert review of one or more patient cases, but needs physicians of the appropriate specialty who have no real or perceived conflicts of interest.

Additionally, IMQ is seeking physicians to support this expansion of services. For more information about any of IMQ’s peer review services, or about becoming a physician reviewer, please contact Julie Hopkins at 415-882-5165 or jhopkins@imq.org


Home   |   About Us   |   Membership   |   For Physicians   |   News   |   For Patients   |   Advocacy   |   Events
Copyright (c) 2017 Orange County Medical Association