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JULY / AUGUST 2013  |  Volume 19  |  Number 4

7%

30%

N DISCOUNT OANCE R U S IN L A C NOR

DISCOUNT ON WASTE MANAGEMENT

10%

DISCOUNT ON INSURANCE BENEFITS

IT’S ALL ABOUT THE BENEFITS VALUE


A former employee sued me for wrongful termination.

You are not alone. Employment-related lawsuits are more common. What many physicians don’t realize is that help is literally a phone call away. SCCMA/MCMS members have access to a unique blend of risk management services and insurance specifically designed to assist physician groups in addressing these important employment issues. Among the features of the sponsored Employment Practices Liability program are: A Helpline staffed by experienced employment defense attorneys. Any manager, officer or principal of your practice has access to the Helpline for obtaining advice on handling workplace issues, including internal sexual harassment complaints, discipline and employee terminations.

For more information on these important benefits, and the special SCCMA/MCMS First-Time Buyers program, please contact Marsh at: 800-842-3761 or email us at CMACounty.Insurance@marsh.com

If a member seeks and follows Helpline advice on an employee termination or demotion which later results in a claim, there is a 50% reduction of the member’s EPLI deductible for that claim. Free, comprehensive criminal background checks for newly hired and promoted managers/supervisors.

Sponsored by:

EEO compliance training for managers/supervisors. An internetbased training program, compliant with California law, provides supervisors with sexual harassment training. Optimal Wage and Hour Defense Coverage. Ask about our First-Time Buyers Program.

61132 (7/13) ©Seabury & Smith, Inc. 2013 • 777 S. Figueroa St., Los Angeles, CA 90017 www.CountyCMAMemberInsurance.com • CMACounty.Insurance@marsh.com

d/b/a in CA Seabury & Smith Insurance Program Management • CA Ins. Lic. #0633005 • AR Ins. Lic. #245544 • 800-842-3761 2 | THE BULLETIN | JULY / AUGUST 2013

SPECIAL MEMBER BENEFITS EDITION


BULLETIN THE

Official magazine of the Santa Clara County Medical Association and the Monterey County Medical Society

700 Empey Way  •  San Jose, CA 95128  •  408/998-8850  •  www.sccma-mcms.org

MEMBER BENEFITS Billing/Collections CME Tracking Discounted Insurance

Feature Article 30 Medical Injury Compensation Reform Act (MICRA)

Member Benefits 4 NORCAL Mutual Insurance Company

Financial Services

5 DocbookMD

Health Information Technology

6 EnviroMerica

Resources House of Delegates Representation Human Resources Services Legal Services/On-Call Library Legislative Advocacy/MICRA Membership Directory iAPP for the iPhone

7 360 Payment Solutions 8 Bureau of Medical Economics 9 OfficeWorks 10 Marsh 12 Reimbursement Advocacy Program 13 Legacy Wealth Advisors 14 SCCMA-MCMS’s Website Just Got an Upgrade

Physicians’ Confidential Line

16 Pace Wealth Management Group of Wells Fargo Advisors

Practice Management

17 Health Resource Services, LLC

Resources and Education

18 It Pays to Be a Member

Professional Development

24 CMA Webinars At-A-Glance

Publications

26 CMA Launches Exchange Resource Center

Referral Services With

27 Mayaco

Membership Directory/Website

28 SCCMA-MCMS Discount Ticket Program

Reimbursement Advocacy/

29 MICRA Savings

Coding Services Verizon Discount SPECIAL MEMBER BENEFITS EDITION

34 TPO – The HR Experts 35 SCCMA Alliance Application JULY / AUGUST 2013 | THE BULLETIN | 3


NORCALMUTUAL.COM

When does 3 = 7?

When 3 hours of CME saves you 7% on your premium. As forfor members of endorsing medical societies, NORCAL MutualMutual offers As an an exclusive exclusivebenefit benefit members of endorsing medical societies, NORCAL

an additional 2% supplemental savings to our standard management discount program. offers an additional 2% supplemental savings to 5% ourrisk standard 5% risk management discount program. who are also SantaAssociation Clara County Medical Association Eligible insureds* whoEligible are alsoinsureds* Santa Clara County Medical (SCCMA) active members (SCCMA) County MedicalbySociety active canpersonal receive can receiveand a 7%Monterey discount on their premium earning (MCMS) 3 NORCAL CME members credits. Great, aservice 7% discount premium discount by earning 3 NORCAL CME credits. Great, personal plus a 7%on risktheir management equals superior value. service plus a 7% risk management discount equals superior value.

Learn more, call 877-453-4486 or visit norcalmutual.com today. A N o r c A l G r o u p c o m pA N y

* The risk management discount program is for eligible physicians who practice solo or in groups of two to four. Insureds who are part of NORCAL’s surcharge program are not eligible for the program.

4 | THE BULLETIN | JULY / AUGUST 2013

SPECIAL MEMBER BENEFITS EDITION


DocbookMD is a free benefit for CMA members.

SPECIAL MEMBER BENEFITS EDITION

JULY / AUGUST 2013 | THE BULLETIN | 5


6 | THE BULLETIN | JULY / AUGUST 2013

SPECIAL MEMBER BENEFITS EDITION


Look What’s New in Membership! By Jean Boileau Cassetta, Membership Director

accepting credit cards should improve the payment process, helping patients to afford these medical procedures. 360 Payment Solutions has negotiated special pricing for SCCMA/MCMS members and is able to match or beat any processor fees. By switching to 360, many members have saved more than the cost of their annual dues! 360 Payment Solutions also is very community focused. Five percent of their profits are donated back into many other non-profit organizations within the Santa Clara County, and many of the 360 Payment Solutions staff volunteer with many of these organizations. Their goal is to be a true partner with their clients so they know they are working with a processor they can trust.

As I’m sure most of you are aware, the legislative representation, lobbying, and advocacy (both at the grass-roots and state level) are just a few of the many things that we do at SCCMA/MCMS/CMA on your behalf. Member benefits, discounts, and services are others. Recently, SCCMA/MCMS and 360 Payment Solutions partnered to help members improve customer service and reduce costs of accepting and processing credit cards in their practice.

• Guaranteed pricing - 360 does not raise fees • No annual fees and no contracts • FREE online virtual terminal ($95 value) • Discounted equipment pricing (wholesale costs) • 1-hour FREE training on credit card compliance and risk education

For more information and details about 360 Payment Solutions, for a FREE review of your current credit card processing situation, or to start accepting credit cards, contact Jesse Meddaugh at 408/637-1160 today.

360 Payment Solutions is a credit card processing company based in San Jose and they were founded on the core values of honesty and integrity. 360 prides itself on offering solutions with full disclosure pricing with no “junk” fees. Their consultative and educational approach allows for customized solutions for our members that reduce costs and increase efficiency for your staff. With the ever rising cost of health care, coupled with increasing expenses passed on to the patients, physicians are experiencing difficulty in collecting payments for procedures. The ease of

Contact Jesse Meddaugh at 408-637-1160 SPECIAL MEMBER BENEFITS EDITION

JULY / AUGUST 2013 | THE BULLETIN | 7


The Bureau Of Medical Economics (BME), A Membership Benefit You Can’t Afford Not To Use

8 | THE BULLETIN | JULY / AUGUST 2013

The volume of delinquent health care debt has undoubtedly increased in the last few years. When it comes to the amount of patients that are either unable or unwilling to pay their medical bills, the pond has grown larger, and in terms of patient ability to pay, the pond has also grown shallower. Many physicians are tempted to take on the job of collections in-house, rather than “pay” someone else. In these times of constantly changing laws and regulations, including the Affordable Care Act (ACA), patient rights are expanding. With the creation of the Consumer Financial Protection Bureau (CFPB), the rights of those owing money are not only broadening, but are being policed by this newly created entity. Acceptable methods of collecting money just a few years ago may now create liability for a physician’s office.

DO YOU KNOW…

• The Bureau of Medical Economics (BME) is a non-profit collection agency, formed by the Santa Clara County Medical Association (SCCMA), specializing in medical collections, and is a discounted member benefit? • As a member, you have access to BME’s experienced staff including a full-time attorney specializing in medical collection law, certified billing, and medical codes; a collection staff with decades of experience; and a technology staff utilizing the latest in PHI security, patient online bill pay, and web portal access to its clients? • Your membership entitles you to discounts for BME services, and at no financial risk? In fact, there is never a fee until monies are collected. BME’s clients, who are members of the medical association, receive a 5% member benefit discount, placing most of our clients at a 30% commission level. • BME is a preferred vendor of the California Medical Association (CMA)? • BME will put on seminars regarding whether your office is up-to-date and compliant with the latest laws in medical collections/billing including trends in credit reporting, autodialing to patients, balance billing, consent forms, etc.? • If the terms FDCPA, TCPA, FCRA, CFPB, direct and vicarious liability sound foreign to you, BME will address these and other issues at one of its free upcoming seminars? For further information about this member benefit, please contact BME’s client relations director, Karen Jorgenson, at 408/998-5811 ext. 3034 or SCCMA’s membership director, Jean Cassetta, at 408/998-8850 ext. 3010.

SPECIAL MEMBER BENEFITS EDITION


Ask about preferred rates for MCMS & SCCMA members

Experience the OfficeWorks difference today!

SPECIAL MEMBER BENEFITS EDITION

JULY / AUGUST 2013 | THE BULLETIN | 9


Sponsored Insurance Benefits Overview for Members of Santa Clara County Medical Association/Monterey County Medical Society/CMA Marsh/Seabury & Smith Insurance Program Management serves as the insurance advisor for the Santa Clara County Medical Association, Monterey County Medical Society, CMA and their members. We design and implement sponsored insurance plans and services available only to members and their employees — with discounted pricing, enhanced coverage or both. The following is a brief program overview:

Protect Your Practice Medical – Healthcare reform is here. We can assist you in evaluating group and individual health insurance options for you and your employees both in and out of the exchange. Also, save with qualified high deductible health plans and a health savings account.

Workers’ Compensation – Required of all employers, it covers your employees in the event of a job-related injury. Members receive competitive rates.

Health Savings Accounts – Open a CMA Health Savings Account, use federal tax deductions and earn interest on a federally tax free basis. Unused funds roll over each year. Employment Practices Liability Insurance – Protect yourself from

Protect Your Family writing, with timely enrollment, up to the Guaranteed Issue amount. 10% member discount.

Group Term Life Program (3+ members/ employees) – No medical underwriting, with timely enrollment, up to the Guaranteed Issue amount. 10% member discount.

Business Overhead Expense – Protect your practice with disability insurance up to $10,000 per month. Don’t divert personal disability income to pay for normal fixed office expenses. In a group setting, it pays the member’s share of fixed expenses. Covered expenses include your rent, utilities, employee salaries, society dues and professional liability premiums.

Business Owners Package Program

Long Term Disability Plan – Protect your most important asset — your ability to earn an income! You may apply for up to $10,000 per month in benefits. The plan includes Medical Specialty Definition of Disability and a residual disability benefit. Level Term Life – You and your spouse may apply for up to $1,000,000 of 10 or 20 year Level Term Life insurance. Rates are projected to remain level during the first 10 or 20 years of the policy reducing the long term costs of the policy significantly.

Individual Medical Plans – Healthcare reform is here. We can assist you in evaluating individual health insurance options for you and your dependents age 26 and over, both in and out of the exchange. Also, save with qualified high deductible health plans and a health savings account.

discrimination, sexual harassment and wrongful termination claims. The plan includes risk management training (web-based), an employment law information hotline and insurance coverage for judgments and defense costs up to $1,000,000. Ask about the Special First Time Buyers program.

This coverage provides important business liability and property protection. Protects your practice against financial loss resulting from claims of actual or alleged damage caused to others. Protects your furniture, fixtures and inventory to help repair or replace a loss. Data breach coverage is now available.

Group Disability Plan (3+ members/

Professional Liability – We can help

Group Universal Life – This plan provides

employees) – Monthly disability benefits of up to $15,000. Definition of Occupation includes Own Specialty. No medical under-

place your professional liability coverage with NORCAL Mutual, SCCMA/MCMS’s sponsored insurer.

permanent life insurance protection with limits up to $1,000,000. An optional cash accumulation account enables you to contribute certain amounts in the cash account and earn interest (minimum of 4%) on a tax deferred basis.

10 | THE BULLETIN | JULY / AUGUST 2013

Long Term Care – Members are eligible to receive a 5% premium discount on Long Term Care policies. The discount also applies to your spouse, parents or parents-in-law. Special plans for group practices can also be developed.

SPECIAL MEMBER BENEFITS EDITION


We Encourage You To Use Your Member Benefits! Our Client Advisors are available at 800-842-3761 to discuss how these programs can benefit you! Or visit our website at www.CountyCMAMemberInsurance.com for more information.

Group Dental – Up to $2,000 annual benefit. No deductible for preventive benefits. Employee coverage is available. Members may also enroll without their employees during special open enrollment periods each year. High Limit Disability – This plan provides additional disability limits up to $25,000 per month on a guaranteed basis. Members are eligible for a 20% discount.

Personal Insurance Concierge – This benefit helps physicians analyze, transfer, and manage risks relating to their personal exposures — e.g., homes, automobiles, valuables, fine art, yachts — all through a single point of contact. Call 855-CMA-9855 for more information.

Marsh, SCCMA, MCMS and CMA do not provide tax or legal advice. Please consult with your personal advisors on any of these issues.

1-335 (7/13) ©Seabury & Smith, Inc., 2013 777 South Figueroa Street, Los Angeles, CA 90017 CMACounty.Insurance@marsh.com www.CountyCMAMemberInsurance.com 800-842-3761

d/b/a in CA Seabury & Smith Insurance Program Management CA Ins. Lic. #0633005 AR Ins. Lic. #245544 SPECIAL MEMBER BENEFITS EDITION

Health Care Reform: 2014 Marks a New Era Health care reform is in full-swing with the heftiest legislation set for 2014 — when health insurance will become available to millions of Americans who were previously uninsured. Starting January 1, 2014, most Americans will be required to have health insurance and most businesses will be required to offer coverage to their employees. In addition, health insurance exchanges will be available to facilitate access to coverage.

Changes Coming in 2014 • Individual Mandate – Everyone (with few exceptions) will be required to have health insurance or pay a penalty. ■ Penalties start at $95 per individual, $285 per family, or 1% of income (whichever is greater), and increase in subsequent years. • Employers (Enforcement delayed until 2015) – Employers with 50 or more fulltime employees must offer adequate coverage that is affordable* for at least 95% of its full-time employees or pay a penalty (i.e. play or pay) if one full-time employee goes to an exchange and receives a premium tax credit. ■ If coverage is not offered, penalty is $2,000 multiplied by the number of full-time employees (minus the first 30 employees). ■ If coverage is offered but not affordable or does not cover at least 60% of essential benefits, the employer will be assessed $3,000 for each employee receiving a tax credit or $2,000 per full-time employee (the lesser will apply) (excluding the first 30 employees). • All states must have a health insurance exchange available for individuals and small business owners to view, compare, and purchase health plans offering minimum essential coverage.

■ Subsidies – Through the exchange, individuals may qualify for a subsidy in the form of a tax credit if household income is between 100-400% of the federal poverty level. • Guaranteed issue – Health insurers must sell coverage to everyone, regardless of pre-existing conditions, and can’t charge more based on health or gender. • No annual or lifetime limits – Individual and group health plans may not impose annual or lifetime limits. • Free preventive care – Plans offering minimum essential coverage must provide several preventive services and screenings at no charge.

Options for Employers with Less Than 50 Employees • Purchase coverage via the SHOP exchange (Small Business Health Option Program) or traditional market. • Stop offering coverage and let employees buy an individual plan from the exchange. • Provide a defined contribution to assist employees with purchasing coverage. • Apply for tax credits in the SHOP exchange to help cover the cost of premiums if the employer: • Employs 25 or fewer employees. • Pays annual wages averaging less than $50,000 per full-time equivalent employee. • Provides at least 50% of the cost of health care coverage for their employees.

Learn More Call a Marsh Client Advisor for more information at 800-842-3761.

* Affordable coverage is defined as coverage where employee only contributions do not exceed 9.5% of household income. JULY / AUGUST 2013 | THE BULLETIN | 11


UNPAID CLAIMS PILING UP?

Increase your cash flow!

Follow these 5 easy steps to expedite in-office collection: Step: 1

Collect Accurate Data

Remember—collection of accurate data is vital to your practice. Verify the information below at every patient encounter: • HMO or IPA affiliation • Name of insurance company • Name of Primary Care Physician (PCP)—with some plans this information can change monthly • Patient’s home address. Do not accept a P.O. Box, in lieu of a home address • Patient’s phone number

Gain Leverage in Collecting Payments from managed care plans • Address and phone number of patient’s current employer • If the patient visit requires a referral from a PCP, secure the referral number prior to the patient visit

Step: 2

Discuss Fees and Billing Procedures With Your Patients

It is very important to inform new patients about billing policies, when they call for an appointment. Place a sign at the check-in area advising patients that co-pays and deductibles are due at the time of service. Also, incorporate these policies in your patient registration form. Collect any applicable co-pays and/or unmet deductibles at patient checkout. Strict adherence to the foregoing will eliminate the additional expense of follow-up billing. Consistent observance of the “pay at time of service” policy not only reduces overhead, but reinforces the custom with patients, resulting in their readiness to pay prior to leaving the office.

Step: 3

Electronic Billing

Claims should be filed electronically, whenever possible. This practice will significantly expedite payments and save resources, i.e. staff time, supplies, postage. In order to ensure timely reimbursement, whether billing electronically or via submission of paper claims, it is imperative that claims are “clean” and accurate, i.e. employ proper use of CPT procedure codes, modifiers, and ICD-9 diagnosis codes. The availability of up-to-date coding manuals, familiarity with current coding literature, augmented with attendance at billing-related seminars, are essential tools for precise billing.

Step: 4

Obtain “Physician Claims Inquiry” Forms From SCCMA - MCMS

These bright green forms, identified with the SCCMA- MCMS logo, garner excellent results when affixed to claims that seem to be “hung-up” in the system. Attach this attention-getting form to a copy of the original claim(s) and resubmit to the carrier—30 days after the first submission for PPOs and 45 days for HMOs.

Step: 5

Request Help From SCCMA-MCMS RAP

After 30-45 days, if there is no response to the “Physician Claims Inquiry,” complete and sign an RAP form, and attach a copy of the claim, the patient’s insurance card, along with any related correspondence. See mailing information on back panel.

Reimbursement Advocacy Program Reimbursement Advocacy Program (RAP) is a benefit available only to members of the Santa Clara County Medical Association or Monterey County Medical Society. Through RAP, association members gain leverage in collecting payments from managed care plans (and other payers) slow in honoring claims. The RAP program also provides physicians, their office managers, and/or billing staff with coding and billing guidance.

Contact RAP for Assistance With: • Carrier Failure to Process “Clean Claims” in Accordance With State Law (30 days for PPO plans & 45 days for HMOs) • Habitual Downcoding • Treatment Authorization and Subsequent Denial • Payment Inconsistent with the Physician’s Contract and CPT Guidelines • Coding Guidance

For assistance contact Sandie Becker, CMC sandie@sccma.org 12 | THE BULLETIN | JULY / AUGUST 2013

SPECIAL MEMBER BENEFITS EDITION


Legacy Wealth Advisors Managing the reserve investment accounts of the Santa Clara County Medical Association (SCCMA) and the Bureau of Medical Economics (BME) since 2000

1900 The Alameda Suite 510 San Jose, CA 95126

Wealth Management Legacy offers a broad range of wealth management services to SCCMA and Monterey County Medical Society (MCMS) physician members and their families. Such services include: • Financial Planning, Risk Management, Educational & Retirement Planning Projections • Liquidity Management and Cash Flow Analyses • Estate Tax and Charitable Planning • Existing Portfolio Analysis • Design and Implementation of Investment Strategies • Consolidated Portfolio Reporting and Asset Tracking

P: (408) 452-7700 F: (408) 452-7470 Email: Info@lwallc.com

Member Savings! Legacy offers a one-hour complimentary financial planning check-up to Association members (this is a $500 savings). For more information, please call Lawrence Pizzella at (408) 452-7700 or email lawrence@lwallc.com

             

Save the date!

November 13, 2013. Legacy will be hosting a financial planning seminar held at SCCMA headquarters, at 6:00 PM, free of charge. Details to follow.

www.lwallc.com

SPECIAL MEMBER BENEFITS EDITION

JULY / AUGUST 2013 | THE BULLETIN | 13


Santa Clara County - Monterey County Medical Society’s …get the resources & help

14 | THE BULLETIN | JULY / AUGUST 2013

SPECIAL MEMBER BENEFITS EDITION


website just got an upgrade… you need at SCCMA-MCMS.org.

The all new website offers a

SCCMA-MCMS.org provides a member physician finder. Search by name, specialty, zip code, and more.

member only physician finder, member resources, association programs, up-to-date CMA news, upcoming events, patient resources and more. Make sure to stop by and take a look around.

Physician finder results provide you with info such as contact info, mapped locations, and even photos.

www.SCCMA-MCMS.org

Get info on all of your SCCMA-MCMS member benefits plus your CMA benefits at SCCMA-MCMS.org.

The Bulletin and archived issues are available online with the SCCMA-MCMS.org bookshelf.

SPECIAL MEMBER BENEFITS EDITION

JULY / AUGUST 2013 | THE BULLETIN | 15


We are  pleased  to  welcome  Wells  Fargo  Advisors  in  serving  the  members  of  the  Santa  Clara  County  Medical   Association  (SCCMA)  and  the  Monterey  County  Medical  Society  (MCMS).  The  California  Medical  Association   (CMA)   has   teamed   with   Wells   Fargo   Advisors   (WFA)   in   a   corporate   partnership   to   provide   investment   planning     resources  to  CMA  members.     The   Pace   Wealth   Management   Group   of   WFA   is   a   relationship   manager   in   Santa   Clara   and   Monterey   Counties  for  members  interested  in  learning  more  about  the  depth  of  services  available.   Carlton   is   a   CERTIFIED   FINANCIAL   PLANNER™   Professional   with   22   years   of   experience   and   is   a   Premier   Advisor*   at   WFA.   He   can   provide   one-­‐on-­‐one   personalized   services   to   each   member.   There   are   reduced   fee   rates  for  investment  advisory  programs  that  have  been  negotiated  on  your  behalf.  Additionally,  there  are   waived  annual  fees  for  Command  Asset  Program  (CAP),  IRA  accounts,  and  Rollover  IRAs.

Pace Wealth  Management  Group     of  Wells  Fargo  Advisors  Investment  Management  Services   Healthcare  Practice  Financing   Envision  Planning  Process

 Education Planning

 Retirement Planning

 Business Financing

 Securities Backed  Lending**

 Estate Investment  Planning

 Insurance &  Annuities

Carlton B.  Pace,  CFP®,  CIMA®   First  Vice  President  -­‐  Investment  Officer   Pace  Wealth  Management  Group   One  Almaden  Blvd.  Suite  1000  San  Jose,  CA  95113   1  (408)  291-­‐2011      -­‐        1  (800)  876-­‐4848   carlton.pace@wfadvisors.com   www.carltonbpace.com   CA  Insurance  Lic  #OB26158     Wells  Fargo  Advisors  pays  a  fee  to  the  CMA  to  market  their  products  and     services  to  CMA  members.   *  Premier  Advisor  status  is  awarded  to  Financial  Advisors  who  meet  or  exceed  Wells  Fargo  Advisors’  high  standards  as  measured  by  one  or  more  of  the  firm’s  criteria   for  revenue  generation  ,  educational  attainment  and  client-­‐service  best  practices.   **Lending  and  other  banking  services  available  through  the  Lending  &  Banking  Services  Group  of  Wells  Fargo  Advisors  (NMLS  UI  2234)  are  offered  by  banking  and  non-­‐ banking  subsidiaries  of  Wells  Fargo  &  Company,  including,  but  not  limited  to  Wells  Fargo  Bank,  N.A.  (NMLSR  ID  399801)  Member  FDIC;  Wells  Fargo  Home  Mortgage  and   Wells  Fargo  Equipment  Finance,  Inc.  All  loans  and  lines  of  credit  are  subject  to  credit  approval,  verification  and  collateral  evaluation.  Initial  credit  decision  is  subject  to   your  meeting  specific  underwriting  requirements,  and  final  approval  will  be  based  upon  your  satisfying  these  requirements.  Certain  restrictions  apply.  Programs,  rates,   terms  and  conditions  are  subject  to  change  without  advance  notice.  Products  are  not  available  in  all  states.  Licensed  by  New  Hampshire  banking  department.  

Investment and Insurance Products:

NOT FDIC-­‐Insured    

NO Bank  Guarantee    

MAY Lose  Value    

Wells  Fargo  Advisors,  LLC,  member  SIPC,  is  a  registered  broker-­‐dealer  and  separate  nonbank  affiliate  of  Wells  Fargo  &  Company.      

16 | THE BULLETIN | JULY / AUGUST 2013

SPECIAL MEMBER BENEFITS EDITION


TA CLARA SAN

Y MEDIC UNT A CO

C AL

IAT SSOC ION • LA

Health Resource Services

IF O R N IA

Who We Are

Our Business

HRS/Amerinet is a group purchasing organization (GPO) founded in 1980 as a marketing affiliate of Amerinet. HRS/ Amerinet membership includes health care organizations as well as dental and veterinary facilities. We are owned by a non-profit organization which allows us to concentrate on our members, not the bottom line. HRS/Amerinet’s core values and business approach reflect our health care heritage. We treat our members and vendors with the same considerations as health care providers view their patients. We are friendly, professional, data driven, responsive, conservative, ethical, and actively seek long-term healthy outcomes. With hundreds of thousands of member organizations representing millions of Americans, HRS/Amerinet is one of the largest GPOs in the nation. As of 2011, we have saved our members over $1.1 billion. Our owner, Virginia Mason Medical Center (www. virginiamason.org), was recently named the nation’s top hospital of the decade by Leapfrog, an independent health care association of large employers whose mission is to make health care delivery safer and affordable.

HRS/Amerinet negotiates discounted rates on products and services driven by the industry needs of our members. These savings are passed along to our members. Essentially, HRS/ Amerinet leverages the purchasing volume of its membership to obtain favorable pricing from preferred manufacturers and service providers. HRS/Amerinet membership is free and voluntary. And we make it easy to register and access the vendor discounts. HRS/ Amerinet has an active customer service team to answer member questions and direct members to particular vendor representatives.

Our Vendors HRS/Amerinet is the GPO that helps members lower costs, enhance revenue, and improve quality of care by customizing a set of performance solutions that delivers quantifiable savings, actionable data, and guidance members can trust HRS/Amerinet offers its members access to over 800 agreements that include over 1,000,000 SKUs. Here are some of the product groups HRS/Amerinet contracts cover:

How to Join HRS/Amerinet

If you are interested in joining HRS, or simply learning more about the program, please contact Evan and mention you are a part of SCCMA or MCMS:

Evan Stoll (800) 842-6663 • (801) 478-5772 fax Evan.stoll@amerinet-gpo.com SPECIAL MEMBER BENEFITS EDITION

For Our Members HRS/Amerinet is committed to helping our members achieve new levels of success now and years from now. Every day, our clinical and supply chain experts are hard at work developing solutions that deliver real benefits to our members and those they serve.

• • • • • • •

Construction Diagnostic Imaging Energy Solutions Environmental Services Executive Resources Food Service Information Technologies

• • • • •

Laboratory Medical and Surgical Supplies Office Solutions Pharmaceuticals Plant Engineering

22% Verizon discount

By simply signing up for HRS/Amerinet you will also receive a 22% Verizon discount and additional discounts from Office Depot, Staples, Office Max, Sprint, CDW, Southern Computer Warehouse, SHI, FedEx, and UPS, to name a few. JULY / AUGUST 2013 | THE BULLETIN | 17


18 | THE BULLETIN | JULY / AUGUST 2013

Membership Benefits Listing 2013-2014

SPECIAL MEMBER BENEFITS EDITION


When you join SCCMA/MCMS/CMA, you hire a powerful professional staff to protect the viability of your practice. By protecting your practice from legal, legislative, and regulatory intrusions, we let you focus on what’s really important: your patients. Practice Management/Assistance Amerinet/Health Resource Services (HRS): A Group Purchasing Organization (GPO) whose primary focus is negotiating discounts on many of the products and services that you use every day. As a member of Amerinet, you will have access to contracts that will help you reduce your overhead without changing how you are currently doing business.  By becoming a member of Amerinet/ HRS, you will also receive a 22% discount on Verizon Wireless for your business and employees’ personal lines. Additional discounts given from Staples, Office Max, Sprint, CDW, Southern Computer Warehouse, SHI, FedEx, and Ups, to name a few. All this is available at no cost to you. For more information, just complete the request form at http://amerinet-hrs.com/santaclara or call Evan Stoll, at 800/842-6663 or 206/583-6516. DocBookMD:  SCCMA/MCMS members are eligible for a free download of the DocBookMD an app which allows members to securely send HIPAA compliant messages directly from their iPad, iPhone, and Android devices. Find out more about DocbookMD’s newest feature called Care Team, which allows you to communicate with your non-physician colleagues. Go to the App Store or Google Play now to download DocBookMD today. To register for FREE, all you need is your CMA I.D. number. To obtain your CMA I.D. number, call SCCMA at 408/998-8850 or MCMS at 831/455-1008. Practice & Liability Consultants LLC: Members receive $10 off the regular hourly consulting fees. Since 1985, Practice & Liability Consultants have worked with over 1,700 practices as practice management and malpractice prevention specialists. Services include practice assessments, valuations, practice sales/ brokerage (see information below), benchmarking, mergers, operations/personnel issues, manager recruitment, partnership/group, formation/improvements, and seminars. Benefits include greater productivity, increased gross and net income, greater patient satisfaction, and a more pleasant work environment. Fees are based on either a flat fee or hourly basis and, where possible, a minimum and maximum fee is quoted. Please SPECIAL MEMBER BENEFITS EDITION

call 415/764-4800, or contact dphairas@practiceconsultants. net. Website: www.practiceconsultants.net. Practice Consultants: They provide practice brokerage services to the medical community throughout the United States. They assist sellers of practices and buyers seeking practices. Practice brokerage is a commission-based service that is usually paid for by the seller upon successful completion of the transaction. The fee is 10% of the total purchase price of the transaction, with a minimum fee of $15,000. If a sale or partial sale is contemplated, they will: • Analyze the market value • Along with you, determine an asking price • Market the practice • Screen responses • Negotiate the transaction with the buyer • Manage the development of all necessary documents (sales contract, covenant not to compete, promissory note, security agreement, etc.) • Guide the parties through the transaction, including explaining due diligence • Coordinate all escrow and legal services for the parties • Perhaps most importantly, they take the burden of the sales process off your shoulders so you can concentrate on your practice Contact: Gary@PracticeConsultants.com or 800-576-6935, www.PracticeConsultants.com. enviromerica, Inc. is a Bay-Area-based compliance consulting firm specializing in OSHA, HIPAA, AAAASF, AAAHC, JCAHO, CAP, IMQ, CLIA, and other regulatory agencies and accreditation requirements. They have assisted thousands of medical and dental facilities in California with all of their regulatory compliance needs for the past 14 years. They assure their clients are up to all standards, keeping their offices, patients, and staff safe and keeping them clear from hefty fines that are often levied by the regulatory agencies – such as CAL/OSHA, the Department of Health, the EPA, as well as the Medical Board of California. Services include annual training, up-to-date

Continued on page 20 JULY / AUGUST 2013 | THE BULLETIN | 19


Membership Benefits Listing, 2013-2014, from page 19 and customized safety manuals, all appropriate office documentation including complete and compliant MSDS books, plus complete physical compliance of the office. Via an insurance policy, EnviroMerica guarantees all their clients against any and all fines they may receive from any of the regulatory agencies.

ticing physicians. Accessible to members at www.cmanet.org/ resource-library or by calling 800/786-4262.

enviromerica/Waste Management: enviromerica is now the exclusive vendor of choice for the CMA for all regulatory compliance and medical waste management. All SCCMA/MCMS members receive an exclusive discount of at least 30% on all waste management services offered. Members will also receive a Complimentary Compliance Review from enviroMerica (valued at $275) and receive a 20% discount off their already low prices for compliance. Call 650/655-2045 or 888/323-0583 for more details.

PrivaPlan: Receive $170 discount (from $495 retail down to $325) on a do-ityourself On-line HIPAA Privacy & Security Compliance Toolkit and/or Online HIPAA Training (toolkit code): sccma325toolmcms. Also available: Remote & On-Site Security Risk Analysis, a required Core Meaningful Use measure. Visit www.PrivaPlan.com. For a special CMA toolkit price of $325 (retail $495), use Coupon Code:  sccma325toolmcms,  or Code:  sccma129trainmcms  for $129 training (retail $169). Email  support@privaplan.com  for more info on a Security Risk Analysis for your practice.

TPO Human Resource Management: TPO is an award-winning HRconsulting firm serving primarily the Bay Area. Typical services include general HR consulting, employee handbook development, neutral third-party investigations into employment matters including harassment, managerial training on HR regulatory and leadership skill-building, and helping employers maintain current best HR practices. How they work with SCCMA and MCMS members: Over the past 17 years, TPO has provided HR support to SCCMA, as well as the members of SCCMA and MCMS. TPO has facilitated numerous HR training programs for members to attend and has provided many resource articles throughout the years. SCCMA/MCMS members receive a free initial consulting call ($50 savings) and then 10% off the initial work, products, and services with TPO. Contact Melissa Irwin, SPHR-CA, Sr. Consultant: 831/647-7292 or melissai@tpohr.com. OfficeWorks, Inc.: Members receive preferred pricing and a FREE working interview.  When your office is short staffed, are you getting the help you really need?  OfficeWorks is your employment remedy! We specialize in placing medical assistants, receptionists, transcriptionists, and records clerks, as well as biller/collectors, coders, and office managers.  Whether you require full or part-time professionals, permanent, or temporary placements, vacation or maternity leave coverage – THEY CAN HELP! OfficeWorks provides: pre-screened candidates  with health care backgrounds and the specific skills your office requires. Call Lauren Taylor, OfficeWorks Talent Manager, at 877/463-3123 or 510/444-2161 Ext. 102.

Legal Services Medical Legal Library (Formerly CMA On-Call): This online library contains over 4,500 pages of up-to-date legal information on a variety of subjects of everyday importance to prac20 | THE BULLETIN | JULY / AUGUST 2013

Legal Services: CMA legal experts provide immediate member assistance for HR, medical regulatory or legal questions. Call 800/786-4262.

Financial Services Medical School Debt Management: GL Advisor is a financial advisory firm that specializes in helping physicians effectively manage their medical school debt and other financial matters. Members receive a $50 discount on one month of service. A coupon code is required to access this discount. Get your code at www.cmanet.org/benefits or call 800/786-4262. SCCMA’s Reimbursement Help Center: Trouble getting paid? In the past two years, CMA’s practice management experts recouped over $5.5 million from insurance carriers on behalf of physician members. CMA provides members with one-on-one assistance to identify, prevent, and fight unfair payment practices. For local assistance contact Sandie Becker, CMC Coding Reimbursement Specialist at 408/998-8850 Ext. 3007 or 831/455-1008 Ext. 3007. Reach CMA’s reimbursement experts at 888/401-5911. CMA Payor Contract Analysis: CMA members have free access to objective written analyses of major health plan contracts at www.cmanet.org/ces. Each analysis is designed to help physicians understand their rights and options when contracting with a third party payor, as well as which contract provisions are prohibited by California law. 360 Payment Solutions: 360 Payment Solutions is a merchant credit card processor located in San Jose. The company was founded on the beliefs and core values of honesty and integrity. The credit card processing industry is very competitive and can be confusing for business owners. This is why 360 Payment Solutions focuses on teaching their clients to understand the fees by taking a consultative, educational, and service-driven approach. In the health care industry, SPECIAL MEMBER BENEFITS EDITION


costs continue to rise and patients become increasingly dependent on the use of plastic as a form of payment. This has made accepting credit cards an imperative asset to growing your Practice. 360 Payment Solutions has negotiated special pricing for SCCMA/MCMS members and is able to match or beat any processors’ fees. For a FREE review, for more information, or to set up an appointment, contact Jesse Meddaugh at 408/6371160, www.360paymentsolutions.com. Wells Fargo Advisors: Enjoy access to our new partner, Wells Fargo Advisors, LLC, for financial advice and guidance from medical school through retirement. Dedicated regional advisors are available to address your financial needs. To learn more about these services and special CMA member benefits, contact your local team of financial advisors at 408/291-2002 or email carlton.pace@wfadvisors.com. Legacy Wealth Advisors, LLC: Provides financial planning, retirement planning, professional money management, and more! Members receive a one-hour complimentary consultation (over a $300 savings). For more information, call Lawrence Pizzella at 408/452-7700. Bureau of Medical Economics (BME): Receive a 5% discount off the basic rate for collections. (Rate based on volume – You only pay when they collect.) For more information regarding BME’s collection services, call Karen Jorgenson at 408/286-6219.

Insurance MARSH - Medical, Workers’ Comp, Life, Disability, LongTerm Care, and More: Marsh serves as the insurance advisor for the Santa Clara County Medical Association, Monterey County Medical Society and their members. They design, develop, and implement insurance plans available only to members – with discounted pricing, enhanced coverage, or both. They assist members and their office managers in all modes of practice, by providing information, programs, and guidance to assist with insurance buying decisions. Call 800/842-3761; or email: CMACounty.insurance@marsh.com; or website: www. CountyCMAMemberInsurance.com. Car and Homeowners/Car Insurance: Mercury Insurance Group offers discounted auto and homeowners insurance for CMA members. Benefits include a 10% discount on auto coverage and a 25% discount when home and auto insurance are bundled. Contact Mercury Insurance Group, (888) 637-2431 or www.mercuryinsurance.com/cma.

NORCAL Mutual Insurance Company: Formed by physicians in 1975 to provide the highest quality medical professional liability insurance products and services to its policyholder-owners. NORCAL Mutual insures nearly 20,000 physicians and other health care professionals in solo practice, medical groups, hospitals, clinics, and allied health care facilities in California, Alaska, and Rhode Island. More than three-quarters of NORCAL Mutual policyholders have been with the company longer than five years. They stay with NORCAL Mutual because it stands with them, providing vigorous defense to the standard of care, unparalleled risk management, and personalized local service. In 1984, NORCAL received their first “A+” rating from A.M. Best. They have maintained an “A” or better rating every single year since then. NORCAL offers a variety of FREE online CME courses for members of NORCAL. For more information, visit www.norcalmutual.com or call 877/453-4486.

Professional Development CME Tracking/Credentialing: CMA’s Institute for Medical Quality (IMQ) certifies CME activity for credentialing purposes to the Medical Board of California, as well as to hospitals, health plans, specialty societies, and others. CME certification is $29 a year for CMA members, $49 for non-members. Contact IMQ at 415/882-5151 or www.imq.org. CMA Webinar Series: CMA’s webinar series gives physicians the opportunity to watch online presentations on important topics of interest and interact with legal and financial experts from the comfort of their homes or offices. The webinars are free to CMA members and their staff. All of our webinars are also archived for on-demand viewing at any time in our resource library. There are currently more than 100 archived webinars on topics ranging from HIPAA, to health reform, to coding, billing, and compliance. www.cmanet.org/events. SCCMA/MCMS Seminar/Webinar Series: Member physicians and their office staff often attend FREE-of-charge seminars covering legal issues, HIPAA, risk management issues, contract negotiations, reimbursement, billing, OSHA compliance, how to open/close/how to determine the value of a medical practice, HR requirements/guidelines, and much more. Check out www. sccma-mcms.org/TheBulletin for more information. CD-10 Training: The transition to ICD-10 will take strategic planning and considerable preparation. CMA has partnered with the largest and most respected coding organization, AAPC, to provide our members with a complete suite of ICD-10 solutions at steeply discounted rates. Visit www.cmanet.org/aapc for more information. Certified Professional Coder Program: CMA members and their staff receive big discounts on Certified Professional Coder (CPC) training and certificates from AAPC. AAPC’s CPC credential is the gold standard for medical coding in physician office

Continued on page 22 SPECIAL MEMBER BENEFITS EDITION

JULY / AUGUST 2013 | THE BULLETIN | 21


Membership Benefits Listing, 2013-2014, from page 21 settings. Contact your local county medical society for more information.

mary and the current status of litigation in which CMA is a party or has filed a brief as amicus curiae.

Health Information Technology (HIT)

Legislative Hot List: CMA’s Center for Government Relations publishes the Legislative Hot List weekly during the legislative session. The Hot List provides a summary and the current status of CMA-sponsored bills, as well as the progress of other significant legislation.

Epocrates: CMA members get a discount on all Epocrates mobile and online products. Save 30% on subscriptions to Epocrates products such as the #1 rated Epocrates Essentials. Epocrates provides point-of-care access (via mobile devices and the web) to information on drugs, diseases, and diagnostics. For more information, visit www.cmanet.org/benefits. Mayaco Marketing • Internet offers CMA members discounted website development services for their practice. SCCMA/MCMS members receive up to $1,000 off of website packages. Website design services start at only $1,250. You have the freedom to choose a Basic or Premier Package depending on need and size of practice, they provide staff training and ongoing website maintenance, mobile friendly and easy to navigate, and the site will be completed and launched within 30 days or less! For more information, visit www.mayaco.com/physicians or call 209/957-8629. Mention CMA membership to receive exclusive discount price for product and services.

Publications CMA produces a number of publications to keep members upto-date on the latest health care news and information affecting the practice of medicine in California. Members and registered website users can subscribe to any of these publications by visiting www.cmanet.org/newsletters. CMA Alert: CMA publishes a biweekly e-newsletter, CMA Alert, to keep its members up- to-date on critical issues affecting the practice of medicine in California. CMA Capitol Insight: CMA Capitol Insight is a biweekly column by veteran journalist Greg Lucas, reporting on the inner workings of the state Legislature. CMA Practice Resources: CMA Practice Resources (CPR) is a monthly bulletin from the Center for Economic Services. This bulletin is full of tips and tools to assist physicians and their office staff in improving practice efficiency and viability. CMA Press Clips: Get daily reports on health care policy and medicine from newspapers and magazines throughout California and around the nation delivered to you by email. Legal Case List: CMA’s Center for Legal Affairs publishes the Legal Case List once a month. The Case List provides a sum22 | THE BULLETIN | JULY / AUGUST 2013

Regulations Quick List: CMA’s Center for Medical and Regulatory Policy publishes the Regulations Quick List once a month. The Quick List provides summaries and status updates on various regulations being tracked by CMA. OMSS Advocate: CMA’s Organized Medical Staff Section publishes the OMSS Advocate, a quarterly newsletter that provides CMA-OMSS member medical staffs with updates on current events and issues. You must be an OMSS member to receive this newsletter. Email medstaffhelp@cmanet.org for more information. For more information about advertising in any of CMA’s publications, email to: advertising@cmanet.org. The Bulletin: Members receive a FREE subscription to the voice of Monterey and Santa Clara County physicians. This bimonthly publication includes medical articles, classifieds, new member benefits, coding/billing/ collection advice, CME classes and webinars, seminars, new members listing, and more! SCCMA/MCMS Pictorial Membership Directory: Appear in SCCMA/MCMS’s annual pictorial membership directory! Receive a FREE directory each year ($60.00 value) and receive a 50% discount off each additional directory purchase by member. Contact Maureen Yrigoyen at 831/455-1008 or 408/998-8850 Ext. 3001 for details.

AUTOMOTIVE SERVICES

Autobahn Los Gatos

Autobahn Los Gatos: Specializing in BMW and Mercedes Benz repair, members, their families, and staff receive a 10% discount on labor. Call Dave or Gary at 408/356-5985, to set up your appointment today. (Don’t forget to mention you are a SCCMA/MCMS member.) Car Rentals: Save up to 25% on car rentals for business or personal travel. Members-only coupon codes are required to SPECIAL MEMBER BENEFITS EDITION


access this benefit. Get your code at www.cmanet.org/benefits or call 800/786-4262. Call Avis at 800/331-1212 or Hertz at 800/654-2200. Classic Car Wash: The Santa Clara County Medical Association has partnered with the premier car wash company in Santa Clara County, Classic Car Wash, to provide a valuable new member benefit. Now as a valued member of SCCMA, you will receive a $5.00 discount on a car wash! This represents an 18% 28% savings, depending on which car wash you select! In addition, we wanted to thank each member by providing a benefit you can extend to your staff and family members. Therefore, under the terms of our agreement, you may share this exclusive member benefit with your family and staff as well. Classic Car Wash has four locations in Santa Clara County to serve you. Details and locations are listed in the coupon (one must present a coupon to receive this discount). Discount coupons are available on SCCMA/MCMS’s website at www.sccmamcms.org under the “Membership” tab, so you can print additional coupons as needed. There are information and offers regarding Classic Car Wash, please visit their website at www. classiccarwash.com.

legislative awareness and action, lifelong friendships, active local, state, and national projects, close support for the medical family. The SCCMAA is a 501C3 charitable foundation. For more information, call Suzanne Jackson (SCCMA Alliance) at 408/354-3447.

Member Supplies Citti’s Florist: SCCMA members receive a 20% discount on flowers, plants, or gifts. (Locally delivered or picked up orders only.) $10.00 off wire orders world-wide. No other discounts apply. Go to www. cittisflorist.com and enter discount code SCCMA. 20% discount available at the following locations: Santa Clara Citti’s Florist, 800 Scott Blvd, Santa Clara – 408/246-7272; San Jose Citti’s Florist, 3100 Stevens Creek, San Jose – 408/984-8900; or Campbell Citti’s Florist, 990 E. Hamilton Ave, Campbell – 408/371-7000. Staples: Save up to 80% on office supplies and equipment from Staples, Inc. Visit www.cmanet.org/benefits to access the members-only discount link.

Member Resources Mailing Lists/Labels: To send new practice announcements, inform your colleagues of a particular legislation or upcoming event. Members can order mailing labels by specialty, zip code, or total membership. Members receive a 50% discount by calling Pam Jensen, SCCMA/MCMS, at 831/455-1008 or 408/9988850 Ext. 3012. Physician Referral Service: Our physician referral service provides 1200 referrals online and handles around 1200 calls per month. Patients can select a physician by city, specialty, language, Medicare, or Medi-Cal, and gender. Call Jean Cassetta, SCCMA/MCMS, at 831/455-1008 or 408/998-8850 Ext. 3010 for a “Physician Referral Service Participation Agreement” or to sign up today. Discounted Tickets & See’s Candies Certificates: Discounted tickets available for members, their staff, and families online at: California’s Great America, Gilroy Gardens, Disney Theme Parks, Santa Cruz Beach Boardwalk, Monterey Bay Aquarium, Raging Waters, Roaring Camp, Universal Studios, Six Flags Discovery Kingdom, and many more! Gift certificates also available for See’s Candies. For more information go to: http://www. sccma-mcms.org/ or call Danielle Painter to purchase See’s gift certificates, 408/998-8850 Ext. 3008. The Alliance: Members of the Alliance work together to promote quality health in Santa Clara county through education, community service programs, and legislative advocacy. Benefits of membership include advocacy for quality health care, SPECIAL MEMBER BENEFITS EDITION

MedicAlert: MedicAlert is a nonprofit foundation with over 50 years of lifesaving experience identifying and providing vital medical information to emergency personnel for over 4 million members worldwide. CMA members and their patients save $10 on new adult enrollments and $2.95 on Kid Smart Enrollments. For more information, visit www.medicalert.org/cma or call 800/253-7880. Security Prescriptions: Get 15% off tamper-resistant security prescription pads and printer paper. Visit the RX Security website, www.rxsecurity.com/cma.php. Magazine Subscriptions: 50% off subscriptions to hundreds of popular magazines, with a best price match guarantee. Contact Subscription Services Inc. at www. buymags.com/cma or 800/289-6247. Copyland/Zip 2 Print: Members receive excellent customer service with a 10% discount on all quality printing, from prescription pads, new practice announcements, brochures, medical forms, post cards with mailing service, etc. FREE shipping or delivery depending on your office location. For more information, please call or email Frank Ettefagh at 408/971-2722 or frank@ zip2print.com. Of course you’re always welcome to visit us at our new location at: 2342 Stevens Creek Boulevard, San Jose, CA, 95128, or check web site at: www.zip2print.com.

JULY / AUGUST 2013 | THE BULLETIN | 23


2013 Education Series AUG 21

Aug. 21: HIPAA Compliance: The Final HITECH Rule David Ginsberg • 12:15 – 1:15 p.m. The HITECH Act created the extensive funding incentives and standards for adopting electronic health records; it also created new HIPAA rules or modified existing ones. This webinar will provide an overview of the changes to HIPAA and key steps medical practices can take to comply with these changes.

AUG 28

Aug. 28: Medicare: Proposed Changes for 2014 Michele Kelly • 12:15 – 1:15 p.m. This webinar will focus on proposed policy changes to the physician fee schedule for the year 2014 (excluding any discussion on the SGR, or revised payment methodology). This discussion will provide an opportunity for physicians to hear how new or revised policies may impact their practice, and allow them to provide input to CMA during the Notice and Comment period.

SEPT 4

Sept. 4: Appropriate Prescribing and Dispensing: New Measures Previously, this topic was postponed indefinitely. Fortunately, we have rescheduled this webinar. It will be held on September 25th.

SEPT 11

Sept. 11: California’s Health Benefit Exchange: The Positives and Perils of Contracting Brett Johnson • 12:15 – 1:45 p.m. Beginning in 2014, California’s private health insurance market will never look the same – individuals and small employers will be able to purchase health insurance coverage through the state’s health insurance exchange, named Covered California. It is estimated that by the end of 2016, over one in five Californians will get their health insurance through the Exchange. In October of 2013, Californians will be able to access the Covered California website and begin enrolling in plans for the 2014 benefit year. Depending on health plans’ distribution of enrollees, a surge of physician contracting efforts may occur as these plans attempt to ensure adequate networks are in place prior to January 1, 2014. In this presentation, you will learn more about California’s exchange and what it will mean for physicians. You will also gain an understanding of some of the risks and benefits of being contracted to provide services to exchange enrollees.

SEPT 12

Sept. 12: ICD-10 Documentation for Physicians: Part 1 AAPC • 12:15 – 1:15 p.m. Continued on Sept. 19 and 26. This three-part series covers the key information necessary to understand key documentation elements to help you not only prepare for ICD-10, but for all the regulations surrounding your practice today.

SEPT 18

Sept. 18: Recipe for Financial Success: Key Steps to Increasing Your Net Income Debra Phairas • 12:15 – 1:15 p.m. Physicians and office managers need business management skills, particularly in the financial area. This workshop will teach critical skills in analyzing the practice profit/loss statement, accounts receivable ratios and staffing patterns and how to access specialty comparison norms. At least one source of comparison data specific to your medical specialty will be given to each participant.

24 | THE BULLETIN | JULY / AUGUST 2013

SPECIAL MEMBER BENEFITS EDITION


SEPT 18

Sept. 19: ICD-10 Documentation for Physicians: Part 2 AAPC • 12:15 – 1:15 p.m. Continued from Sept. 12 and ends Sept. 26. This three-part series covers the key information necessary to understand key documentation elements to help you not only prepare for ICD10, but for all the regulations surrounding your practice today.

SEPT 19

Sept. 26: ICD-10 Documentation for Physicians: Part 3 AAPC • 12:15 – 1:15 p.m. Continued from Sept. 12 and 19. This three-part series covers the key information necessary to understand key documentation elements to help you not only prepare for ICD10, but for all the regulations surrounding your practice today.

SEPT 26

OCT 30

Sept. 25: Appropriate Prescribing and Dispensing: New Measures Medical Board • 12:15 – 1:15 p.m. Representatives from the Medical Board of California will discuss outcomes from the Forum to Promote Appropriate Prescribing and Dispensing, held February 2013, including what the Board is proposing/supporting; what the legislature is proposing, and how these measures will be implemented if adopted.

Oct. 2: Successful Medi-Cal Provider Enrollment for Physician Providers DHCS • 12:15 – 1:45 p.m. Physicians must re-enroll in Medi-Cal as one of the provisions of the Affordable Care Act (ACA). This training will cover basic instructions and guidelines on the proper way to complete a Provider Enrollment Application Package. We will discuss the importance of reviewing and understanding program requirements and how to avoid common mistakes when completing enrollment forms. We will also cover specialized physician enrollments, important changes to the program due to ACA implementation, and where to find additional program information and PED contact information.

NOV 6

Oct. 30: CMS Quality Reporting Programs: What Physicians Need to Know and Do Now to Improve Care and Avoid Penalties CMS • 12:15 – 1:45 p.m. Presented by the Centers for Medicare & Medicaid Services (CMS), webinar attendees will understand the background and rationale for CMS incentives and payment adjustments that affect physicians, including the Physician Quality Reporting System (PQRS), the ePrescribing (eRx) Incentive Program, the Electronic Health Record (EHR) Incentive Program, and the new Value Modifier (VM) program; be able to define what actions they need to take to receive each incentive and avoid payment adjustments; and know where to go to obtain further information about CMS quality programs and stay abreast of future developments.

NOV 13

Nov. 6: External Auditors and You: Medi-Cal Recovery Audit Contract Process DHCS • 12:15 – 1:15 p.m. Presented by the Department of Health Care Services (DHCS), this webinar will help you gain information on the current status of the Medi-Cal external audit contract process, understand rules and timelines for implementation, and understand how to work with external auditors.

DEC 4

Nov. 13: Managing Difficult Employees and Reducing Conflicts Debra Phairas • 12:15 – 1:45 p.m. Very few medical or business schools teach hands-on human resources management skills and techniques. This information-packed workshop will teach you the secrets of how to lead, coach and manage difficult employees; set practice values; and reduce conflict in the practice.

DEC 5

Dec. 4: Medicare: 2014 New Rules Michele Kelly • 12:15 – 1:15 p.m. This webinar will focus on final rules from the Medicare Physician Fee Schedule that will affect physician practices during 2014 and beyond. This will help you prepare for any continuing or new programs that may negatively impact payments, as well as prepare you for revisions to policies that may impact your billing and reimbursement.

Dec. 5: ICD-10 Documentation for Physicians: Part 1 AAPC • 12:15 – 1:15 p.m. Continued on Dec. 12 and 19. This three-part series covers the key information necessary to understand key documentation elements to help you not only prepare for ICD10, but for all the regulations surrounding your practice today.

The above webinars are being hosted by the California Medical Association. Please register at www.cmanet.org/events. Once your registration has been approved, you will be sent an email confirmation with details on how to join the webinar. Questions? Call the CMA Member Help Line at (800)786-4262.

Please note that this calendar does not include CMA’s ICD-10 training courses to be offered in 2013.

JULY / AUGUST 2013 | THE BULLETIN | 25


CMA Launches Exchange Resource Center

In 2010, Congress passed historic sweeping health care legislation, the Patient Protection and Affordable Care Act (ACA), which reformed the individual and small group health insurance markets and, beginning in 2014, will provide health insurance to much of the nation’s uninsured. Under the ACA, two-thirds of California’s unin26 | THE BULLETIN | JULY / AUGUST 2013

sured may be eligible to purchase coverage through the health benefit exchange. The exchange’s goal is to begin open enrollment on October 1, 2013 – with coverage beginning on January 1, 2014. To help educate physicians about the exchange and ensure that they are aware of important issues related to exchange plan

contracting, the California Medical Association (CMA) has developed a resource page where physicians can find all of CMA’s exchange-related news and resources. The new exchange resource center can be found at www.cmanet.org/exchange.

SPECIAL MEMBER BENEFITS EDITION


personal

physician practice

websites “After working with another firm for over a year to develop a new website with little results and lots of aggravation, we hired Mayaco. In a short time we had a fully operational website that met our rigorous requirements. The Mayaco staff could not be more responsive and technically savvy. Our website is easy to navigate, attractive and a great tool for our membership.”

FR MO IE BIL ND E LY

Mary Lou Licwinko, JD, MHSA Executive Director/CEO San Francisco Medical Society

Features Total # of Pages Staff Training for Website Updates Mobile-Friendly Web Design Unique Web Address Downloadable Forms Google Maps for Location Physician Bios Personalized Email Rotating Home Page Banner Patient Appointment Request Helpful Resources Video Support Helpful Health News & Fitness information Onetime Cost for Website CMA Member Discount

CMA Member Price SPECIAL MEMBER BENEFITS EDITION

Basic Package

Premier Package

6

25

a a a a a

a a a a a

Up to 3 Up to 3

Up to 10 6 or more

$1,950 - $700

$3,950 - $1,000

$1,250

$2,950

a a a a a

EXCLUSIVE CMA Member Benefit

For more information: www.mayaco.com (209) 957-8629 JULY / AUGUST 2013 | THE BULLETIN | 27


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SPECIAL MEMBER BENEFITS EDITION


savings of $ over 99,000 The Medical Injury Compensation Reform Act (MICRA) is California’s hard-fought law to provide for injured patients and stable medical liability rates. But this year California’s trial lawyers have launched an attack to undermine MICRA and its protections, and we need your help. Membership has never been so valuable!

WAYS SCCMA/MCMS-CMA IS WORKING FOR YOU! Santa Clara and Monterey County physicians are saving an average of $99,481 this year

Are You a SCCMA/MCMS-CMA Member? 2012 SANTA CLARA AND MONTEREY COUNTY MICRA SAVINGS CHART General Surgery

Internal Medicine

OB/GYN

Average

Santa Clara/Monterey County

$22,286

$6,315

$29,188

$19,263

Miami & Dade Counties, FL

$190,088

$46,372

$201,808

$146,089

Nassau & Suffolk Counties, NY

$127,233

$34,032

$204,684

$121,983

Wayne County, MI

$121,321

$35,139

$108,020

$88,160

FL-NY-MI Average

$146,214

$38,514

$171,504

$118,744

MICRA Savings

$123,928

$32,199

$142,316

$99,481

(Non-Invasive)

Monterey County Medical Society Santa Clara County Medical Association 700 Empey Way, San Jose, California 95128 Phone: (408)998-8850 • Fax: (408)289-1064 * Medical Liability Monitor - Annual Rate Survey Issue, Vol. 37, No. 10, October 2012. Annual rates with limits of $1 million/$3 million.

SPECIAL MEMBER BENEFITS EDITION

JULY / AUGUST 2013 | THE BULLETIN | 29


This article is reprinted with the permission of San Diego Physician (with some revisions) Background: California’s landmark 1975 Medical Injury Compensation Reform Act (MICRA) is a law that ensures injured patients receive fair compensation while preserving every Californian’s access to health care. MICRA has kept the doors of medicine open for nearly 40 years, protecting California’s health care safety net by keeping medical malpractice insurance available and affordable. Prior to MICRA, out-of-control medical liability costs were forcing clinics, doctors, and other health care providers to leave the practice of medicine altogether. MICRA has helped stabilize medical liability costs, keeping more providers and clinics open and treating patients — and more stability means health care providers of all types have been less likely to close their doors because of skyrocketing liability premiums. Weakening MICRA’s intent or protections will result in higher health care costs overall, no improvement in quality, and reduced access to services. Even with MICRA, many specialty services today, like obstetricians, nurse midwives, community clinics, emergency providers, and rural pro30 | THE BULLETIN | JULY / AUGUST 2013

viders, remain particularly vulnerable to any liability increases or weakening of MICRA’s reforms. We only need to look at other states to see how important it is to preserve MICRA. States with medical liability reform are able to attract more doctors, and are less likely to suffer from shortages of specialty providers leading to the closing of hospitals, clinics, and trauma centers. According to the Texas Alliance for Patient Access, Texas enacted medical liability reforms in 2003 and has since added more than 14,000 instate, active physicians. Additionally, 35 rural Texas counties have added at least one obstetrician, including 16 counties that previously had none; 46 counties that did not have an emergency medicine physician now do; and 15 counties that did not have a cardiologist now do. In New York, a state without reforms, 19 counties are without obstetricians, 22 are without internal medicine specialists, and 15 do not have surgical specialty doctors, according to a 2010 study by the Center for Health Workforce Studies. According to a July 2012 story in The New York Times, several hospitals in New York City are partially or completely without liability insurance due to the high cost of liability premiums. SPECIAL MEMBER BENEFITS EDITION


Trial lawyers submit ballot initiative to overturn MICRA On July 24, 2013, California’s trial attorneys made good on their May threat to ask voters to repeal California’s landmark Medical Injury Compensation Reform Act (MICRA). Language was submitted to the California Attorney General in Sacramento, the first step in placing an initiative on the ballot. The initiative’s main provision would increase the cap on speculative, “non-economic” damages from the current $250,000 to more than $1.2 million, with automatic increases every year.

 The measure filed is nothing more than a self-serving attempt by trial lawyers to generate more in legal fees.

 CMA and a coalition of doctors, hospitals, nurses, community clinics, local governments, labor unions, police, emergency responders, employer groups, and others will wage a significant campaign to expose the lawyers’ self-serving agenda and to defeat the measure.
 
If the trial lawyers are successful, it will cause malpractice rates to skyrocket, force the closure of safety-net clinics, and recreate the same conditions that threatened to throw California’s health care system into SPECIAL MEMBER BENEFITS EDITION

crisis during the early 1970s.

 Imagine receiving notice that your medical malpractice premiums will increase 250% or even 400%. That’s what occurred in 1974 and 1975, leading to a crisis of unprecedented proportions that forced providers to close their doors, leave California, or choose to go without coverage.

 That’s why MICRA was passed and that is why we must work to stop the trial attorneys from obliterating the cap that has protected patients and physicians from repeating the crisis of the past.

 California’s physicians must rise to stop this attack, and in order to do so, CMA needs your support. 
 Physicians know the value of MICRA, but it will be costly to educate the general public to ensure they are not misled by deceitful trial attorneys looking for increased paydays. Funding is needed to continue our public outreach campaign, targeted voter mailings, and strategic advertising. Each of these tactics helps ensure that California’s public knows the

Continued on page 32 JULY / AUGUST 2013 | THE BULLETIN | 31


MICRA, from page 31 tremendous threat posed to health care in California by the trial attorneys’ misguided money grab.
 In short, we need your help.

 To help us defend MICRA, we are asking that you donate $150 (or more!) to CMA’s po-

litical action committee (CALPAC) today. CALPAC is the state’s only political action committee operated by physicians, for physicians, and has for the last 38 years served as the first line of defense of MICRA. Please visit http://www.cmanet.org/

Argument Against MICRA: The $250,000 cap on pain and suffering was passed more than 30 years ago. Shouldn’t it be raised, at least to keep up with inflation? Response: Remember that patients receive unlimited compensation for all economic damages. In other words, wages, medical costs, and punitive damages are all paid on an unlimited basis, and these payments are going up at more than twice the rate of inflation. The reasonable $250,000 cap on noneconomic damages is an effective way to limit meritless lawsuits and keep health care costs lower, but, not surprisingly, it has been targeted by trial lawyers because it restricts the amount of money they can collect in damage awards. The trial lawyers and their allies would benefit from increased lawsuit payouts, but we would all pay through higher health care costs and reduced access to health care providers. Prior to MICRA there were no incentives to limit meritless litigation. As a result, lawyers were suing doctors, clinics, and other health care providers out of California. Obstetricians, community clinics, and others couldn’t afford the high cost of litigation and insurance, and they were shutting down or leaving. Patients were losing access to their doctors and other health care providers. That’s why MICRA put these reasonable limits on noneconomic damages in place. For almost 40 years, MICRA has been successful in limiting meritless lawsuits, in helping keep health care costs lower, and in preserving access to care for all Californians. Argument Against MICRA: Sponsors of this initiative say that changing the MICRA laws and increasing the noneconomic damages cap will help improve quality by holding doctors accountable. They say there are 98,000 medical deaths each year due to error. Response: First, we believe even one medical error is too many, but changing MICRA won’t do anything to reduce medical errors (or improve quality). Instead, it will create a whole new set of problems by reducing access to health care services for some of our most vulnerable populations and increasing the cost of health care for all Californians. Make no mistake, this is just an attempt by trial lawyers to increase their lucrative payouts. Argument Against MICRA: Those who don’t have high economic damages are sometimes limited to $250,000 in noneconomic damages. Is that fair? Response: Remember that, under MICRA, patients will be made whole for loss of any and all economic damages, or out of pocket costs, that they have paid in the past or will pay in the future. But, if we change MICRA and health care costs increase as expected, it’s exactly California’s lower-income individuals and seniors who will be hurt the most because they are already struggling to afford medical coverage. If the cap is increased, lawyers will have more incentive to file mer32 | THE BULLETIN | JULY / AUGUST 2013

issues-and-advocacy/cmas-top-issues/micra/ donate/ to donate and defend your ability to practice in California. For more information on MICRA and how you can help, visit www.cmanet.org/micra.

itless claims. Lawsuits increase the cost of health care for everyone, and those on the lower end of the socio-economic scale will be hurt the most. And keep in mind that these individuals will still have to pay a premium even under federal health care reform. More lawsuits do nothing to improve health care; they just enrich trial lawyers at everyone else’s expense. Argument Against MICRA: Under MICRA, if a baby is unable to make it past delivery, and fault is found with the medical provider, MICRA limits the family to $250,000 in noneconomic damages. Is that fair? Response: My heart goes out to any parent who loses a child, no matter how young or old. I’m sure everyone would agree there’s no amount of compensation that could make up for the loss of a loved one. But we need to remember why MICRA was passed in the first place. Before MICRA, lawsuits were forcing doctors’ medical liability premiums to skyrocket so high that they couldn’t afford to practice medicine. Physicians were quitting medicine or leaving California to treat patients in other states. Patients were losing access to health care services. MICRA has stabilized health care, it has provided fair compensation to injured patients, it has allowed doctors to remain in practice treating patients, and it has kept health care costs lower by limiting meritless lawsuits. More lawsuits do nothing to improve health care. It only enriches trial lawyers, and we all pay. Argument for MICRA: MICRA protects access to health care services. Explanation: Prior to MICRA, out-of-control medical liability costs were forcing community clinics, health centers, doctors, and other health care providers out of practice. MICRA was intended to, and has been successful in, stabilizing liability costs. MICRA is especially critical in protecting specialty and high-risk services, including women’s health care, community clinics, health centers, and rural providers that can least afford skyrocketing costs. States without medical liability reform suffer from shortages of providers leading to the closing of hospitals, clinics, and trauma centers, and leaving patients with no doctors in their immediate vicinity. When we are trying to implement federal health care reform and provide access to health care for all Californians, this is the worst possible overreach at the worst possible time. With millions of patients entering the health care system under the Affordable Care Act and reimbursements from Medicare, Medi-Cal, and Denti-Cal being slashed, changing MICRA will worsen this situation. Argument for MICRA: MICRA protects against rising health care costs. Explanation: Increasing the amount of noneconomic damages allowed under MICRA from $250,000 to $500,000 would raise health care costs in California by at least $9.5 billion annually, according to the State’s former nonpartisan legislative analyst. That translates into approximately $1,000 annually for SPECIAL MEMBER BENEFITS EDITION


a family of four. Any legislation attempting to circumvent MICRA’s intent and protections will result in higher health care costs and reduced access to services. The threat of a ballot measure is nothing more than a money grab by trial lawyers that will come at the expense of higher health care costs for all patients and decreased access for patients and clinics already struggling to keep their doors open. Argument for MICRA: MICRA protects patients’ rights and preserves access to the courts. Explanation: MICRA preserves patients’ access to fair compensation when they have justifiable claims, including economic damages for all past and future medical costs; economic damages for lost wages, lifetime earning potential, and for any other conceivable economic losses; punitive damages, which seek to punish a defendant; and up to $250,000 available for noneconomic damages, sometimes called pain and suffering awards. Under MICRA, the average size of medical liability awards in California has increased faster than the rate of inflation. MICRA limits attorneys’ fees so patients, not lawyers, receive more from awards. Argument for MICRA: MICRA protects California’s strong patient safety record. Explanation: California has a strong patient safety record. Between 2003 and 2009, according to the Agency for Healthcare Research and Quality, California had far fewer adverse patient safety events per 100,000 people than the average of all other states. Argument for MICRA: MICRA is supported by a large and diverse coalition of patient advocates and health care providers across California. Explanation: MICRA’s supporters consist of more than 700 groups, including doctors and health care providers, local governments, public safety and labor groups, community clinics and health centers, organizations committed to disease prevention, hospitals, medical and dental societies, medical groups, health care provider-owned professional liability carriers, and many more from around the state. Time and time again, the trial lawyer-funded Consumer Watchdog group has tried to undermine the care afforded to California’s neediest patients with threats. Time and time again, patients, advocacy groups, constituents, and hundreds of organizations have rallied behind MICRA’s merits. Trial lawyers should take the hint: The people have spoken, and they don’t want to change a successful policy that would just siphon millions of dollars away from patients and into the pockets of wealthy trial lawyers. In the most recent polling, voters support MICRA by more than a 2–1 margin, with 56% in support and 25% opposed to the law.

SPECIAL MEMBER BENEFITS EDITION

In Order to Be Victorious in This Fight, We Need Your Help! DONATE: A fight of this magnitude will be extremely costly. CMA is urging all physicians to consider a donation to CMA’s political action committee (CALPAC), which for the last 38 years has served as the first line of defense for California’s historic physician protections. Call 800/225-7229. JOIN: If you are not already a member of SCCMA-MCMS/CMA, please consider joining today. By joining SCCMA-MCMS/CMA, you will help to ensure that the voice of California’s physicians is heard loud and clear in the capitol and beyond. Together, our unified voice can move mountains. Call 408/998-8850 (SCCMA) or 831/455-1008 (MCMS).

JULY / AUGUST 2013 | THE BULLETIN | 33


HR FOR MEDICAL PRACTICES PROVIDING HR SUPPORT TO SCCMA AND MCMS MEMBERS FOR OVER 18 YEARS • Auditing medical office employment practices, providing initial and ongoing updates to bring (and keep!) the operations within regulatory compliance. • Creating and/or revising Employee Handbooks and associated HR Administration Forms. • Facilitating Staff Development Training programs on communication, teambuilding, patient relations, problem solving and more. • Providing on-going expert HR Consulting support for busy medical office managers to assist with hiring, performance & leave management, employee relations and separation of employment. • Conducting CA's legally mandated Harassment Prevention Training for all supervisors, managers and leads for medical practices with 50 or more employees. • Presenting Managerial Effectiveness Training to supervisors and managers of medical companies with team leaders. • Providing HR Consulting advice to managers, owners and physicians on an “as needed” basis.

COMPLIMENTARY CONSULTING CALL & 10% Off Initial Work Exclusively for SCCMA/MCMS MEMBERS

Contact Melissa Irwin, SPHR-CA Senior Consultant/Training Specialist (831)647-7292 or melissai@tpohr.com

34 | THE BULLETIN | JULY / AUGUST 2013

Go to: www.tpohr.com SPECIAL MEMBER BENEFITS EDITION


Santa Clara County Medical Association Alliance and Foundation Annual Membership Dues July 2013-June 2014

Membership in the Alliance is very important to our continued efforts to promote quality health in our community. Your tax deductible county membership dues and/or that of your spouse/partner increases the Alliance’s ability to participate in and aid with health concerns in our community. Alliance membership allows you to be directly involved in our projects, activities, and events. Even if you do not have time to actively participate in our projects, or can only participate occasionally, your tax deductible dues and Foundation contributions are very important as they support our ongoing health projects, grants, and scholarships.

Membership Categories

• • • •

Regular Member: Physician, spouse, domestic partner, divorced spouse Sustaining Member: Retired physician or spouse, domestic partner, divorced spouse of a part-time, retired, or deceased physician Physician-in-Training: Medical student, resident, or spouse, domestic partner of a medical student or resident Friend of Medicine: Neither a physician, medical student, nor spouse, or domestic partner of a physician, or medical student. Must be sponsored annually by an Alliance Member.

 Name Spouse/Domestic Partner’s Name           __________________________________________________________________________________________  

( As you wish it to appear. Please print.)

Address___________________________________________________________________________________  

Street

City

_________________________________ Contact Phone

ST

FAX Number

Email Address

Regular Membership Dues Sustaining Membership Dues Physician-in-Training Dues   Checkbook Member        Friend  of  Medicine        

$105.00* $ $ 80.00* $ $ 15.00 $ $105.00* $    $    55.00                          $  __________

* County dues ($25) are tax deductible. (Included in the dues total are the optional $50 AMA Alliance dues.)$ Friend of Medicine $ 55.00

Sponsor’s Name

Contribution to SCCMAA Foundation(tax deductible)$ CALPAC Membership $ 25.00 $ Total $

MC Exp

Pay Dues Through the Medical Association

Pay your Alliance dues directly …...through an invoice from the ……Medical Association.

My check is enclosed payable to SCCMAA I prefer to charge my credit card**: Visa Card #                                            (**  A  $4  service  fee  will  be  added)   Signature

Pay Dues by Mail Send dues to: SCCMAA Membership 700 Empey Way San Jose, CA 95128

   

Zip

Amex /

Pay Dues Online

                           www.sccmaa.org

Santa Clara County Medical Association Alliance and Foundation 700 Empey Way, San Jose, CA 95128 408-998-8850 www.sccmaa.org

SPECIAL MEMBER BENEFITS EDITION

JULY / AUGUST 2013 | THE BULLETIN | 35

2013 July/August Part 2