A Quarterly Publication of Florida Medical Group Management Association

Florida MGMA NewsFlorida MGMA News

Vol. XIII Issue IV

Fall 2015

MARK YOUR CALENDARS! Florida MGMA Annual ConferenceJune 22-24, 2016 - Hyatt Regency Grand Cypress, Orlando

The Florida MGMA 2016 Conference will be held June

22­24 at the Hyatt Regency Grand Cypress. This is later

than our usual May dates, so mark your calendars and

bring your family! The Hyatt Regency Grand Cypress is

an excellent location for a quick summer vacation right in

your backyard! Your hotel stay includes a 850,000 gallon

lagoon­style pool that has 12 waterfalls, a water slide, a

rope bridge, and a swim­through rock grotto with a hidden

jacuzzi. Also included is use of the fitness center as well

as various bikes and boats and even a rock climbing

wall...all at no additional cost! We have secured group

rates on the hotel which will be sent out to all members in

January.

Located just one mile from Walt Disney World® Resort

and five miles from Sea World®, Hyatt Regency Grand

Cypress is the perfect option for experiencing everything

Orlando offers. No matter what you’re in the mood for,

Hyatt Regency Grand Cypress has it, from world class

championship golf and tennis to leisurely afternoons sail­

ing on our private lake. As a Disney Good Neighbor Hotel,

the resort offers easy access to the most popular theme

parks in Orlando, as well as attractions, cultural activities,

spectator sports and world­class shopping. You'll find an

endless variety of things to do during your resort retreat.

Our conference agenda will be mailed to all members in

January, but make your plans now to join us! Please con­

tact our office at flmgma@yahoo.com if you have any

questions.

2014 ­ 2015

BOARD OF DIRECTORS

President

Marynell Lubinski, FACMPE

Miami Jewish Health Systems

President Elect, Conference Chair

Sherry Mills

North Florida Surgeons

Treasurer

Ilene Gilbert­Droge, FACMPE

SMH Physician Services, Inc.

Past President

Michael A. Franks, MPA, CMPE

Premier Dermatology

Florida Collaborative Chair

Kevin Lockett

Mayo Clinic

ACMPE Representative North

Tom Menichino, FACMPE

The Villages Health

ACMPE Representative South

Lori­Ann Martell, LPN, CMPE

Advanced Medical Center, Inc.

Vice President ­ North East

Thomas Balestrieri

NoPark Avenue Dermatology

Vice President ­ North West

Chip Geitz, CPA, CMPE

Medical Center Clinic

Vice President ­ Central

Gerry Bessette

Medical Associates of Brevard

Vice President ­ Central West

Tracey Mitchell

USF Physicians Group

Vice President ­ South East

Mario Salceda

Memorial Healthcare System

Past President at Large

Henry Del Riego

FIU HealthCare Network ­ FIU Health

Member At Large

Kevin Pizzuti, CMPE

Executive Director

Lisa Beard

(561) 452­6702 ~ flmgma@yahoo.com

Dear Colleagues,

Dear FLMGMA Members:

I was very honored, and excited, to

be elected to the office of President for

FLMGMA in October 2015, for the

upcoming year (2016).

As I write this message to all my col­

leagues on this Thanksgiving holiday,

my mind is filled with all the chal­

lenges we faced as Administrators in

our practices this past year: higher

operating costs, Meaningful Use, the

deployment of ICD10 (for which our

Florida Collaborative Committee is an

excellent resource), the Physician

Quality Reporting System (PQRS),

the Value­Based Payment Modifier,

and many others. We will continue to

face, and deal with, the same chal­

lenges in 2016, and will continue to be

required to do “more­with­less,” as we

all have become accustomed to, over

the passing years. I know that those

factors kept me on my toes, constant­

ly adjusting, and I suspect many of

you experienced the same.

One of my favorite quotes comes from

Jack Welch (past CEO of General

Electric): “Before you are a leader,

success is all about growing yourself,

when you become a leader, success

is all about growing others.” I try to

implement that wisdom every day in

my position at North Florida Surgeons

in Jacksonville, FL.

With that, I would like to remind you to

renew your membership with FLMG­

MA for the upcoming year, and to

invite a colleague you know that would

benefit from our organization. FLMG­

MA offers Webinars throughout the

year (which qualify you for American

College of Medical Practice

Executives credits), with nationally­

known speakers, addressing current

topics, to assist you in running your

practices at a state­of­the­art level.

These Webinars are free to FLMGMA

members. The networking opportuni­

ties throughout the state of Florida are

also a benefit that you cannot receive

from any other organization in our

field.

The Annual Conference will be held

from June 22­24, 2016, at The Hyatt

Regency Grand Cypress in Orlando,

FL, and is guaranteed to be beneficial

to all who attend. (MARK YOUR CAL­

ENDARS)!!!

Lori­Ann Martell, LPN, CMPE –

Practice Administrator (the Chairman

of the conference), is already busily

planning with Executive Director, Lisa

A Message from the President

Marynell Lubinski, FACMPE

Florida MGMA President

2

3

Florida MGMA Free Member Webinars

Telemedicine ­ Tim Sagers, MD

Medical Director ­ MercyCare Business Health Solutions

November 10, 2015 / 1:00 ­ 2:00pm EST

TO REGISTER: Login to the Florida MGMA Website www.flmgma.com with your User Name and

Password and go to the Education Tab ­ Webinars Page and follow the link

ABOUT THIS WEBINAR:

During this webinar the presenter will cover: 1. The recent evolution in employer and healthcare consumer expectations and

utilization

2. Explain the current spectrum of telemedicine usage in the U.S.

3. Technology required to deliver employer based telemedicine

4. Demonstrate current telemedicine capabilities

Getting Ready for 2016: The Reimbursement Landscape for Medical Practices ­ Elizabeth Woodcock, MBA, FACMPE

December 8, 2015 / 1:00 ­ 2:15pm EST

ABOUT THIS WEBINAR:

Discover how shifts in the health care landscape will impact your practice in 2016 ­ and

beyond. In this dynamic presentation, national speaker, trainer and author Elizabeth

Woodcock gives you the lowdown on emerging trends that can pose both opportunities

and threats to your practice in the coming year. You’ll have a front row seat as Elizabeth

shares today’s hot button topics, such as the:

· Final Medicare reimbursement for 2016 – what specialties will feel pain,

which ones gain

· Summary of the CPT® changes for 2016

· Coding and billing for the newly covered advanced care planning

· Payment cuts for the government’s “voluntary” incentive programs, including

the value­based payment modifier

· Effectively managing the newest payer in the market, namely, your patient

Are you ready for 2016? You’ll walk away from this webinar armed with information and knowledge to understand

how your practice can weather the storms and take advantage of the opportunities in the coming year.

Visit our Webinars page to view past Florida MGMA Member Webinars On­Demand. Be sure you are logged

in to view this page.

Past Archived Webinars:

Leaning In: Skills for Emotional Resiliency ­ Ellen Haroutunian

Automating the Life Cycle of a Practice Dollar? ­ Ken Bradley

Managed Care Analysis and Negotiations ­ Jackie Boswell

Managing Up ­ Marc D. Halley, MBA

4

For two payers and a clearinghouse, the early returns on ICD­10 are positive

In a panel led by the Medical Group Management

Association's (MGMA's) Health Information

Technology Policy Director, Robert Tennant, repre­

sentatives from payers, such as Humana and

UnitedHealthcare, as well as representative from

Emdeon, a clearinghouse, said they have seen very

low rejection rates and no major issues in the early

days of ICD­10. They were all, however, very cau­

tious and not willing to get overly excited.

"Everyone is pleased with the results … but no one

is dancing in the end zone quite yet," said Ross

Lippincott, vice president of provider regulatory pro­

grams at UnitedHealthcare. "We have quite a ways

to go. We're keeping our foot on the gas in monitor­

ing, outreach support, [and] collaboration, and the

whole industry shouldn't be taking a premature sigh

of relief."

As of Oct. 9, Lippincott said United Healthcare had

processed 2.3 million ICD­10 claims. He noted that

provider call center volumes were within the normal

range, pre­authorizations were processing as

expected, and there was only a slight uptick in rejec­

tion rates, at less than 0.2 percent.

Both Lippincott and Sid Herbert, director of the ICD­

10 implementation team at Humana, touted their

organizations' efforts to prepare providers for ICD­

10. Like UnitedHealthcare, Humana has also seen

low rejection rates and a normal call volume thus

far. More than 50 percent of claims, by Oct. 7, were

coded in ICD­10.

"It was somewhat similar to Y2K; we worked like

demons, and everything proceeded the way it

should have," Herbert said. "That's not to say it will

continue that way, but I think we have enough data

that says we won't have major catastrophic issues."

'At the Beginning of This Journey'

It wasn't just payer representatives who had a posi­

tive message on the transition. Mike Denison, sen­

ior director for regulatory programs at Emdeon,

which has a large all­payer network for its clearing­

house services, said even though a lot of providers

didn't conduct any readiness testing with the com­

pany before the transition date, most are using ICD­

10 codes when they should be. Moreover, he said

they haven't seen a significant increase in claim

rejections, as it's trending in line with prior daily

averages.

Denison said he was "cautiously optimistic," going

forward. The efforts to keep providers prepared, the

three said, will continue past the Oct. 1 deadline. All

three companies offer an ICD­10 command center.

Overall, the MGMA's Tennant said he is hearing that

claims are moving through the system. He said if

there were massive issues, the organization

would've found out. Still, in the spirit of waiting to

celebrate, he said there were short­ and long­term

questions on ICD­10 that needed to be answered.

Specifically, he had questions around the four state

Medicaid agencies (California, Louisiana, Maryland,

and Montana) which aren't accepting ICD­10 codes,

and whether granular coding would actually lead to

better data and improved quality of care.

Tennant, seemingly half­kiddingly, said that when

the same roundtable convened in a month, they'd

be talking about the increase in denials. However,

considering CMS' previous projections of post Oct.

1­denials, he may very well be right.

"We're only at the beginning of this journey. We're

now at the point where can move information back

and forth between providers and payers based on

real­world conditions. We're beginning a learning

process that will benefit us all over a short period of

time. This is beginning of the journey. I'm hopeful

the issues will be small, but be assured, that it's in

the payers' best interest to actually pay a claim

quickly, accurately, and effectively. Anything beyond

that causes rework and dissatisfied the provider, so

there is no real positive result," said Herbert.

http://www.physicianspractice.com/icd­10/cautious­

optimism­early­days­icd­10#sthash.ZKKAlKRz.dpuf

5

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6

Florida MGMAWelcomes New

Members

6

Active Members

Esther Kovacs

Urology Center of Winter Park

Winter Park

Miriam Williams

Panama City Urological Center

Panama City Beach

Florida MGMA Job Board

Title Company City

Director ­ Physician Practices Memorial Healthcare System Hollywood

Billing and Collections Manager Internal Medicine Associates of Lee County Ft. Myers

Billing Manager Internal Medicine Associates of Lee County Ft. Myers

Medical Practice Administrator DoctorsManagement, LLC Vero Beach

Director of Operations for Primary Care Sarasota Memorial Health Care System Sarasota

The following positions are currently being advertised in the Florida MGMA Job Board.

For full details, please visit our website at www.flmgma.com.

Members may post their open positions at no cost.

Payers Won't Always Be So Lenient in ICD­10

So far the in the new ICD­10 world, CMS and private payers have been going on

easy on specificity requirements. For many practices, this has been a huge help.

However, if you are getting comfortable with this flexibility as the new norm then

you may be in for an unpleasant surprise.

The introduction of ICD­10 has always been handled with something of a carrot

and stick approach. For years CMS and congress alternated between warnings

and reassurances, urging providers to thoroughly prepare while offering repeated

delays and concessions about easing the requirements during the transition. The

delays led many practices to think ICD­10 wasn't coming at all, causing them to put

off training, testing, and making financial preparations until dangerously late, and

scrambling to get ready when it was obvious no more delays were in the cards.

The concessions on specificity might be creating a similar false sense of security.

It's going great! We aren't getting a huge increase in denials! We've nailed this

thing! But if you're counting on payers continuing to accept codes that are only "in

the family of codes" or "just make sense," and trusting your software to know things

that you don't, you are living on borrowed time. More help from Congress is unlike­

ly to arrive this time, either. "When CMS announced the flexibility rule," said Robert

Tennant, senior policy advisor for the Medical Group Management Association,

"interest on Capital Hill diverted almost immediately."

Barbie Hays, coding and compliance strategist for the American Academy of

Family Physicians, said that she has received several calls from people asking

how to code something that their EHR couldn't find. "Practices should NOT rely on

their EHR," she said. If you're having this problem, Hays said you have a couple

of options. "I would first recommend getting an actual hard copy of the ICD­10­CM

code book. There are many vendors that sell this, such as OptumIngenix, Amazon,

and the AAFP (the AAFP does not endorse any particular vendor or brand). The

second option— and this is not recommended, but could work in a pinch— is to

Google the term and read the results." Hays adds that this last maneuver is not

advisable if you are not familiar with coding convention and practices.

Bottom line is this: If things are going well for you because you are relying on your

EHR and the indulgence of your payers, you might be headed for a fall. If you

aren't up to speed with ICD­10, get that way as quickly as possible. You've heard

it before but they weren't crying wolf last time and they aren't now.

­Avery Hurt

Physicians Practice

New Local Chapter Formed

We have formed a new local chap­

ter in the Panama City Beach

Area! For more information,

please contact:

Linda Swadener, FACMPE

Practice Administrator

Surgical Associates of NW Florida

(850) 215­5023Surgicalassociatesnwf@gmail.com

7

ACMPE...The Road to Certification

As leaders in the healthcare field, have you ever thought

about where you are, where you have been and what

you will be doing next? I sure have. I have been in

healthcare 25 years, and the changes I have been part

of are amazing. I am a firm believer my career is more

than a job. It is a passion. I don’t believe our jobs as

administrators, managers, physicians, etc. need to be

this hard. I also realize I could not have survived some

of the changes without the great mentors, colleagues

and friends I have made along the way. The rules, reg­

ulations and responsibilities administrators and manag­

er are faced with can be stressful. MGMA has worked

hard to provide many resources to help reduce our

stress. One of the great resources MGMA has provided

to us is the opportunity to become board certified in the

American College of Medical Practice Executives. Once

you become board certified, you then become eligible to

obtain your Fellowship in the American College of

Medical Practice Executives.

Am I eligible?

You are eligible to apply for the board certification once

you have completed a minimum of two years in health­

care management, with at least 6 months in a supervi­

sory role.

Why do I need to become Board Certified?

Some may ask, why become board certified? While

there are many answers to this question, most who

chose to make this a career goal do it for the experience

of gaining knowledge about subjects they may not have

much exposure to. Board certification gives administra­

tors and managers recognition for skills and knowledge

they have and the opportunity to learn new skills.

How do I get started?

There are three steps to certification:

1. Join MGMA­ACMPE

2. Pass 175 question objective exam and 3 quest ions

essay exam. (Exams are held in various testing sites.)

3. Accumulate 50 hours of CEU’s (Continuing Education

Units). CEUs are obtained by taking the practice exam

for the test, attending local, state and national confer­

ences and meetings, educational webinars, on­line

study groups, and by reading articles in the MGMA con­

nection.

The next certification exams will be held November 9­

21, 2015. Registration information is located at

www.mgma.com/exams.

Exam sites can be found at: http://www.castleworld­

wide.com/cww/our­solutions/test­delivery/test­site­

cities/#uslocations

Preparation for the Exam:

A great way to prepare for taking the exam is to practice

to see what areas you may need to study more.

Remember this exam is based on what you do as

administrators and managers every day. Don’t get lost

in forever preparation. This often leads to frustration

and then procrastination. Practicing first will give you

the confidence you need to successfully pass the exam.

The Body of Knowledge web portal

(www.mgma.org/bok) is great resource to use when

preparing for the exam. All 6 domains are on the website

and will also allow you to take a quiz over each domain.

There are also sample essay questions.

Fellowship

Once you have successfully completed your board cer­

tification, you will have an opportunity to obtain your fel­

lowship. Fellowship is the highest distinction in Medical

Practice Management. In order to obtain fellowship sta­

tus with the College of American Medical Executives,

you must submit a professional paper on a relevant

healthcare topic.

Questions? Contact our Florida MGMA ACMPE

Forum Representatives!

­ Lori­Ann Martell, LPN, CMPE 239.216.1252 or

lmartell@advancedmedicalcenter.com

­ Tom Menichino, FACMPE 352.674.8905 or

tom.menichino@thevillageshealth.com

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The 16 Most Absurd ICD­10 Codes

There are 68,000 billing codes under the new ICD­10

system, as opposed to a paltry 13,000 under the cur­

rent ICD­9. The expansive diagnostic codes, intended

to smooth billing processes and assist in population

health and cost reduction across the healthcare deliv­

ery system, have providers across the board worried

about integration: A recent survey by the American

Health Information Management Association and the

eHealth Initiatives found that 38% of providers think

revenue will decrease in year following the switch from

ICD­9, while only 6% think revenue will increase.

Still, providers are preparing for the switch. After yet

another delay this year, the official changeover date is

set for October 1, 2015 , and 40% of respondents say

they will be prepared to do end­to­end testing by the

end of this year.

Despite the controversy surrounding ICD­10, there is

one universally agreed­upon upside to the hyper­spe­

cific coding system: Weird and obscure codes that

stand for bizarre medical injuries. There's even an

illustrated book, Struck by an Orca: ICD­10 Illustrated.

(Healthcare Dive is super into it.)

Therefore, behold! The 16 most absurd codes in the

entire ICD­10 set, with a little advice from Healthcare

Dive on how to handle these cases should they come

into your ER:

16. V97.33XD: Sucked into jet engine, subsequent

encounter.

Sucked into a jet engine, survived, then sucked in

again? First of all, that really, really sucks. Second of

all, this patient is obviously Wolverine, and should be

detained for imaging and posterity.

(Technically, this means "subsequent encounter with a

physician" not "subsequent encounter with a jet

engine," but that's less dramatic.)

15. W51.XXXA: Accidental striking against or

bumped into by another person, sequela.

The "sequela" here implies the kind of human bumper

cars that can only happen at a music festival, the sub­

way or possibly an active combat zone. Potentially

fatal for agoraphobics. Recommend handling with

care.

14. V00.01XD: Pedestrian on foot injured in colli­

sion with roller­skater, subsequent encounter.

First, are roller skates even still a thing anymore? I

mean, other than how one knows spring has sprung in

Central Park? Second, can you call a person on roller

skates a pedestrian? Thirdly, if the answers to one and

two are "yes," then these things should be outlawed,

because they are obviously dangerous.

13. Y93.D: Activities involved arts and handcrafts.

Camp is a dangerous thing. Hot glue guns and knitting

needles definitely wouldn't be allowed on a plane, yet

we habitually allow 7­year­olds to play with them. This

is a public health crisis that needs to be addressed.

12.Z99.89: Dependence on enabling machines and

devices, not elsewhere classified.

There's a reason they call it the Crackberry. This is an

obsolete joke, but there just isn't an iPhone pun that

can compete with "crackberry."

11. Y92.146: Swimming­pool of prison as the place

of occurrence of the external cause.

There is also a code for "day spa of prison as the place

of occurrence."

10. S10.87XA: Other superficial bite of other spec­

ified part of neck, initial encounter.

Alright, people. Let's call a spade a spade. "Other

superficial bite of other specified part of the neck?"

This is a hickey. Admit it. Although why anyone would

be admitted for that remains a mystery.

continued on page 10

9

10

The 16 Most Absurd ICD­10 Codes, continued

9. W61.62XD: Struck by duck, subsequent

encounter.

tweet this quote

8. W55.41XA: Bitten by pig, initial encounter .

First, be sure that the patient is restrained from doing

whatever he or she may have done to provoke the pig

in the first place. Security should be placed on alert.

Also, what was this person doing in a farm setting in

the first place? Pigs are not pets.

7. Z63.1: Problems in relationship with in­laws.

Who doesn't?

6. W220.2XD: Walked into lamppost, subsequent

encounter.

No. No. People. You only get to do this once. ONCE.

If a patient is going around whacking into lampposts

regularly, there is a deeper problem here, and he

should be referred to psych immediately.

5. Y93.D: V91.07XD: Burn due to water­skis on fire,

subsequent encounter .

How does this happen? Are water skis even flamma­

ble?

4. W55.29XA: Other contact with cow, subsequent

encounter.

"Other contact with cow." OTHER CONTACT WITH

COW? There are codes for "bitten by cow" and "kicked

by cow." What else is there?! What, precisely, is the

contact with the cow that has necessitated a hospital

visit?!

3. W22.02XD: V95.43XS: Spacecraft collision injur­

ing occupant, sequela.

The existence of this type of code does not engender

trust in the National Aeronautics and Space

Administration. Shouldn't they have more control over

their spacecraft than that? Or are they just careening

around in the ether, pinging into one another and injur­

ing occupants/astronauts?

2. W61.12XA: Struck by macaw, initial encounter.

Macaws are endangered—some are extinct in the

wild—so if a patient has been struck by a macaw,

chances are, it was the patient's fault. Consider calling

the SPCA and/or the police. The macaw needs to be

found and treated immediately.

1. R46.1: Bizarre personal appearance.

LADY GAGA, IS THAT YOU? WE LOVE YOUR MEAT

SUIT.

But seriously, who gets to decide what constitutes

"bizarre personal appearance"? Let the people do

what they want!

­ Katie Bo Williams

Industry Dive, the parent company of Healthcare Dive,

covers business news for executives in a number of

industries. Many of our publications are free, including

our daily newsletters.

Meaningful Use in 2015 – Finally Set in Stone

11

Last week, the Centers for Medicare and Medicaid

Services (CMS) issued the long­awaited Final Rule

on the EHR Incentive Program. The notification was

overdue, as the first day of the final reporting period

for 2015 – October 3 – has passed. Indeed, CMS has

confirmed that the reporting period is any continuous

90 days in 2015. Justifying its delay in the issuance

of the rulemaking, CMS explains that the modifica­

tions being delivered accommodate all eligible pro­

fessionals who have been diligently working towards

a successful attestation based on the current pro­

gram requirements. In addition to releasing the final

criteria for the now­named Modified Stage Two, this

Final Rule also addresses the future of the program,

in the context of the new Merit­based Incentive

Payment System (MIPS), as well as Stage Three.

Unlike the government, we won’t waste our time

mulling over the program’s future, instead turning our

attention to what actions you need to take now to

avoid the 3% penalty for 2017.

Without further ado, the final 10 Modified Stage Two

criteria and measures for Meaningful Use are sum­

marized herein:

1. Protection of patients’ health information through a

security risk analysis.

2. Implementation of 5 clinical decision support inter­

ventions, and drug/drug and drug/allergy interaction

checks.

3. Computerized provider order entry for medications

(60%), labs and radiology orders (30% each).

4. Electronic prescriptions for 50 percent of all per­

missible prescriptions, including formulary checks.

5. Creation and electronic transmission of summary

of care records for more than 10% of transitions of

care and referrals.

6. Delivery of patient­specific education resources to

more than 10% of all unique patients with office visits

during the reporting period.

7. Performance of medication reconciliation for more

than 50% of the incoming transitions of care.

8. Provision of timely access to health information for

more than 50% of all unique patients seen during the

reporting period to view online, download and trans­

mit to a third party; with action confirmed on the basis

of having one patient view, download or transmit dur­

ing the reporting period.

9. Confirmation that secure electronic messaging is

enabled – i.e., yes/no.

10. Reporting – or at least on the path to reporting –

to a public health agency or a registry for two meas­

ures.

The 10 criteria for the new Modified Stage Two are

changing slightly in 2016, with a requirement to

report that at least one patient seen during the report­

ing period sent an electronic message, increased

back to the 5% of all patients in 2017. In 2017, the

“view, download, transmit” objective also reverts back

to the 5% measure. CMS has declared that the 90­

day reporting period is only for 2015, with the full cal­

endar year reporting required for 2016.

CMS decided not to issue another set of criteria for

Stage One, instead requiring all participants to move

to this Modified Stage Two in 2015 – however, Stage

One participants are provided extensive exclusions

and alternative objectives and measures. Thus,

despite the fact that all eligible professionals are

required to attest to Modified Stage Two, the specifi­

cations for Stage One participants essentially create

a separate reporting requirement – one that is much

less burdensome.

CMS has yet to update the website for the EHR

Incentive Program, but you can read the 752­page

Final Rule (which will be on view until its official pub­

lication, slated for October 16) – or perhaps just

spend a few minutes reviewing CMS’ announcement

that accompanied the issuance of the new criteria.

CMS won’t open the attestation portal until the begin­

ning of 2016, but you’ll have until the end of February

to report (with CMS already indicating that they may

extend that through March). Until then, get in gear for

Modified Stage Two in order to gain any remaining

bonus payments – and avoid the payment adjust­

ments being imposed in 2017 based on this year’s

performance.

­ Elizabeth Woodcock, MBA, FACMPE

www.elizabethwoodcock.com

12

Customer service didn't used to be closely associat­

ed with running a medical office but it has become

increasingly important in order to survive in a com­

petitive market. Consumers have more choices as to

where they receive care and are increasingly con­

scious of what they're getting for their money. On top

of that, insurers are starting to tie financial incentives

to patient satisfaction.

To thrive in the new market, patient­centered care

must be woven into the fabric of the practice, experts

say. The whole staff needs to be involved in creating

a culture of service that extends from the time a

patient schedules an appointment to when they pay

their final bill.

"It has to start from the top because if staff doesn't

see it prioritized by the physician they won't care as

much," says Lauren King, director of customer serv­

ice at DoctorsManagement, a medical and health­

care consulting firm based in Knoxville, Tenn. "It's not

just about having a one­hour workshop but establish­

ing an ongoing campaign where someone is leading

the cause and issuing frequent reminders.

"Training is critical so that all staff members know

their roles and how they impact patient satisfaction,

says Owen Dahl, a practice management consultant

based in The Woodlands, Texas. That might include

roleplaying where staff members practice how to deal

with different scenarios, such as an angry patient.

"The more you can do to train and review those sce­

narios with staff, the better off you will be," he says.

"It reduces the stress on the part of staff members

and helps them communicate better with the patient.

"It helps to establish protocols and give staff the tools

they need to deal with various types of patient

encounters on their own, says Michael Munger, a

family physician and medical director at St. Luke's

South Primary Care in Overland Park, Kan.

Empowering staff to work at the top of their licensure

not only fosters teamwork but also strengthens their

ties with patients.

"Staff members should be able to deal with certain

issues without having to consult with a doctor," says

Munger. "For example, we empower our medical

assistants to talk to patients about their health

screenings and immunizations or go over health

habits. By doing that, we find that patients start to

identify with the nurse and medical assistant as part

of the overall team and feel a bond with them.

"All staff members should not only know their role in

the patient experience but also that they will be held

accountable, says Julie Boisen, managing director

for Navigant Consulting's Healthcare practice, based

in its Plankinton, S.D. office. You can add specific

questions to customer satisfaction surveys about the

quality of care received from individual staff mem­

bers, for example, or perform chart audits.

"If the medical assistant is in charge of measuring

patients' height and weight and taking their blood

pressure when they come in, make sure that actually

occurs by conducting an audit," Boisen says. "Those

procedures are reassuring to patients because it indi­

cates that you monitor quality of care.

"With ongoing training and frequent communication

among physicians and staff, customer service will

soon become second nature, says Munger.

"Everyone who touches the patient, not just the clini­

cal staff, should be working as a team and talking to

each other," he says. "You want your patients to think

of you and your care team as an extended family."

­ Janet Colwell

www.physicianpractice.com

Customer Service a Key Element to Your Practice

13

How Social Media Can Benefit Your Practice

A large chunk of the US population is turning to social

media for health­related information. If its power is

harnessed wisely, it can be a powerful tool for your

practice. Network through these platforms have

expanded the social life of health, which now goes far

beyond a doctor’s office. Patients who share a partic­

ular health condition can talk directly to each other,

share their experiences, educate each other, and

recommend doctors and treatments that have

worked for them.

As such, it can be used as an ideal platform to share

your practice visibility, connect directly with target

patients, and influence their opinion about your prac­

tice. Entrepreneurial physicians have understood the

possibilities of social media marketing and have

leveraged it to their benefit. It’s about making a brand

of your practice through social media marketing.

Here are five benefits of social media that physi­

cians should understand:

Richer customer experiences

Every patient interaction you have on various plat­

forms like patient­review websites, blogs, Facebook,

Twitter, and LinkedIn is an excellent opportunity to let

the world know about service at your practice.

Through these interactions, you can get to know the

mindset of patients. You can utilize this medium to

address the issues patients may have faced at your

practice, apologize for any inconvenience you’ve

caused, and assure them that nothing less than the

best healthcare services will be provided.

Every post you make on social media platforms can

be a chance to convert potential patients. If you have

a reasonable following on social media, you can reap

tri­fold benefits of simultaneously connecting with

new patients, existing ones, and other visitors who

can be future potential patients.

Wider bandwidth for brand exposure

Experts say social media is the most important factor

for brand management these days, to showcase your

brand and build brand credibility. A strong online

presence enhances a physician’s trustworthiness as

well as boosts their website’s traffic and search

engine ranking. It provides additional exposure to

your practice.

Improved services

“How a physician or hospital responds to negative

comments and complaints can carry equal or more

weight than positive consumer engagement,” accord­

ing to one report from PricewaterhouseCoopers

(PwC). These issues, when brought to attention on

social media, can be addressed and resolved imme­

diately because there is an outlet for a dialogue.

When social media users observe that their issues

and problems are handled right away and solutions

are being worked out, they have a feeling that cus­

tomer service is taken seriously. On the other hand, it

gives the physician a chance to be aware about what

is being said about his or her practice. This can be a

great opportunity in some cases, where the physi­

cians can handle an angry or upset patient at the very

first instance he or she posts something, before the

situation becomes aggravated.

Discovery of new trends

Change is law of nature. Even your patients keep

evolving with time. So how will you come to know

what patients really want out of a consultation? For

instance, because of obesity, someone with diabetes

might be seeking a diet and healthy lifestyle consul­

tation to cure the disease naturally. Here, social

media comes to rescue! You can spark a discussion

among patient communities on platforms like

Facebook, Twitter, and LinkedIn. These discussions

continued on page 14

How Social Media Can BenefitYour Practice, continued

reveal the mindset of patients and revelations can be

manifested in the form of better services at your prac­

tice.

A cost­effective way to connect with patients

According to Hubspot, 84 percent of marketers found

that as little as six hours of effort per week given to

social media is enough to generate increased traffic.

Targeting a large audience through social media with

this time investment, which is about one hour per

day, isn’t a bad deal. Moreover, the only true cost is

the time involved. After clinic hours, if you can spare

one hour per day for engaging on social media, it will

give you a good return on your time invested.

However, if you aren’t able to devote this time, you

can consider deploying a staff member for these

activities.

The doctor­patient relationship is the nexus of

Western healthcare systems. As the patients are

evolving with social media, it’s imperative for physi­

cians to evolve with them, or else they will be left

behind the competition. Social media networks are

new channels to represent your practice as a brand

in the online market. It’s time for physicians to recog­

nize the practical benefits of using social media to

influence patient perceptions.Manish Chauhan is

Digital Marketing Manager at myPracticeReputation

which is an easy­to­use reputation management

solution for physicians to help monitor, protect and

promote their medical practices at all times in the

simplest way possible.

­ Manish Kumar Chauhan

Manish Chauhan is Digital Marketing Manager at

myPracticeReputation which is an easy­to­use repu­

tation management solution for physicians to help

monitor, protect and promote their medical practices

at all times in the simplest way possible.

14

Look for more HIPAA audits in the future

In two recent reports, each with a specific focus,

the OIG strongly recommended that the Office for

Civil Rights (OCR) step up its HIPAA oversight

and enforcement activities. One report assessed

the OCR’s oversight of covered entities’ compli­

ance with the HIPAA privacy rule and the second

analyzed the OCR’s enforcement related to

reported breaches. In conducting its analysis

under both reports, the OIG reviewed closed

cases involving alleged or actual violations of

HIPAA privacy requirements and previously

reported breaches. The analysis also involved

surveys of OCR staff and interviews with OCR

officials. The OIG’s findings and recommenda­

tions are summarized below.

The OIG took issue with the fact that, rather than

proactive initiatives, the OCR’s oversight activi­

ties are primarily reactive in response to com­

plaints, self­reporting (in the context of a breach),

tips or media reports. The OCR stated that it has

not fully implemented its proactive audit program,

as mandated by HITECH Act, which is to assess

covered entities’ compliance with the privacy

standards. Accordingly, the OIG recommended

that the OCR implement a permanent audit pro­

gram to supplement the OCR’s investigation

activities.

The OCR concurred with OIG’s recommenda­

tions and noted that it will be launching a perma­

nent audit program in early 2016 to include both

desk reviews and onsite reviews. These audits

will also include HIPAA business associates.

Notwithstanding the anticipated audit program,

the OCR noted that budgetary constraints have

presented an obstacle to the OCR implementing

additional responsibilities as may have been

required. Accordingly, the OCR stated, the

longevity of the audit program will depend on the

availability of necessary resources.

sumers compare plans and

better understand total out­

of­pocket costs. HHS also

plans to add more features

in the future, such as the

ability to search for health

plans that include specific

physicians as in­network.

The 2016 enrollment period

will remain open through

Jan. 31, 2016. To learn

more about the ACA

exchanges, visit MGMA’s

Insurance Exchange

Essentials for Practices

Executives webpage and

view our ACA Patient Resources.

Five options to check status of Medicare ICD­

10 claims

To allow physician practices to identify potential prob­

lems with claims submitted using ICD­10 codes (or

other issues), the Centers for Medicare & Medicaid

Services (CMS) has outlined five ways for physician

practices to check the status of claims submitted to their

Medicare Administrative Contractors (MACs):

1. Interactive voice response: Provides access to

Medicare claims information through a toll­free tele­

phone number.

2. Customer Service Representative: Call if you are

unable to access claims information via interactive

voice response.

3.MAC web portal.

4. Directed data entry.

5.Health care claim status request and response

(276/277): Request the status of claims (via a 276

transaction) and receive a response electronically (via a

277 transaction).

Visit your MAC's website for additional information on

these options.

MGMA: Washington Update

CMS allows exclusion for meaningful use

public health reporting objective

Earlier this month, the Centers for Medicare & Medicaid

Services (CMS) finalized changes to the reporting crite­

ria for the EHR Incentive (meaningful use) program.

Starting in 2015, eligible professionals (EPs) are now

required to report certain public health measures, which

were previously optional. If EPs were not intending to

report these public health measures, CMS has

announced that they may now claim an alternate exclu­

sion in 2015 because the agency issued the changes so

late in the year.

Out of the three public health measures, EPs can claim

an alternate exclusion for up to two measures, depend­

ing on their stage of the meaningful use program. To

learn more about this alternate exclusion and all of the

modified 2015 meaningful use requirements, access

MGMA’s member­exclusive overview.

Medicare Part D prescriber requirements

delayed

The Centers for Medicare & Medicaid Services (CMS)

recently announced a delay in the requirement that to

prescribe under Medicare Part D, physicians or eligible

prescribers must be enrolled in Medicare or, for those

who have opted out of the program, have a valid affi­

davit on file with their Medicare Administrative

Contractor (MAC). The new effective date for these

requirements will now be June 1, 2016. However, pre­

scribers of Part D drugs not currently enrolled in

Medicare should submit their enrollment applications or

opt­out affidavits to their MACs as soon as possible to

avoid patients’ Part D prescription drug claims from

being denied by their Part D plans beginning June 1 of

next year. More information on these Part D prescriber

requirements is available at:

h t t p s : / / w w w . c m s . g o v / O u t r e a c h ­ a n d ­

E d u c a t i o n / M e d i c a r e ­ L e a r n i n g ­ N e t w o r k ­

MLN/MLNMattersArticles/Downloads/SE1434.pdf

ACA open enrollment period begins Nov. 1

Nov. 1 is the start date for consumers to purchase 2016

health insurance coverage through the federal and state

health insurance exchanges, established by the Patient

Protection and Affordable Care Act (ACA). The

Department of Health and Human Services (HHS)

announced upgrades for the federal marketplace web­

site healthcare.gov, such as new tools to help con­15

Post Office Box 380124

Birmingham, AL 35238­0124

Visit us on the web at www.flmgma.com

WE KNOW GOOD MEDICINE WHEN WE SEE IT, AND WE’RE DETERMINED TO DEFEND IT.

MagMutual’s Florida Claims Committees consist of physicians

just like you. They review cases with the same care they’d

wish for their own. We hire the top local attorneys who are

guided by our local expert claims specialists. And we won’t

settle a claim without your consent. What else would you

expect of a physician-owned, physician-led company?

Good medicine deserves the best defense.

To learn how MagMutual defends physicians, call 1-800-741-0611

or visit MagMutual.com.

Insurance products and services are issued and underwritten by MAG Mutual Insurance Company and its affiliates.

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