Archive for MVP

Are You a Medicare Provider Without an EHR?

Are You a Medicare Provider Without an EHR?

You can still avoid the MIPS 4 percent penalty by participating this year!

In 2017 the TEST portion of MIPS allows a provider to submit one Quality measure (previously known as PQRS) for less than a 90 day period to potentially avoid a 4 percent MIPS penalty (to be incurred in 2019) on Medicare Part B claims. One example of this is G8427 – Current Medications Documented. Every office typically documents a patient’s Current Medications. If you submit this code on your claims, even if only for a short period of time, you will be participating in the test portion of MIPS and may avoid a 4 percent penalty on Medicare Part B in 2019.

Remember, you will need to do this for every TIN/NPI combination in your practice.

The graph below shows a broad overview of the current MIPS attestation guidelines. Each line gives a brief summary of the four different attestation paths an office can choose from for 2017. Based on your 2017 participation, the above information references the row with one star and explains the simple criteria required this year to easily avoid a 4 percent penalty which incurred in 2019.

Need help understanding these new MIPS requirements? Contact MediSYS today at 1 (334) 277-6201 or email questions to sales@medisysinc.com. Our staff has been assisting practices with various CMS incentive programs since their inception. We combine years of experience with ongoing support and detailed expertise for our clients at no additional support charges.

 

For information on MediSYS electronic health records and practice management solutions as well as outsourcing CCM services, please contact MediSYS at sales@medisysinc.com and visit the website at www.medisysinc.com. MediSYS is an official partner with the Medical Association.

 

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A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part III)

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part III)

Editor’s Note: The following is the final installment of a three-part series discussing important provisions in physician employment agreements.

When a physician leaves a medical practice, especially if the physician stays in the area to compete against his/her former employer, the situation can become stressful and acrimonious. During the final weeks of employment, the departing physician can start to focus more on his/her new practice to the detriment of the current employer, and disputes often arise regarding access to medical records, soliciting patients and employees and when to schedule procedures – before or after termination. We have seen both medical practices and departing physicians engage in questionable conduct in order to keep as many patients as possible. Lawyers are often engaged in negotiating the terms of separation or, in a worse-case scenario, filing or defending a lawsuit.

Over the years, we have counseled hundreds of physician practices on how to successfully navigate the various issues that arise when a physician departs, regardless of whether the physician is an employee or an owner. Careful planning on the front end through a comprehensive employment agreement is the most important element in an amicable and fair separation. More often than not, we have found that disputes and subsequent litigation can arise when the employment agreement is not properly drafted or does not adequately address the specific terms of separation.

This three-part series provides a summary of the key provisions (with sample language) that can be incorporated into a physician employment agreement to help mitigate problems when a physician leaves your practice. Since each medical practice is unique, please consult with your own attorney before using any of the provided sample provisions in a physician employment agreement.

Protecting the Practice’s Confidential Information. Especially if the departing physician will continue to practice in the same service area as the medical practice, it is very important that the practice protects its sensitive and confidential information, including medical records, charge masters and policies and procedures. As such, the employment agreement should address the confidentiality of such items. Failure to do so will make it more difficult for the medical practice to protect its sensitive information.

Physician agrees that all data and information which he/she receives from Employer, whether directly or indirectly, in connection with this Employment Agreement or Physician’s employment with Employer shall be considered confidential and proprietary information belonging solely to Employer (the “Confidential Information”). Without limiting the foregoing, “Confidential Information” shall mean any written or oral information of Employer, including, without limitation, all business or management studies, patient lists and records, financial information, Employer documents, forms, business or management methods, marketing data, fee schedules, employee and operating manuals, trade secrets as defined by the Alabama Trade Secret Act, as amended from time to time, accounting information, and any other information treated by Employer as being confidential or labeled “Confidential” by Employer. Physician shall hold such Confidential Information in strictest confidence and shall not make use of such Confidential Information except in the performance of his/her services for Employer. Physician shall not disclose, distribute or otherwise divulge such Confidential Information to any other third-party without the prior written consent of Employer, except in the performance of his/her services for Employer. Notwithstanding anything contained in this Section to the contrary, the obligations of Physician under this Section shall not apply to information or property which Physician can demonstrate is: (a) now in the public domain or later publicly available through no fault of Physician, (b) has been or is in the future rightfully obtained without restriction by Physician from other sources not subject to a confidentiality agreement, or (c) independently developed without use of Employer’s Confidential Information. Upon request of Employer and upon termination of this Employment Agreement, Physician shall immediately return to Employer all Confidential Information which Physician received from Employer or any Confidential Information within Physician’s possession. The terms of this Section shall survive termination of the Employment Agreement.

Protecting the Practice from Future Liabilities. When a physician leaves a medical practice it is still possible for the practice to face liability stemming from the physician’s past conduct. For example, federal payers, such as Medicare and Medicaid, as well as commercial payers, can audit medical practices for professional services rendered several years prior to the date of the audit.  Further, HIPAA violations, malpractice issues and other misconduct may not surface until after a physician leaves a medical practice. Unless the employment agreement continues to hold the departing physician responsible after termination for his/her conduct during employment the medical practice may have insufficient remedies in the event a problem arises.

Physician shall hold harmless, indemnify and defend Employer, and its members, partners, officers, directors, employees, successors, representatives and assigns, from and against any and all liabilities, costs, damages, suits, judgments, fines, losses, demands or expenses of any kind whatsoever (including, but not limited to, court costs, arbitration fees, if applicable, and attorneys’ fees and expenses actually and reasonably incurred) from or attributable to: (a) any breach by Physician of this Employment Agreement, (b) any and all negligent or intentional acts and/or omissions of Physician, and/or (c) any overpayment, refunds, offsets or recoupments related to claims for medical services provided or ordered by the Physician, but only to the extent the Physician received compensation from the claims subject to the refund, offset or recoupment.  The terms of this Section shall survive termination of the Employment Agreement.

While it may take more work on the front-end, having a well-thought out and comprehensive physician employment agreement will save significant time, effort and potentially money when a physician leaves your medical practice.

Read the full series:

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part I)

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part II)

Howard Bogard is a Partner with Burr & Forman LLP and serves as the Chair of the firm’s Health Care Industry Group. Kelli Fleming is a Partner with Burr & Forman LLP practicing in the firm’s Health Care Industry Group.

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The Lowdown on Public Wi-Fi

The Lowdown on Public Wi-Fi

I am writing this from an airplane. Often, when I hop on a plane — particularly for a long flight — I wait for the ascent to 10,000 feet and immediately jump onto public Wi-Fi, just as I do in coffee shops, the dentist’s office, and pretty much anywhere else I can grab a signal. But that was before I spent an hour chatting with Joe Gervais, director of security communications at LifeLock, and part-time hacker (though Gervais points out, he hacks “only for good”). The point of the conversation was to figure out when it’s okay to use public Wi-Fi, when it’s not, and what you can do instead. Here’s what I learned…

What is public Wi-Fi? Any Wi-Fi that’s shared with someone other than yourself and the members of your household. A guest account that’s been set up for visitors to a particular company? Hotel Wi-Fi, free or not? In-flight Wi-Fi? Public, public and public. It doesn’t matter if it’s free or you pay a fee, or if it’s password protected.

Get that? Even if the Wi-Fi network requires a password, that doesn’t mean it’s safe.

What danger does that pose for me? Whenever computers are on a shared network, all the data is flowing over shared “wires.” Every computer on the network can see all the data flowing over that network. The default behavior, Gervais explains, is to ignore data that isn’t meant for your machine. But if you’re technically savvy and so inclined, you can, essentially, flip a switch and see everything. Most of it, he says, is garbage unless you’re a “network geek, a hacker, or attacker.” Then you can learn things that could be used, for example, in targeted phishing attacks.

For example? Say you’re a veteran, and you’re researching PTSD. You go online to search the terms, “PTSD” and “treatment.” Maybe you look up a local treatment center or a Veterans Administration support group. How much information an attacker can glean depends on the kinds of website pages you visit.

If you’re on secure websites (which have “https” in the URL address) vs. insecure ones (which have only “http”), the attacker can see the site itself, but not the page you went to. Visit enough sites, though, and it still might give someone enough information to launch a relevant phishing attack against you.

Even downloading apps on public Wi-Fi is to be avoided. A sophisticated attacker could pose as that app telling you there’s an update and use that via phishing to get you to give up personal information—your financial info, for instance, if you were downloading a bank’s app.

This is getting very scary. You’re telling me. But there a few things you can do to keep yourself safer.

  1. Limit your behavior on public Wi-Fi. Don’t do anything on your browser that you wouldn’t do if a stranger was sitting next to you staring at your screen, Gervais says. That means no transacting. It also means not sending emails that contain sensitive information. You’re better off picking up the phone or, if that’s not possible, texting.
  2. Use a VPN app. VPNs are virtual private networks and they come in app form for your smartphone and tablet. This creates an encrypted channel, so your online business is protected from prying eyes. Some good ones include WiTopia and F-Secure Freedome. You will find plenty of free ones in the app store, but Gervais cautions: “If you’re not paying for the VPN, you the user, are the product.” Use your hotspot. If you don’t want to go the VPN route, use cellular data on your phone and, for your computer or tablet, connect using the personal hotspot on your phone. Now that many of the cellular carriers are going to unlimited data, you can feel better about using it freely.

Oh, and while you’re at it, make sure your home Wi-Fi network is protected with a strong password. You don’t want neighbors “borrowing” your bandwidth, slowing your internet connection, or — if they’re so inclined — seeing what you’re doing online.

Contributed by LifeLock, which is a partner with the Medical Association. Medical Association members receive a discount on LifeLock memberships. Click to learn more.

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A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part II)

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part II)

Editor’s Note: The following is the second installment of a three-part series discussing important provisions in physician employment agreements.

When a physician leaves a medical practice, especially if the physician stays in the area to compete against his/her former employer, the situation can become stressful and acrimonious. During the final weeks of employment, the departing physician can start to focus more on his/her new practice to the detriment of the current employer, and disputes often arise regarding access to medical records, soliciting patients and employees and when to schedule procedures – before or after termination. We have seen both medical practices and departing physicians engage in questionable conduct in order to keep as many patients as possible. Lawyers are often engaged to try and negotiate the terms of separation or, in a worse-case scenario, to file or defend a lawsuit.

Over the years, we have counseled hundreds of physician practices on how to successfully navigate the various issues that arise when a physician departs, regardless of whether the physician is an employee or an owner. Careful planning on the front end through a comprehensive employment agreement is the most important element in an amicable and fair separation. More often than not, we have found that disputes and subsequent litigation can arise when the employment agreement is not properly drafted or does not adequately address the specific terms of separation.

This three-part series provides a summary of the key provisions (with sample language) that can be incorporated into a physician employment agreement to help mitigate problems when a physician leaves your practice. Since each medical practice is unique, please consult with your own attorney before using any of the provided sample provisions in a physician employment agreement.

Protecting Other Practice Employees. When a physician leaves a medical practice he/she may want to encourage other practice employees (i.e., nurses, technicians, receptionists, etc.) to leave and work for the physician. These employees are a valuable asset to the medical practice and oftentimes the medical practice has invested significant time and resources in training its employees. Under Alabama Code Section 8-1-1, which was amended Jan. 1, 2016, a medical practice can protect an employee from being hired by a departing physician; provided, however, that the practice can demonstrate that the employee is “uniquely essential” to the medical practice. The term “uniquely essential” has not been specifically interpreted by the courts, but appears to require that the medical practice demonstrate that the protected employee(s) is not easily replaced due to a unique skill set or training, and the loss of the employee(s) would be detrimental to the medical practice.

Physician agrees that, during the term of this Employment Agreement and for a period of one (1) year following termination of this Employment Agreement, regardless of the cause of such termination, Physician shall not, directly or indirectly, through any individual, person or entity, without the prior written consent of Employer: (a) solicit, induce or attempt to solicit or induce away, or aid, assist, or abet any other party or person in soliciting, inducing or attempting to solicit or induce away from employment or other association with Employer, any employee of Employer, or (b) employ, hire or contract for services with any employee of Employer, or any person who was an employee of Employer during the six (6) month period prior to termination of Physician’s employment with Employer. The Employer and Physician acknowledge that the restrictions contained in this Section are reasonable and necessary to protect the protectable interests of Employer which include, without limitation, Employer’s confidential information, Employer’s commercial relationships with its patients, patient goodwill associated with its business, and the unique training of its employees, which was and is provided by Employer at considerable expense.  Physician acknowledges and agrees that the Employer’s employees hold positions uniquely essential to the management, organization and service of the Employer.

Compensation.  When a physician leaves a medical practice he/she will be compensated through the date of termination. If, however, the employment agreement provides for some form of bonus compensation based on, for example, collections or other measures of productivity, the employment agreement should address whether the physician is eligible for a bonus, pro-rated through the date of termination, or if termination before the end of the bonus measurement period results in the physician forfeiting any bonus. In addition, if the physician is paid based on production (e.g., collections less allocated expenses), then the employment agreement should address whether accounts receivable generated by the physician which are collected after termination for some designated time period will be counted toward the physician’s final paycheck, or if only collections received through the date of termination will be allocated to the physician. With either a bonus or production compensation model, some employment agreements provide that the departing physician will not be eligible for a bonus or the allocation of any post-termination collections if the physician terminates the employment agreement without cause or if the medical practice terminates the employment agreement with cause. Regardless, it is very important to clearly delineate in the employment agreement how compensation will be addressed upon termination.

Continuing Malpractice Insurance.  When a physician leaves a medical practice it is critical that medical malpractice insurance is maintained which provides continuing insurance for the physician’s professional services if a claim arises after the date of termination. Payment of a reporting endorsement (sometimes referred to as “tail insurance”) is typically an item negotiated by the parties. Regardless of how the costs are allocated, it is important that the employment agreement require either the purchase of a reporting endorsement or that the departing physician be obligated to maintain his/her then current malpractice insurance without interruption for a period of at least four years (eight years if minor patients are involved) after termination of employment. The following sample provision obligates the departing physician to pay for tail insurance, but can be modified as appropriate to provide that the medical practice will cover the costs of such insurance.

Immediately upon termination of employment with Employer, Physician shall, at Physician’s sole expense: (a) purchase or obtain a professional liability insurance reporting endorsement (e.g., tail coverage) with the same base and excess coverage limits and annual aggregate as the professional liability policy made available by the Employer for the Physician (the “Professional Liability Insurance Policy”) in order to provide continuing insurance protection for Physician and Employer against claims for malpractice or negligence occasioned by the acts of Physician while he/she was an employee of Employer (hereinafter referred to as the “Reporting Endorsement”), or (b) make arrangements for the continuation of the Professional Liability Insurance Policy with the same professional liability insurance carrier and with the same base and excess coverage limits and annual aggregate as the Professional Liability Insurance Policy, and listing Employer as an additional insured on such policy (hereinafter referred to as the “Continuation Policy”).

To evidence compliance, Physician shall provide to Employer within ten (10) days following the date of termination of this Employment Agreement either: (a) a copy of the Reporting Endorsement, or (b) a copy of the Continuation Policy, a “Certificate of Insurance Holder,” evidencing the existence of the Continuation Policy and written confirmation from the insurance carrier that Employer is listed as an additional insured on the Continuation Policy. If Physician obtains the Continuation Policy, and within ____ (____) years after termination of employment with Employer, should the Continuation Policy lapse, terminate or be modified so as not to satisfy the definition of a “Continuation Policy” in this Employment Agreement, or should Physician ever change professional liability insurance carriers, Physician agrees that he/she shall immediately purchase the Reporting Endorsement and that he/she shall provide Employer with a copy of the Reporting Endorsement at that time. If Physician fails to purchase such coverage and/or provide Employer with a certificate of same in accordance with the above‑stated requirements, Employer shall have the right, as hereby acknowledged by Physician, but not the obligation, to purchase such coverage and notify Physician in writing of the total premium costs thereof. Physician hereby expressly acknowledges and agrees that the total premium cost for such coverage purchased by Employer under this Section (plus a ten percent (10%) administrative fee) shall be immediately due and payable by Physician to Employer upon Physician’s receipt of said notice and Employer shall have the right to offset Physician’s cost of insurance against any amounts due Physician, with Physician reimbursing Employer for any deficiency. The terms of this Section shall survive termination of the Employment Agreement.

While it may take more work on the front-end, having a well-thought out and comprehensive physician employment agreement will save significant time, effort and potentially money when a physician leaves your medical practice. Stay tuned for Part III of this three-part series which will discuss protecting confidential information and protection from future liabilities.

Read the full series:

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part I)

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part II)

A Physician is Leaving Your Practice – “Must Have” Employment Agreement Provisions (Part III)

Howard Bogard is a Partner with Burr & Forman LLP and serves as the Chair of the firm’s Health Care Industry Group. Kelli Fleming is a Partner with Burr & Forman LLP practicing in the firm’s Health Care Industry Group. Burr & Forman, LLP, is an official Bronze Partner with the Medical Association.

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Four Types of Identity Fraud on the Upswing

Four Types of Identity Fraud on the Upswing

If you thought that the promising (albeit modest) drop in the total dollars stolen by identity thieves in 2015 was a harbinger of things to come, think again.

According to the just released 2017 Identity Fraud Study from Javelin Research, the number of victims of this crime—in all its permutations—climbed to a record high of 15.4 million last year. And, despite the fact that the average amount per fraud went down, the total cost topped $16 billion, also an all-time high. What does that say about efforts to rein in identity thieves?

“We’ve gotten pretty good at closing the door once the horse has left the barn,” says Al Pascual, Javelin senior vice president and head of fraud and security. But we need work when it comes to “barring the door” to begin with.

The research, funded by LifeLock, also made clear that even if you don’t maintain a large online presence, taking steps to protect your identity is a smart move. Offline consumers are less likely to experience fraud, Pascual explains. But when it happens it’s worse, because it takes more time to detect. On the other hand, if you’re highly connected, your risk is much higher than average. But you’re also likely to detect—and shut down—attempts at fraud more quickly. How do you protect yourself? “If you’re not digitally inclined, sign-up for a credit protection service,” Pascual says. “If you are, don’t use the same passwords even across retailers.”

The study, now in its 14th consecutive year, highlights a number of specific places identity fraud and theft are on the rise or particularly troubling. Here’s a look at what they are and how to protect yourself:

Card Not Present Fraud

What you need to know: Incidences of this type of fraud, where a thief uses your card number without having the actual card, rose 40 percent last year. Pascual expects those gains to continue. “We’ve gone digital because it’s convenient,” he says. “So have criminals.”

How to guard against it: Take advantage if your credit card offers ways to obscure your payment details, advises Dr. Stephen Coggeshall, Chief Analytics and Science Officer of ID Analytics. Some credit card issuers and fraud protection services will send you alerts if a charge is made and your card is not present. Do that as well. And pay attention to your credit card statements, watching, in particular, for charges you don’t understand.

New Account Fraud

What you need to know: This form of fraud, where a thief steals enough of your identifying information to open an account in your name, is on the upswing. Incidents nearly doubled from 2014 to 2015, and this year showed “almost the same degree of growth,” Pascual said. Importantly, the new accounts being opened are not just at traditional lenders, but also at alternative ones, including payday lenders and peer-to-peer lenders. Those are tougher to track.

How to guard against it: Monitoring your credit, by either taking a very consistent look at your own reports or having a service do it for you, is the key here. One advantage of some services, notes Pascual, is that they look beyond the item on your credit reports to checking and savings accounts and alternative lenders. Also, it sounds run of the mill, but open every piece of mail you get from a financial institution—even those you don’t patronize. Often, you’ll receive notice when an account is opened in your name, giving you a chance to shut it down and alert the credit bureaus.

Account Takeover Fraud

What you need to know: This type of fraud is distinguished by the fact that a criminal is essentially trying to usurp control for a pre-existing account that you’ve set up. Signs that it might be happening include receiving change of password or change of address notices that aren’t prompted by your actions. “These cases result in the highest average loss amount, and sometimes a consumer can be stuck for more of the bill,” says Pascual, explaining that it can be difficult to prove that you didn’t take the actions involving your account, such as removing or spending funds.

How to guard against it: Don’t reuse passwords across sites—particularly across financial ones. Criminals will take the password list from one breach and try those passwords at every major bank across the country to see if they can be used. Tell your financial institutions you want multiple notifications—by both text and email—if actions are taken on your account. “The idea is to make it harder for communication to be severed between you and the institutions,” says Pascual. And if two-factor authentication is available for entry to any of your financial sites, use it.

Sophisticated Phishing

What you need to know: The phishers have gotten better at their game. “We’re used to seeing phishing with poor misspelling, bad grammar, and poor formatting,” says Coggeshall. Criminals have moved beyond that. Today, corporate emails are being spoofed and employees are being sent letters from the CEO or finance department that look legitimate. In some cases, hackers take the time to learn things about you specifically, then target you with a specially crafted phish.

How to guard against it: If someone contacts you that you’re not used to hearing from and asks for any sort of financial or identifying information, a bell should go off in your head. Don’t click on the email. Don’t give out information by phone or text. Instead, back away and—if you believe it might be real—initiate the communication yourself to figure out if the need is legitimate.

LifeLock is a partner with the Medical Association, and physician members receive discounted rates on LifeLock memberships.

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Federal Regulations Stipulate Physicians Need a Translator…

Federal Regulations Stipulate Physicians Need a Translator…

And, we have a solution. The Medical Association has partnered with CTS Language Link to deliver multilingual interpretation and translation communication services to meet the growing needs of your practice. As of Oct. 16, 2016, physicians receiving financial assistance from HHS, except solely Medicare Part B, must provide language assistance for persons with limited English proficiency (Section 1557 of the Affordable Care Act – Nondiscrimination Provisions).

Medical Association members will receive a 20% discount from CTS LanguageLink from standard rates. With over-the-phone interpretation services, physicians have access to more than 240+ languages, and the call center is available 24/7/365 with no monthly minimums, no monthly fees, and no volume requirements. The rate per minute is $1.40 for all 240 languages and dialects for Medical Association members. (Standard rates are $1.75 per min and $100 set-up fee.)

CTS LanguageLink provides document translation for 110+ languages. Document translation quotes are provided at no charge. Physicians can email documents to be translated and receive a quote within 24 hours.

Once physician members sign up for CTS LanguageLink, it takes about 1-2 business days to start utilizing services. CTS LanguageLink has established and extensive language resources, utilizing only native-speaking, professional translators and interpreters, uniquely qualified for your project needs. CTS LanguageLink is a recognized leader in providing the most trusted multilingual communication services to a wide range of corporate and government clients since 1991.

Click here for more information and to register.

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Can You Trust that Shopping App?

Can You Trust that Shopping App?

Just because you downloaded a shopping app from a legitimate app store doesn’t mean the app itself is legitimate.

Recent news reports note that fake retail and product apps have shown up in Apple’s App Store and the Google Play store. The timing couldn’t be worse, given the holiday shopping season is upon us.

The New York Times reported the counterfeit apps have masqueraded as familiar retail chains, including Foot Locker, Nordstrom, Zappos and others. The New York Post said an app bearing the Coach label offered 20 percent off. Coach told the newspaper it doesn’t have an app. CNET reports similar issues.

While some of the apps are relatively harmless, the Times reported there are risks to be concerned about:

  • Providing your credit card information could lead to potential financial fraud
  • Some fake apps could contain malware that can steal personal information or even lock the phone until the user pays a ransom.
  • Some fakes encourage users to log in using their social media credentials, potentially exposing sensitive personal information.

What should you do? Be on the lookout for apps that signal they’re not real — butchered English, a lack of app reviews and no history of previous app versions.

One of the best ways to make sure you’re downloading a legitimate app? Go to your chosen retailer’s website to look for links to download the company’s real apps. Those links should take you to the retailer’s legitimate app on the app stores.

*Article reprinted with permission from LifeLock. LifeLock is a partner with the Medical Association, and members receive discounts on memberships. Click here for more information.

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Cruise Deals for Alaska in 2017 — Special Rates for Association Members!

Cruise Deals for Alaska in 2017 — Special Rates for Association Members!

Experience Alaska’s majesty next summer aboard a Princess Cruise! Book now though Nov. 16 with your travel partners at Two Sisters Travel, and take advantage of the 3-for-Free Sale Event offering complimentary cabin upgrades, onboard credits, and free gratuities. Package your cruise experience with 3-4 nights on land to explore Denali National Park.

Get a no-obligation cruise quote online or call Two Sisters Travel at (843) 284-3241 to discuss planning your next vacation whether it’s Alaska, Caribbean, Europe or Walt Disney World. Two Sisters Travel offers the Medical Association’s members free, easy and stress-free concierge travel planning services. Call or click today!

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Save more than $1,300 on Last-Minute Disney Cruises

Save more than $1,300 on Last-Minute Disney Cruises

Take advantage of incredible last minute Disney Cruise deals and share the splendor of the holidays aboard a Very MerryTime Cruise.

A winter wonderland awaits you aboard each Disney Cruise ship as well as on Disney’s private island, Castaway Cay! You’ll enjoy special holiday-themed entertainment, decorations, and activities, including:

Mickey’s Tree-Lighting Magic –Disney characters lead holiday carols and the lighting of the glittering, three-deck-tall tree.

Winter Wonderland Ball – Celebrate the arrival of Santa and Mrs. Claus, with your favorite Disney friends at a glamorous ball.

Holiday Carolers – Dickens-inspired characters and carolers carry the spirit of the holidays throughout the ship while singing holiday classics, sometimes with the help of favorite Disney friends.

All of these special events are in addition to the activities you already love, like meet and greets with Santa, building gingerbread houses, listening to holiday storytellers and dancing at the tropical-themed “Deck the Deck Holiday Party.”

With last minute rates as low as $130 per person, per night you don’t want to miss this opportunity to spend quality time with your family this holiday season! These rates are available on select 3, 4, or 7-night Caribbean & Bahamas itineraries sailing from Port Canaveral or Miami.

Hurry, these deals won’t last long. Call Tara McCoy at Two Sisters Travel at (843) 284-3241 for details, or get a no-obligation quote online! Become a Facebook fan at facebook.com/twosisterstravel. Two Sisters Travel is an official partner of the Medical Association.

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2017 Chronic Care Management Changes and Outsourcing Chronic Care

2017 Chronic Care Management Changes and Outsourcing Chronic Care

Medicare’s shift towards value-based care means the traditional model of health care reimbursement has just had a major shakeup. With value-based care, providers’ payments are now based on the value of care physicians deliver to patients and their health outcomes.

Patients with chronic conditions often require greater care outside of the office. Beginning Jan. 1, 2015, The Centers for Medicare & Medicaid Services (CMS) began paying for Chronic Care Management (CCM) services. Requiring at least 20 minutes of non-face-to-face care, providers receive an average reimbursement of $42 per patient per month with two or more chronic conditions. CCM has grown in popularity and many providers are seeing the increase in revenue. However, a number of physicians are still struggling to incorporate chronic care management into their practice. While the CMS requirements of CCM may be overwhelming, chances are many physicians are already managing Medicare patients with two or more chronic conditions and not getting the extra reimbursement to help with the added care.

The 2017 Medicare Physician Fee Schedule rule was finalized on Nov. 2, 2016. Providers will see payment changes for care management services in 2017. There are several changes that CMS has proposed regarding chronic care management. These changes are set to make billing rules within CCM simpler as well as expand the payment for complex CCM, including patients with behavioral health conditions. The new fee schedule rule will offer a new set of codes for providing care management to those patients.

Highlights from the 2017 Medicare Physician Fee Schedule regarding CCM

  • Simplification of CCM billing rules
  • Payment for complex CCM patients (CPT code 99487)
  • Supervision requirement change for CCM by Rural Health Clinics (RHC) and Federally Qualified Health Clinics (FQHC)
  • Pay for non-face-to-face extended E & M services

Part of the simplification of the CCM billing rules means the possibility of no longer requiring a consent form from the patient, but rather the provider would simply document in the patient’s medical record that CCM information was provided to the patient. Another benefit of this final rule is that initiating visits no longer have to be face-to-face office visits, unless the patient is considered a new patient or the patient has not been seen within the year prior to commencement of CCM. However, if providers do initiate CCM on a face-to-face visit, they can use the new GPPP7 to bill for that visit and receive a higher payment of $63.68.

Along with these changes to CCM for 2017, there is also a 3.5 percent increase in the CCM payment rate for 2017. The current rate in 2016 for CPT code 99490 is $40.82. This increase would make the 2017 rate $42.21. For complex CCM payments (CPT code 99487), the proposed rate for 2017 is $92.66. The complex CCM, CPT code 99487 requires 60 minutes of non-face-to-face care per month. CMS has also proposed an add-on code for complex CCM (CPT 99489) for each additional 30-minute increments of non-face-to-face time, at a proposed 2017 rate of $46.87. Please note: reimbursement rates vary by region.

MediSYS has outsourced full-service CCM to ease the burden on providers of meeting the CCM requirements while saving providers time and resources to enhance patient care.

“Providers have been very responsive to outsource chronic care management services because of the additional help they receive that saves them time and brings in additional revenue,” explained Jennifer Woodward, director of operations with MediSYS.

Outsourcing your CCM solution can help you increase revenue and expand patient satisfaction as well as provide you better patient access through a broader clinical depiction. CCM will also prepare providers for 2017 and the changes that MACRA has implemented in the healthcare industry to improve patient care and focus on value-based quality goals.

“With MIPS starting next year, providers are working hard to prepare for the changes that coming. By outsourcing this portion of the program, it provides them more time to work on the other aspects of the quality payment program to report effective care coordination,” Woodward said.

For information on MediSYS electronic health records and practice management solutions as well as outsourcing CCM services, please contact MediSYS at sales@medisysinc.com and visit the website at www.medisysinc.com. MediSYS is an official partner with the Medical Association.

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