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Communicating Adverse Outcomes
Submitted Courtesy of Omnisure Consulting Group
Used by permission
The responsibility to inform a patient or his/her family of an adverse health care outcome is an inevitable part of providing health care. Adverse events or disappointing outcomes occur; not necessarily as a result of an error or negligent care, but often for reasons outside the provider’s immediate control. Events may be correlated to the patient’s diagnosis or co-morbidities, side effects of medication or treatment, or, as is sometimes the case, tied to the unrealistic expectations of patients or families.
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Prevent and Respond to Breaches of Patient-Information Security
Submitted Courtesy of Leeanne R. Coons, Esq. and Krieg DeVault, LLP
Used by permission from the MGMA
With increasing frequency, the media report another security breach that compromises sensitive personal information. Breaches can occur in any sector of society, including health care, and affect millions of people annually. Such breaches occur in a variety of ways, including system hackers; theft/loss of laptops, personal digital assistants and computer disks; or unencrypted information e-mailed to the wrong address. Given the sensitive nature of information held by health care providers and the increasing use of electronic technology, medical practice administrators should take steps to prevent such security incidents. You should also prepare a response plan in the event that such an incident occurs.
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Physician Employment Agreements
Physician Employment Agreements
By Bill Fleming, RPLU
Assistant Vice President, Underwriting
The Doctors Company
Bringing a new physician into a growing practice can be exciting for both the group and the new hire. But even the best professional relationships can come to an end, and clarity at the beginning will serve all parties well, particularly if a departure is accompanied by hard feelings. For that reason, we strongly recommend that all groups make use of written agreements, whether the physician is an employee or an independent contractor.
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Physician Retention: Keeping it Consistent and Effective Through an Innovative "Non-Program"
Submitted Courtesy of Kurt Scott
Physician Search and Consulting Division
VISTA Staffing Solutions
Front-line recruiters are acutely aware of the factors that make physician recruitment a full-time job, and often a very stressful process. These include internal issues specific to your healthcare organization as well as national conditions such as the growing physician shortage and the tendency of physicians in some specialties to move their practices more often.
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Top Ten Things Practice Administrators Need to Know About Their Equal Opportunity Policy
Submitted Courtesy of Michael Patrick O’Brien
Attorney, Jones Waldo
Part of my employment law practice includes visiting with healthcare organizations and helping them train their employees and practice administrators about employment laws, including laws prohibiting discrimination and harassment. The federal employment laws discussed in this article apply only to employers with 15 or more employees, but some states have similar laws that apply to businesses with fewer employees. Here is my Top Ten List.
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Anatomy of a Pennsylvania Lawsuit
Submitted Courtesy of Jerry Frazer
MGIS Property & Casualty Insurance Services, Inc.
The article is provided as an overview of the legal process in the state of Pennsylvania. It is not all encompassing of the process nor is it intended as legal opinion or advice. To learn more contact the author or your personal legal representative.
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Nine Steps for Responding to Unanticipated Outcomes
Submitted Courtesy of Mary-Lynn Ryan
Risk Management
NORCAL Mutual Insurance Company and the NORCAL Group
One of the most difficult aspects of medical practice is disclosing an unanticipated adverse outcome, but it has to be done. The following nine steps provide a strategy for taking corrective action, maintaining the provider-patient relationship, and decreasing professional liability exposure. Depending on the circumstances, the order in which the following steps are completed may vary. In every instance, however, caring for the patient’s immediate needs should come first.
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The Name of the Game is the Claim
Submitted Courtesy of Robert Tretter
Regional Vice President, MGIS
Why should doctors or members of their staff buy group long term disability? The answer to can be found by asking them this question: “If you got sick or hurt and couldn’t go to work for a lengthy period of time, and therefore couldn’t earn an income, how would you pay your bills?” The need for disability is the foundation of the sale. The contract is the instrument that addresses the need and forms the basis for the claim. And the name of the game is the claim.
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Is Electronic Dispensing Right for Your Practice?
Submitted Courtesy of Mark Dayton, MBA
Manager, MGIS Health eOffice
Electronic drug dispensing is a fast-growing ancillary service providing both quality of care and financial benefits to an expanding number of medical practices nationwide. With the right vendor and fit for your practice, it can be a fairly straightforward path to additional value for your patients and improvement to your bottom line. However, several essential elements play an important role in the success or failure of a dispensing program — items that are not always readily apparent, and are not provided equally by all vendors. This paper helps you analyze each of these elements, and provides guidance on how to ensure that your vendor will be capable of delivering exactly what you need.
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PIAA: Reports Show Med Mal Reforms Help Deficit Reduction
Submitted Courtesy of National Underwriter
Used by Permission
The Physician Insurers Association of America is pointing to conclusions by two bipartisan panels for medical malpractice reform as support for its views that sensible legal reforms curbing med mal claims are critical for deficit reduction policies to work.
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Behavior that Undermines a Culture of Safety
Submitted Courtesy of Mary-Lynn Ryan
Risk Management
NORCAL Mutual Insurance Company and the NORCAL Group
Disruptive behavior by professionals in healthcare settings is well documented as a threat to quality care and patient safety. Managing disruptive behavior requires a coordinated effort based on a written policy and established procedures that cover reporting, confrontation, documentation, response, outside consultation, reprimand, follow-up, and monitoring, as well as support for subject physicians.
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Seven Questions Physicians and Administrators Should Ask Before Investing in Group LTD Coverage
Submitted Courtesy of Keith Mangrum
MGIS Regional Vice President
Think first. Look under the hood, so to speak. Ask questions … lots of questions. Occupation definition? Material duties? Earnings received? Hours worked? These questions and others should be answered to determine whether your group LTD policy will meet and pass the test.
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Disability Plays No Favorites
Submitted Courtesy of MGMA Connexion Magazine
Used by Permission
Disability will strike men and women of all races, occupations, and income levels. Physicians are no exception. A real and growing risk, disability can jeopardize your financial security and threaten the future of your practice. Are you willing to risk your accomplishments and everything you own?
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10 Things a Disabled Doctor Doesn't Want to Hear
Submitted Courtesy of Keith Mangrum
MGIS Regional Vice President
You may have purchased individual disability insurance early in your career and, like many other physicians, you may have added Group Long Term Disability (LTD) insurance to supplement this income protection. But not all LTD policies are alike.
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The RAC Appeals Process
Submitted Courtesy of Wachler & Associates, P.C.
If your organization receives a claim denial or overpayment demand as a result of a RAC review or other Medicare audit, you can appeal this decision through the uniform Medicare Part A and Part B appeals process. The five-stage Medicare appeals process is summarized below.
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What's Keeping Your Physicians Up at Night?
Submitted Courtesy of MGMA Connexion Magazine
Used by Permission
Are your physicians losing sleep over asset protection? We caught up with Jeffrey S. Allen, MD, and asked him a few questions about how physicians can protect their ability to earn an income.
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Contractor Involvement in the Medicare Appeals Process
Submitted Courtesy of Wachler & Associates, P.C.
Providers challenging audit claim denials through the Medicare appeals process can expect to encounter various degrees of contractor involvement at each stage of appeal. Providers should be aware of the contractor’s role at each stage of appeal, the information requests to make at each level, and the limits on the scope of the contractor’s participation.
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Would Tax-Free Disability Benefits Interest Your Physicians?
Submitted Courtesy of MGMA Connexion Magazine
Used by Permission
Although an employer-paid plan using pre-tax dollars can save your physicians thousands in the short run, the taxation of disability benefits in the long run can cost hundreds of thousands of dollars. Here’s what you need to know about IRS Ruling 2004-55 and the 162 Bonus Plan.