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October 1, 2006
Welcome to the Harris County Physician Newsletter Online!
In this issue. . .
Free help getting paid
HCMS mourns loss of Dr. Stephenson
HCMS Business Expo
Congress and Medicare
2007 Candidates Profile
President's Page
In Memoriam
Ledger
News and Updates:
Branches have practice information & CMEs
Member Mentions
Business of Medicine
Classifieds
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Free help getting paid
Need help getting paid faster? Schedule your free and private 30-minute reimbursement consultation with a Texas Medical Association (TMA) reimbursement expert at the Harris County Medical Society (HCMS). The consultations are a benefit of membership.
Consultations will be held at the HCMS, located at 1515 Hermann Drive on Wednesday, Oct. 18 -
Thursday, Oct. 19, 9 a.m. to 4:30 p.m. and Friday, Oct. 20, 9 a.m. to 11:30 a.m.
The free and private consultations will help you find solutions to primary/secondary coverage issues, slow-paying carriers, collection problems, late-filing appeals, Medicaid, Medicare, coding, credentialing, and much more. You will also get free reference materials to help your practice.
Call now to schedule your free appointment. For more information, contact 713-524-4267, ext. 262.
HCMS mourns the loss of Dr. Betty Stephenson
The Harris County Medical Society (HCMS) mourns the loss of former HCMS President Dr. Betty P. Stephenson, who died on Sept. 17. Dr. Stephenson, an anesthesiologist, was a mentor and tireless proponent of legislative improvements for health care.
She became the first woman president of HCMS in 1986 and later became the first woman elected president of the American Society of Anesthesiologists. She also was president of the Texas Medical Association, the Texas Society of Anesthesiologists, and the Texas Gulf Coast Anesthesia Society.
Dr. Stephenson was a member of HCMS for 47 years and will be greatly missed by all of us. She is survived by her husband of 55 years, Dr. Charles T. Stephenson.
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Ethics CMEs at the HCMS Business Expo
The Fall 2006 HCMS Business Expo offers ethics CME seminars in technology/patient communication, quality and employee theft. The Expo also offers information on products and services for your practice, door prizes, and refreshments all for free. The Expo will be Saturday, Oct. 28, at Reliant Center, from 9 a.m. to 3:15 p.m.
The technology and patient communication seminar will focus on patient communication. It will be led by Dr. Philip Suarez, a practicing physician, who will discuss the pros and cons of electronic communications and the regulations affecting it.
The quality seminar will be led by four medical directors representing managed care organizations and an employer.
The employee theft seminar will be led by an assistant district attorney who will discuss how to recognize and prevent theft.
There also will be a legislative update given by Dan Finch, Texas Medical Association director of legislative affairs.
For more information or to RSVP, call 713-526-7378 or visit the HCMS Web site at www.hcms.org.
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TMA takes Congress to task on Medicare
Former TMA President Dr. Bohn Allen, TMA Chief Lobbyist Darren Whitehurst, and other TMA and AMA physician leaders and staff journeyed to Washington, D.C., to urge Congress not to cut physician fees another five to 15 percent in January. TMA, HCMS and other Texas county medical societies organized media coverage to back up the AMA-organized campaign at the capitol.
If Congress does not reverse the cut and fix the payment formula that would slash physician reimbursements by 37 percent over the next nine years, many physicians will be forced to stop seeing Medicare patients. We need all physicians to join us in urging Congress to act.
Also, ask your Medicare patients to send letters. On the HCMS Web site, www.hcms.org, there are letters for physicians and patients that are ready to be downloaded, signed and sent to Congress. Let Congress hear from you.
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Profiles of 2007 Candidates for HCMS Elective Offices
Follow this link to view 2007 Candidate Profiles.
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President's Page - Dr. Diana L. Fite
Care for the uninsured
We’re constantly looking at ways to ease the crowding of our emergency departments (EDs) and provide care for our uninsured. Task forces have addressed the issue and have determined that the solution to these problems is a large puzzle with many pieces.
One of those pieces is the Gateway to Care Provider Health Network (PHN), which began recruiting specialty physicians in the Houston area last year. You may be familiar with the “project access” programs that have been successful around the nation. PHN is the same concept.
It has been one year since HCMS immediate past president Dr. Robert Vanzant devoted his president’s page to Gateway to Care’s Provider Health Network (PHN). Since that time, 130 physicians have volunteered to participate in the specialty care network, and numerous hospitals and laboratories have signed up. I want to particularly recognize and thank Dr. Rakesh Mangal, chair of the Council of International and Affiliated Medical Societies, for recruiting about half of these volunteer physicians.
The PHN provides specialty care for patients who have no insurance and do not qualify for any medical assistance. These patients usually get their primary care from one of the 38 member clinics, such as Fed-erally Qualified Health Clinics. In most cases, they are the working poor who are caught in the middle. When they need help beyond what is available at one of the clinics, they show up in the ED, many times repeatedly.
The real attraction to PHN is that physicians who volunteer to see patients in the program do not have to worry about locating laboratory services, medications or any of the other services that your staff frequently spends hours trying to coordinate. If you see patients through the PHN, their “navigators” will do all of this for you. Also, your charity care will be documented.
The PHN is already collecting some real success stories. A patient was referred from a member clinic to the PHN for gynecological problems. The patient had visited the ED three times this year and had missed work 10 times. She could not afford surgery and was ineligible for any medical assistance. A PHN gynecologist recommended immediate surgery, which he performed in a volunteer hospital. The patient was discharged from the specialist after her first post-op visit to return to the clinic for primary care.
The PHN is in desperate need of cardiologists, dermatologists, orthopedists, endocrinologists, internists, psychiatrists, gastroenterologists, urologists, pediatric otolaryngologists, and pediatric orthopedists.
You can volunteer to see one patient slot per year or one per month, and you can leave the program at any time. Liability protection is provided for caring for these patients. The PHN even provides transportation to your office for the patient if needed.
For those of you who are already providing pro bono care to patients, this is the program for you. No longer will your staff have the burden of arranging for lab work, medications or other specialty care. You may refer your patients who qualify to the PHN for medications.
You may recall that the Texas Medical Association negotiated exemptions for physicians in the new business tax. One of those exemptions was documented charity care. If this appears in the new rules, PHN could be the perfect way to document your charity care.
For additional information on the PHN or to volunteer, call Tan Kaleemullah at 713-783-4616, ext. 231, or visit the HCMS Web site, www.hcms.org, and scroll down to Do you see uninsured patients? and click on more. This is a wonderful way to ease the problem of the uninsured. I urge you to become involved.
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In Memoriam
Dr. Richard DeYoung, an orthopedic surgeon, died Sept. 17. He had been a member of HCMS for 54 years.
Dr. William M. Donohue, an internist, died Sept. 10. He had been a member of HCMS for 66 years.
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Ledger
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CANDIDATES FOR VOTE: October 12, 2006:
Senthil Alagarsamy, MD
Dipika S. Ambani, MD
Peter M. Anderson, MD
Suhasini Atluri, MD
Kris E. Barnsfather, MD
Margaret H. Basu, MD
Ravi S. Bikkina, MD
Andrew Blinkov, MD
Vasudeva R. Boosupalli, MD
Gregory T. Ciaccio, MD
Christopher R. Collaco, MD
Lisa M. Cooper, MD
Prajay Dhir, MD
Can H. Duong, MD
Daalon B. Echols, MD
Edward J. Escobar, DO
Brandon W. Fisher, MD
Colette E. Fisher, MD
James L. Fleming, MD
Alysia N. Furgatch, MD
Dalia G. Galicia, MD
Shuwei Gao, MD
Juan L. Garza, MD
Charito C. Go, MD
Gautam V. Gohel, MD
Cheryl A. Gore, MD
James Grueskin, MD
Howard Hinestroza, MD
Matthew D. Hoggatt, MD
Terry A. Holster, MD
David Isaradisaikul, MD
Edmund S. Kopetz, MD
Brooke E. Lasics, MD
William R. Leighton, Jr., MD
Syed H. Mehdi, MD
Sheilendra S. Mehta, MD
Victor M. Miranda, MD
Dana F. Mitchell, MD
Bong Q. Mui, MD
Carl F. Palumbo, II, MD
Jason Z. W. Powers, MD
Ahmed K. Qadri, MD
Tapan A. Rami, MD
Nasir Rasheed, MD
Megan M. Rust, MD
Mohammad A. Saeed, MD
Arsalan Shahzad, MD
Donald H. Tom, MD
Nicole Tomjanovich, MD
Anh-Tu T. Vu, MD
Angela J. Wyatt, MD
Jerald L. Zarin, MD
Geoffrey A. Zimmerman, MD
INTERN/RESIDENT/FELLOW:
Anita Arora, MD
Ioanna D. Athanassaki, MD
Judy Y. Chang-Strepka, MD
Albert J. Chua, MD
Charles A. Cropper, MD
Ava W. Gallagher, MD
Keith S. Gates, MD
Shefaa S. Goerge, M.D.
Brent A. Hamann, MD
Hamidreza Iranmanesh, MD
Diana Isachievici, MD
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Tabrizi H. Khalili, MD
Daisy Ann S. Matias, MD
Anupam K. Pannu, MD
Amanda L. Peterson, MD
Kevin L. Polglaza, DO
Frank J. Ponce, MD
Danielle R. Rios, MD
Ami N. Shah, MD
Shubha P. Shetty, MD
Peter A. Walker, MD
Christian A. Woodbury, MD
MEMBERSHIP TRANSFER/
WITHDRAWS:
Shadi Q. Al-Khatib, MD
Carlos A. Artime, MD
Charles W. Bailey, MD
Brett W. Baker, MD
Anupama Balakrishnan, MD
Samantha E. Carter, MD
Moises A. Chica, MD
Debra K. Doherty, MD
Veronica G. Fragoso, MD
Mary C. Garcia, MD
Susan C. Gaskill, MD
Tatyana Goldman, MD
Heidi A. Grissom, MD
Daniel C. Gunn, MD
Chris B. Hayes, MD
Jody C. Hayes, MD
Jill P. Heffernan, MD
Frank C. Hinds, MD
Ramoun D. Jones, MD
Rupali R. Kadakia, MD
Tomer Z. Karas, MD
Rizwan H. Khan, DO
Heidi C. Knowles, MD
Koji Kubo, MD
Vinodh A. Kumar, MD
Christian A. Lance, MD
Junyi Li, MD
Ellen W. Lin, MD
Cade M. McDowell, MD
Marsha D. McNeese, MD
Alejandro Mendoza, MD
Blaithnead M. Murtagh, MD
Leigh Z. Naftolin, MD
Dorette J. Noorhasan, MD
Swarajya D. Pabbisetty Naga, MD
Salil H. Patel, MD
Steven G. Pilkington, MD
Edmund P. Pillsbury, MD
Aras Pirat, MD
William F. Polito, MD
Annis M. Rainey, MD
Albert R. Robinison, III, MD
Guadalupe Roldan, MD
Cecilia R. Sanchez, MD
Ali Shehata, DO
Matt R. Siskowski, MD
Jeremy S. Smolik, MD
Rodney J. Stanley, MD
Toni I. White, MD
Lee R. Wiederhold, MD
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News and Updates
Branches have practice information & CMEs
TThe HCMS Branch meetings bring the latest practice management information to your area and provide ethics CME credit. To attend a meeting, make your reservation online at www.hcms.org and click on “Meeting RSVPs” in the left-hand margin or call HCMS at 713-524-4267.
Southeast Branch
6 p.m., Tuesday, Oct. 10
Business of Medicine Part III: Quality Measures-Impact on the Business of Medicine
Pat Harris, HCMS socioeconomic director
1 Hour Ethics CME
Bay Oaks Country Club
Central City Branch
6 p.m., Thursday, Oct. 19
Technology & Patient Communication
Philip Suarez, MD
1 Hour Ethics CME
Trevisio Restaurant
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Member Mentions
Dr. Barry S. Smith received the Outstanding Service Award from the Association of Academic Physiatrists.
Dr. Donna M. Bloodworth received the Above and Beyond Ambassador Award from the National Pain Foundation.
Dr. Michael E. DeBakey received the Doctor of the Century Award from the American Lebanese Medical Association.
Dr. Philip A. Salem received the Life Scientific Achievement Award from the American Lebanese Medical Association.
Dr. Stuart M. Dobbs received the John W. Overstreet, MD Award, given annually to a Methodist physician who demonstrates respect, empathy and caring in his or her interactions with patients, family and staff.
Dr. James C. Grotta was awarded the American Heart Association’s Physician of the Year Award.
Dr. Albert J. Sargent III was awarded the National Alliance on Mental Illness 2006 Exemplary Psychiatrist Award.
Dr. Octavio C. Pinell-Midence received his sixth John P. McGovern Award. The award is given annually to an outstanding clinical faculty member chosen by the senior class of The University of Texas Medical School at Houston.
Dr. Franklin A. Rose and Cindy Rose, his wife, were presented the American Diabetes Association’s Generosity to Mankind Award for their outstanding contributions to the community.
Dr. James E. Key II was named a Distinguished Alumnus of Baylor College of Medicine at the 2006 Baylor Alumni Meeting.
Dr. Nora A. Janjan has been appointed to the Medicare Coverage Advisory Committee. She has also been appointed to the Texas Radiation Advisory Board.
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Business of Medicine
Increasing physician referrals
To increase physician referrals to your specialty practice, do a little self-promotion to increase your visibility and build relationships. Try these techniques:
• Attach a handwritten thank you note to reports you send to your colleagues;
• Talk to your colleagues in the hospital cafeteria;
• Give public lectures on specific diseases to raise your profile as an expert and as
someone who understands patients’ questions and concerns;
• Send news about clinical procedures or drugs related to your specialty to primary
care physicians who can use the information in their own practice; and
• Develop a reputation as someone who provides prompt and complete feedback
information to the referring physician.
How to respond to claims denials
There are proven ways to respond successfully to claims denials and requests for medical documentation from insurance companies. Texas Medical Associations’ Office of General Counsel offers these guidelines:
• Address medical and surgical appeals to the carrier’s medical director. Never address them “To Whom It May Concern.”
• Provide a brief, easy-to-understand summary of the medical records the insurance company has requested.
• Put yourself in the reviewer’s position and ask yourself, “What do I need to know about this reported service/procedure to make a payment determination?”
• Always stress the medical necessity of the service/procedure performed, in addition to decision-making and risk involved, if appropriate.
• Provide copies of your appeal/reply to the Texas Department of Insurance (TDI), if the plan is fully insured. (TDI does not regulate self-funded plans, so be sure to check the patient’s health identification card for “DOI” or “TDI” prior to copying TDI.)
Source: TMA
Presented by the HCMS Board on Socioeconomics
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