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The scoop for ISMS practice management professionals

October 2016
In this Issue

  • A Patient Wants to Hand Over a Baggie Full of Old Meds - Now What?

    prescription bottle

    Many of your patients probably assume they can bring you their old medications for disposal when they clean out the medicine cabinet. Of course, that's if they realize they need to get rid of them in the first place. 

    Here's how you can help: Steer them in the right direction on safe medication disposal. A new ISMS Issue Brief takes a deep dive on this important topic, including information identifying disposal sites, how to handle pharmaceutical samples and more! Click here to download your free copy.

    As you probably know, only authorized collection entities can receive prescription medications, so you shouldn't accept medications from patients. Law enforcement and other government agencies often host "take-back" events in which these drugs can be brought to a legal collection site.

    To mark the next National Prescription Drug Take-Back Day on October 22, ISMS and ISMIE Mutual have developed a kit to help you educate patients about safe disposal of unused and expired prescription medications. The take-back kit was mailed to physicians in your office via postal mail and includes:

    If you did not receive your kit, please contact us via email

  • 'Ask ISMS' and Get Your Questions Answered!

    QandA Blocks

    Our "Ask ISMS" feature in Off the Charts is dedicated to your questions.

    Of course, as a practice management professional of an ISMS member, you may contact the ISMS advocacy team with your questions at any time by calling 800-782-4767 ext. 1470, or  by sending an email.

    Q  Will I automatically be penalized under the new Merit-Based Incentive Payment System (MIPS) if I don't use a certified EHR in my practice?

    A  Not in the first year. The Centers for Medicare and Medicaid Services has made 2017 a "transition year" for MIPS reporting, so you only need to report a single measure in one category in order to avoid a payment penalty in 2019. But this only applies in 2017.

    If future years, you will not necessarily be penalized for not using a certified EHR, but it is a significant risk. MIPS is a single program that is made up of four distinct components, three of which mirror current Medicare payment adjustment programs (PQRS, Meaningful Use, and the Value Based Modifier). The fourth component is new; practices can earn points by participating in Clinical Practice Improvement Activities. The total MIPS score, which determines payment adjustments, is based on a weighted average of the scores practices earn in each component.

    Certified EHR technology, required for participation in the current Meaningful Use program, is required for the Advancing Care Information category (the new version of Meaningful Use), which accounts for 25 percent of a medical practice's total score. Speaking from a purely mathematical perspective, if you receive zero points for a component worth 25 percent of your total score, the burden is increased to score exceptionally well in the other performance categories in order to avoid a payment penalty.

    Q  As an ISMS member office, we received your mailing about the safe disposal of medications. We do not have controlled substances in our office, but do have other samples that sometimes expire before being dispensed to a patient. I see that there are only four companies listed in your take-back kit as being registered with the U.S. Drug Enforcement Agency (DEA) as reverse distributors, but the company we use isn't listed. Is this just for controlled substances and we are okay with the company we use for disposal? 

    A  If you are not dealing with any controlled substances, then the DEA's policies and rules are not applicable to your situation. As a result, you can continue using your disposal company as long as your disposal needs do not include controlled substances.

    Q  Why does the health insurance company keep denying our claim? I know I am using the correct code, but they keep denying the claim and don't say why.

    This is a tricky question. Without digging a little deeper, it's hard to say why an insurance company denies claims or service line items. If you keep submitting the same information and it keeps getting denied, chances are the insurance company is looking for different or additional information. Before you get frustrated and assume the insurance company is being stubborn, make sure to check directly with the company to see if there have been any recent changes to its payment or claims processing rules. Another possibility is that you are filing the claim correctly, but have unfortunately stumbled upon a "processing glitch" that the insurer needs to correct. In many cases, calling the physician service center or contacting your assigned physician representative can shed some light on the issue and help you address or avoid hassles in the future. But if you get stuck on hold, or lost in phone tree never-never land, give us a call and we will try to get some answers on your behalf.

  • Ensure Your Medical Office Adheres to Advertising Rules

    When it comes to advertising, practice management professionals must pay close attention to what can or cannot be stated when advertising medical services.

    So if you are in charge of marketing, check out ISMS' medical legal guideline on advertising. You'll find detailed "do's and don'ts" on how to entice new patients.

    Questions? Contact ISMS' legal department at 800-782-4767 or by email.

    This medical legal guideline is password protected. If you wish to access this resource and need to request a username and password as a practice management professional of an ISMS member, please contact us.

    ISMS has streamlined our most popular member benefit!

    Access ISMS' handy, searchable Medical Legal Resources Index of more than 100 easy-to-use legal documents, letters and forms.

  • Free Practice Management Help Available to Professionals Working for an ISMS Member

    As a practice management professional of an ISMS member, you have access to numerous resources, too! 

    Are you experiencing difficulties or hassles with various government agencies and third party payers including Medicaid, Medicare, private payers, HMOs, PPOs and the like? Need help with MACRA, medical records, HIPAA privacy and security policies, credentialing or reimbursement snafus?

    ISMS can help you resolve these issues. You don't have to go it alone. Contact the ISMS Division of Health Policy Research and Advocacy team at 800-782-4767 ext. 1470, or by email.

    ISMS also has a special content page for our practice management professionals. 

  • You Can 'Bank' on These Personal Financial Services

    Why rely on prepackaged business advice when Bank of America, an ISMS Benefit Partner, tailors its services to the needs of medical practices?

    Meet with a Bank of America specialist for specific recommendations on practice loans, equipment financing, debt consolidation, commercial real estate and much more ... all based on your practice needs.

    ISMS member offices are eligible for reduced loan administration fees. Learn more and find a practice specialist near you today

  • Without ISMS, What Would Illinois Be Like for Your Physician?

    Each year, Springfield lawmakers debate and vote on bills that affect how physicians care for patients. Often the proposed legislation needs work, and would be ineffective and burdensome as drafted. Some bills are so fundamentally harmful to medicine that they must be opposed at all costs!

    Imagine if ISMS wasn't at the table to speak up for physicians.

    The best way to protect your doctor's profession is to encourage him or her to renew ISMS membership

    Please keep an eye out for renewal notices.

    Has your office considered Continuous Membership? Learn more about our convenient monthly billing option that keeps membership active year-round, and saves 5 percent off the annual dues.

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