Dealing with ERISA claims; WSMA advocacy with U.S. Department of Labor
Has your practice received a denial on a submitted ERISA claim? The WSMA can help.
The WSMA is collaborating with the Seattle office of the U.S. Department of Labor to offer a free lunchtime webinar this Wednesday, Nov. 28, which will provide an overview of ERISA Title I, explain fully-insured vs. self-insured health plans, claims procedures and participants' rights, and the role of the Department of Labor in overseeing ERISA arrangements.
ERISA, the Employee Retirement Income Security Act of 1974, affects self-insured health plans. Claims payments and denials with ERISA plans are becoming increasingly problematic for physician practices. In years past, only very large companies took on self-insured health care coverage; now, insurers are marketing third-party administrator/"administrative services only" to companies as small as 50–100 employees. As the employers bear full financial risk, these arrangements are not "insurance" products regulated by the state Office of the Insurance Commissioner, meaning the OIC cannot intervene to protect those patients. However, the U.S. Department of Labor does have oversight of ERISA arrangements.
The WSMA can also assist your practice, should you receive a denial or other adverse action on a submitted ERISA claim, through our advocacy on behalf of WSMA members with the U.S. Department of Labor. Contact Michelle Lott with questions, firstname.lastname@example.org.
Mapping Your Path to Value-Based Care
A mix of traditional and value-based payment complicates day-to-day operations. Some processes and services that lead to success under traditional fee-for-service payment arrangements can contribute to failure under value-based incentives.
During this 60-minute webinar, originally broadcast Thursday, Aug. 9, 2018, Attune Healthcare Partners, Washington consultants and experts in value-based payment, will explain how to map a path to optimize earnings and simplify daily operations with a mix of traditional and value-based payment methods. You'll also learn about Attune Healthcare Partners' value-based resources available to WSMA members.
Understanding New OIC Prior Authorization Rules
This OnDemand webinar, originally presented on Nov. 15, 2017, provides an overview of the new OIC prior authorization requirements and how they may impact your practice. Webinar presenter Jeb Shepard also discusses current OIC rules concerning prescription drugs and provides an introduction to the WSMA Prior Authorization Navigator.
The 3 Most Important Benefits of Implementing a Medical Scribe Program
Medical scribes are the best lever to improve physician efficiency and clinic performance, patient satisfaction, physician retention and recruitment, and clinic revenue. Scribes perform EMR documentation and other clerical tasks for the physician. Delegating these tasks to appropriately trained scribes frees doctors to perform higher-level tasks, making them more efficient and improving their job satisfaction. When clinics implement scribe programs, doctors see dramatic reduction in time spent performing documentation and other non-medical tasks, reduced wait times for patient appointments, improved documentation quality, and better relationships with patients.
In this presentation we review:
- The costs and benefits of implementing a scribe program
- The differences between in-house and outsourced solutions
- And real-world results of case studies in which scribes have been deployed
Medical Records Management: Solutions for Physician Practices
A number of variables affect the length of time a physician practice should keep a medical record. Factors include state/federal laws, medical board policies and the record type (for example, an adult versus a pediatric patient). Managing the medical record is an important responsibility for all practices especially in this changing environment.
This free 90-minute webinar will help you learn about the various rules regarding records retention and solutions for your practice to consider. We’ll also introduce you to Spectrum Information Services Northwest, a WSMA-endorsed partner which offers easy and affordable solutions that reduce the expense and liability risks of managing your patients’ records. SIS NW can assume custodianship of all records, reducing your risk of HIPAA violations.
This program addresses the following topics:
- Risks and requirements for physicians and practices.
- Records management and retention timeframes for Washington state.
- Typical scenarios and possible solutions to reduce risk and workload.
Greg Mennegar has served as vice president of sales for Spectrum Information Services NW, Inc. since 2006. He has over 30 years of experience in the document and records management industry, including management of the imaging program for the Washington State Archives, operations management for one of the largest computer output microfilm service bureaus in the U.S., and extensive sales and consulting experience. SIS NW provides cost-effective imaging services and imaging consulting services with a strong focus on health care. SIS NW provides solutions for medical chart conversions, revenue management, managing patient records and automating paper processes. Greg can be reached at (360) 866-0366 or via email at email@example.com.
This 90-minute webinar was recorded on March 18, 2015.