Not that long ago, before phones with GPS, it was fairly common to become lost in a different city (or even a different part of your own city) and help was needed to become “un-lost.” We could keep driving or stop and ask for directions.
Nasal obstruction is a significant source of decreased productivity, decreased quality of life, and disruption in overall sleep and restfulness. There are many possible causes of nasal obstruction, including allergies, viral upper respiratory infections, nasal/sinus infections, or even very rarely sinonasal malignancies. Primarily, nasal obstruction is a factor of three sites that work together within the nose to create resistance to nasal airflow.
It is back to school time. Although it is still hot outside, many schools have opened, we have taken first day of school pictures, and football practice is underway. As we enter this new season, it’s a good time for physicians to review some practice fundamentals. To that end, I offer ten reminders about regulatory compliance fundamentals that can help to avoid legal liability and an unwanted invitation to Montgomery.
Why do physicians leave their employment with a practice group?
There’s no single reason for such a separation. A physician's leaving might be planned well in advance, or might be an unplanned, precipitous event.
[This is the first of a three-part series. By the end of the series, I hope to have covered national, regional, local, and personal realities of the medical malpractice market so that the reader (especially physicians, practice administrators, office managers, and hospital executives) has a sense of the current disturbing developments they may be experiencing.]
Mogul, mogul, mogul, drop off. It didn’t take long for the widowmaker, a black diamond trail on Snowshoe Mountain, to send me to the emergency room of Pocahontas Memorial Hospital. Snowshoe Mountain in West Virginia has some of the best snow east of the Mississippi and as a first-time
When the Birmingham Medical News asked me to write a blog, they told me I could write about anything. Anything? Anything.
As we all know, 2020 was a difficult year in the healthcare due to the COVID pandemic. Now, with a large number of people vaccinated, there is hope that things will stabilize.
In the past year, most physicians have been so busy with all the complications and changes in approach to care that resulted from the pandemic that they haven’t had time to examine aspects of their practice that aren’t part of the daily work. If you haven’t performed a recent review of the potential threats to your practices’ financial health, I recommend doing that, starting with your commercial insurance plan.
Partnering with an experienced agent who specializes in the healthcare arena can provide you with multiple carrier options to compare while helping you negotiate more favorable terms than some companies will offer to clients who work directly with the carrier only. Let’s take a look at a few of the items my team is focused on for our healthcare clients and the emerging threats that are continuing to impact more medical businesses.
The journey toward mental health parity began in 1961, when President Kennedy directed the Civil Service Commission (now known as the Office of Personnel Management) to implement mental health parity. The Strengthening Behavioral Health Parity Act (“SBHPA”), which was signed into law on December 27, 2020 as part of the Consolidated Appropriations Act of 2021, represents a major milestone in that journey by adding ERISA plans to the plans that are covered by the Mental Health Parity Act of 1996 and by working to achieve parity in physical and mental health care management processes.
Many practices are currently leveraging Microsoft Office 365 for e-mail, file storage, and internal collaboration. Unsurprisingly, the number of threats targeting this information (phishing attacks, compromised credentials, etc.) continues to grow at a rapid rate.
The COVID 19 pandemic has thrown a wrench into all of our day to day routines, including going to work, taking our children to school, running household errands, exercising, and even going to see our doctors or dentists.
Oral Immunotherapy (OIT) for food allergies is a life changing medical treatment that re-trains the immune system to become desensitized to food allergens through regular ingestion of food proteins at increasing doses. Alabama Allergy's Food Allergy Treatment Center provides OIT to patients who are at risk for anaphylactic reactions to peanut, tree nuts, milk, egg, soy, sesame seed, and wheat. This treatment is guided by Sunena Argo, MD Board Certified Allergist and Erin Cuzzort, CRNP.
The importance of a having well-designed website and creating an online presence is crucial to your medical practice now more than ever, regardless of how the pandemic affects your marketing outcomes. You don’t want to risk deterring new and current patients from using your practice.
Pediatric office visits have declined by half during the COVID-19 pandemic, according to the American Academy of Pediatrics (AAP). Not only are children missing well-child checks, but also the vaccines that are given during these visits. Manufacturers are reporting a decline in vaccine orders and vaccine doses distributed through the Vaccines for Children program.
The National Institute of Standards and Technology has published a bulletin that provides several key reminders for people who have had to shift to working remotely as a response to COVID-19. The guidance, which can be found in full at the link below, summarizes previous NIST guidelines for working safely when out of the office.
On March 19, the Alabama Department of Public Health (ADPH) issued mandatory health orders to medical practices statewide to delay all elective medical and dental procedures until April 6th. On March 28, the order was amended such that non-emergency procedures are postponed further notice. Under these guidelines, Medical and dental practices have had to reduce office hours and/or close their office.
Valentine’s Day was last month, and as usual, stores were filled with candy hearts while customers snapped up flowers and greeting cards. With Valentine’s Day now in the rear view mirror, while thinking about the holiday, I realized that we tend to overlook the opportunities we have every day to genuinely impact someone else. I found myself wondering how I could turn the seasonal attempts to show someone appreciation into a day-to-day routine. If I carried this mentality with me throughout the year, what downstream effects would follow? How would this impact not only my personal life, but my career and the culture of my organization?
On Dec. 31, 2019, an outbreak of novel coronavirus (2019-nCoV) was first reported from Wuhan, China. Since then, the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and every major news outlet have kept us up to date on the outbreak and its impact across the world.
Each year, the landscape for physician practices has experienced seismic shifts in the areas of reimbursement, regulatory requirements, technology, and competition. Meeting the challenges of such a shifting landscape is a formidable task for even the most sophisticated of physician practices. Doing so requires a keen eye on what’s ahead and careful planning. So, let’s look at a couple of trends that should be considered in the planning process for 2020.
Breaking a bone is often the first sign of osteoporosis. Approximately one in two women, and up to one in four men age 50 and older will break a bone due to osteoporosis. Osteoporosis causes bone to become brittle and weak, which allows them to fracture with relatively low impact. We typically refer to an osteoporotic fracture as a fragility fracture.
With more healthcare organizations moving to VoIP (Voice-over-Internet Protocol) for their phone and communication needs, it’s important to understand the technology and how to make it work for your business needs. So let’s start with the basics.
Are you struggling to keep your employees engaged? Are you aware of the factors that impact engagement in the workplace? Often, we assume that if employees like their jobs, they will be fully engaged at work, but in reality, healthy workplace engagement extends beyond job satisfaction. Engaged employees not only enjoy their jobs, but are also motivated to work toward a common goal aligned with their company’s vision. It’s a big-picture formula that involves both the organization and management.
Managing medical waste is not for the faint of heart - and neither is managing a medical office. Your facility’s staff must adhere to strict, sometimes time-consuming medical waste guidelines and regulations while providing the highest level of patient care. You must protect the health of your patients, your employees, and the environment. Following best practices in health care delivery, medical waste management, and medical office management can streamline processes and help ensure the best delivery of service in each area.
According to the Medical Group Management Association (MGMA), the fourth most challenging issue in practice management is collecting from self-pay and high deductible patients. With patient payments representing a growing portion of practice revenue, re-engineering how patient collections are approached is crucial to practice success.
Real estate is the second highest expense behind payroll for most healthcare practices. The benefits of capitalizing during lease negotiations can include a healthy raise through increased profitability, reduced debt, a nicer office and more. On the contrary, if negotiations are not handled properly, the results can be decreased profitability, resulting in the need to produce tens to hundreds of thousands of additional dollars just to pay the same bills that should have cost less.
Obstructive Sleep Apnea (OSA) is a common problem affecting nearly one-third of the adult population. The long-term health effects of untreated OSA are beginning to become established and are frightening: increased risk of cardiovascular disease, stroke, dementia, pulmonary hypertension.
Yesterday, I received a text from my eye doctor informing me that I have not scheduled my yearly exam and need to make an appointment. The notification was an electronic version of the Annual Patient Postcard reminders. But unlike the old postcards, the text included links to automatically call the office or direct me to visit self-scheduling. Booking that appointment has been on my to-do list for weeks, but I seem to only remember to do it after the office has closed. Yet, with one click and about two minutes of my time, the mission was accomplished. That’s when it dawned on me – healthcare is going “Amazon.”
As financial advisors, we help our clients to consider and plan not only for their own goals, but also for some of life’s serious “what ifs.” What if you want to retire early? What if you want to buy a vacation home? What if your child is planning to attend graduate school? What if you need long-term care? What if you are raising a young family and you get cancer?
Over the last few years, cell phones have become computers, capable of much of the functionality that your office computer has. This is also true for small portable devices such as iPads, Windows and Android tablets. Are these devices and applications as secure as those you use from your clinic? In most cases, the answer is no.
Trying to comply with HIPAA can be a challenge for healthcare providers, especially when there is so much confusion about specific aspects of the rules. Policyholders contact SVMIC almost every day for assistance with HIPAA-related issues. In fielding those calls and emails, we have identified some commonalities.
What if a microscopic amount of food protein you accidentally ingested quickly resulted in life threatening symptoms such as hives, swelling, vomiting, diarrhea, coughing, wheezing, or difficulty breathing? This is a serious reality for patients with food allergies and results in a constant anxiety and fear of accidental ingestion. Many are never able to eat out at restaurants, go to baseball games, fly on planes, attend movies, or simply have the option to eat at any table in a cafeteria without fear. This not only affects the patients, but their families as well.
Peripheral arterial disease, or PAD, is a disease process in which plaque buildup causes the arteries to narrow, resulting in reduced blood flow to the limbs. This can lead to a variety of medical emergencies: Claudication, stroke, uncontrolled hypertension, and possibly amputation.
The False Claims Act (“FCA” or “Act”) is a federal anti-fraud statute that protects against persons and companies defrauding the government. The Act has been dubbed the government’s “primary litigation tool for recovering losses resulting from fraud.” The FCA imposes civil liability on any one who “knowingly presents…a false or fraudulent claim for payment or approval” to the federal government. It is used extensively to protect against fraud in healthcare.
January 14, 2020 is a special day for Microsoft Corporation (you know that little company that controls 82.88 percent of the computer software market share). On that date, Microsoft will end the life of some of the major software that businesses use. End of life means that the manufacturer will no longer support the product. This list includes:
The Department of Justice designated 12 federal prosecutors across the country as part of the Opioid Fraud and Abuse Detection Units. These Units are assigned to areas where the most opioid drug-related deaths have occurred: California, Nevada, Alabama, Central Florida, East Tennessee, West Virginia, North Carolina, Kentucky, Ohio, Pennsylvania, Michigan, and Maryland. Members of these Units also includes numerous federal, state, and local law enforcement and governing entities including the DEA, FBI, HHS, and other federal and state agencies (Medicaid Fraud Control Units, FDA, IRS, State Pharmacy Boards, etc.). These Units have a specific mandate to target physicians, pharmacists, and ancillary services (addiction treatment centers, etc.).
Studies have shown that almost 9 out of 10 adults have difficulty using the health information they receive. This difficulty reflects a gap in patients’ capacity to obtain, process, and understand basic health information and the services needed to make appropriate health decisions. In other words, the studies reflect a gap in health literacy.
One of the most frustrating things PC users can experience is slow performance or freezing while using their normal programs. It can make even the simplest tasks take several times longer and greatly slow down your work day, which impacts patient care as well. While it will sometimes mean there could be hardware issues and your PC needs an upgrade, there are several steps that you and your IT support can take to speed up the performance of your PC through cleanup tools, anti-virus and anti-malware scans, or optimizing settings.
Benign Prostatic Hyperplasia, or BPH, is a common condition that a lot of men will experience as they age. The prostate, which is involved in male sexual function, sits at the neck of the bladder. I tell my patients that, as it enlarges, it’s like putting your thumb on the end of a water hose. It requires more force to push the urine out effectively. Symptoms can arise as early as our 30’s and perhaps 50% of us will have issues by our 60’s. It causes all sorts of symptoms including slowing of the urinary stream, incomplete bladder emptying, frequent or urgent urination, urinary retention and nocturia. Unfortunately, a large percentage of men will simply ignore these symptoms and just chalk it up to “old age.” Not only can these symptoms be bothersome but, in some cases, it can lead to significant bladder dysfunction, kidney issues, infections, etc
“We’re all wearing our team colors, but colors don’t matter when it comes to concussion,” says Dr. Jimmy Robinson, University of Alabama lead team physician. This year, at the Children’s of Alabama Annual Concussion Summit, a special science, vision, and engineering breakout session featured the insight of Dr. Robinson and others in the trenches of Division I sidelines. Led by UAB’s director of medical athletics, Dr. Heath Hale, and UAB Team Eye Doctor, Dr. Kathy Weise, lead team physicians and scientists from Alabama, Auburn, Florida and Clemson joined forces to weigh in on UAB’s advancements in concussion expertise. What if a contact lens could determine how much the eye sloshes around in the orbit to predict how much the brain moves in the skull when exposed to impact? What if retinal blood flow could predict cerebral blood flow following concussion? What if an objective pupil test could help predict prolonged concussion recovery?
Fraud. It’s an ugly thing and it’s everywhere, the medical industry is no exception. When most people think about fraud, they think about white collar criminals stealing millions of dollars from big name companies, or the “dark web” where most of our social security numbers and credit card numbers are floating around just waiting for a buyer. The truth is most businesses will experience some type of fraud during their operation. It is so important for owners and business managers to be constantly vigilant to protect their practices.
I recently visited a specialty practice at a major health system. As I approached the registration desk a posted sign directed me to a standing kiosk to sign in. The family member I accompanied to the visit was unable to stand at the kiosk, so I provided the needed information and signed her in. Although it was a quick and seamless process, I was concerned because if I needed assistance, there were no employees to ask. Many practices have implemented kiosk sign-ins and have someone to assist a patient with the process if needed. Practice administrators have made the decision to implement kiosk to assure verification of the current insurance policy and prompt the patient to pay any out of pocket expense before they see the doctor. Many of the kiosk solutions allow a pre-registration via email to allow the patient to populate data and upload information from their own device at their convenience. Benefits of Kiosk Sign-ins include: reduction in the staffing at the front desk, decrease in patient wait time, and most impressively is the increase of time of service collections.
One of the greatest challenges healthcare organizations face today is clinical application interoperability – the communication between computer systems, applications, or software to allow them to work in conjunction with one another.
It is especially important for smaller practices to be mindful of Electronic Protected Health Information (ePHI) security regulations – a breach of ePHI can lead to costly notification requirements and potential monetary penalties under the HITECH Act. Managing physicians of small independent practices hold many responsibilities, including the duty to comply with the Security Rule within HIPAA regulations. This article provides a brief overview of federal ePHI compliance safeguards required in a practice. While not meant to be a comprehensive discussion of all requirements, it highlights legal considerations and safeguards a practice must implement to comply with HIPAA ePHI regulations. The federal Security Rule under HIPAA requires a health care provider (typically known as a Covered Entity) to have the minimum ePHI safeguards, listed below.
On Friday, January 19, 2018, the Department of Health and Human Services (HHS) issued a proposed rule that will complicate the issues healthcare providers face in providing treatment to LGBTQ patients.
They were surprised, and you likely be will, too. Of the hundreds of healthcare organizations I’ve helped document HIPAA and meet compliance requirements, most are unaware that their Patient Health Information (PHI) is exposed in some way. If a cyber attacker took advantage of this situation, it could cause damage to your patients, bring giant HIPAA fines, and a loss of reputation.
In the past few years, when we discussed patient satisfaction it pertained only to patient surveys and results. Some managers believe surveys are utilized by specialties, such as, plastic surgery who primarily practice on a cash basis. Consumerism is here to stay! Cost and quality will create a level playing field in healthcare. When working with a practice, I love to sit in the waiting room to see operations from the patient’s point of view. I also search the specialty online to review the competition and the effectiveness of the practice’s website; I may also see online reviews.
If you surveyed managing physicians and office managers from the Birmingham area about their business continuity plans, how confident do you think they would be with their Disaster Recovery solution? Do they feel prepared? Have they even thought about it?
Between phone calls with clients on another day in the financial trenches at Raymond James & Associates, I brainstormed for a good topic to pontificate upon to the readers of this fine publication, and I hope you’ll agree I found it.
The assessment of patient compliance is very difficult. Many patients may not want to disappoint their physician and will not be completely accurate about their degree of compliance. Other patients are not able to accurately evaluate or do not know their degree of compliance. In one study, 10% of patients reported that they were 100% compliant with their medication use. Using pill count methods, however, the use of the prescribed medications ranged from 2% to 130% of the prescribed pills.
Over the last year or so, cryptocurrencies and blockchain technology have grabbed the attention of global markets and its participants.
Until recently, sufferers of chronic or recurrent sinusitis were limited to two treatment options: medication therapy or aggressive sinus surgery. Fortunately, advances in medical science have opened new doors.
We hate to break it to you, but there's a HIPAA requirement you’re more than likely doing wrong. The Department of Health & Human Services’ Office for Civil Rights (OCR) is cracking down on requiring a true Healthcare Security Risk Analysis.
Q: Could you tell us about Norwood Clinic Ophthalmology?
A: We’re a part of Norwood Clinic, which is the oldest and largest multi-specialty medical group in the Birmingham area. At the ophthalmology location, we offer comprehensive ophthalmology services. This includes routine adult and pediatric eye exams; medical and surgical treatment for diseases of the eye and eyelids; and screening for ocular manifestations of systemic diseases such as diabetes.
We also have certified ophthalmic technicians and an optician to assist with the dispensing of glasses and contact lenses.
We all recognize that healthcare is evolving at a rapid pace. With this evolution, the need to share patient information to positively impact quality care, provide a seamless patient experience, plus save time for your staff to coordinate care is of critical importance. By making the most of new technology, today’s office equipment can easily and securely, help you do just that.
Approximately 12 million Americans suffer from peripheral artery disease (PAD), yet general awareness of the disease is at 25%. Patients over the age of 50 with a history of smoking, high cholesterol, diabetes, hypertension, and heart disease are at the greatest risk. A staggering 50% of PAD patients have unrecognized symptoms that may progress directly to severe disease.
Full scale recruitment is under way for the Alabama Genomic Health Initiative (AGHI), a partnership of the University of Alabama at Birmingham (UAB), HudsonAlpha Institute for Biotechnology and Children’s of Alabama. Funded by a $2 million appropriation from the Alabama legislature to UAB, the AGHI is one of the nation’s first statewide efforts to use genomic analysis to identify those at high risk for genetic diseases.
Venous reflux in the lower extremity is when blood from the foot which should travel towards the heart reverses downwards due to gravity.
As of September 30, 2017, the Department of Health and Human Services Office of Civil Rights (OCR) has received notices of 237 breaches. 46% occurred as result of hacking or IT security incidents; many at the business associate level. Ransomware is rampant and projected to increase 670%. As a covered entity, although a breach occurs at your business associate, under HIPAA, you are responsible for your protected health information and responding to the breach. OCR has been clear that breaches of 500 or more records will be investigated. Given the significant increase in breaches over the past few years, advance preparation is critical and can reduce the cost and burden of breach response.
Did you know a single patient health record can earn cybercriminals 10 times the price of a stolen credit card number on the black market?
The Office of Civil Rights is auditing small and large healthcare providers alike, imposing multi-million dollar fines in some cases. Meanwhile, the same electronic storage, mobile devices, and cloud-based applications that patients, doctors, and healthcare staff want to use often compromise a practice’s ability to keep that patient data safe.
It has now been two years since the implementation of ICD-10, everyone survived! While denials have been minimal, the goal of implementing ICD 10 to acquire more specificity and a complete picture of health has not been fully achieved. Physicians and managers have created a new set of shortcuts to assure payment of claims, relying on paper superbills or inappropriate conversions from ICD 9 to ICD 10.
As a hand and upper extremity Orthopaedic surgeon, I see many patients that present to my office with pain in their elbow and forearm. For a certain subsets of these patients, I ultimately diagnose them with lateral epicondylitis, or tennis elbow. Oftentimes, their reaction is the same. They say, “Doc, I don’t even play tennis, how could I have tennis elbow?!” Unfortunately, many people assume that lateral epicondylitis will only affect those individuals that are active in racquet sports, when in reality; tennis elbow can affect both men and women regardless of their hobbies.
The city of Marion is an old town rich in Alabama history that pre-dates the Civil War. It’s home to many antebellum homes, Judson College and Marion Military Institute, the nation’s oldest military junior college. Few people may know that a young Coretta Scott, born and raised in Marion, wed her husband, Rev. Dr. Martin Luther King Jr., on the front lawn of her mother’s home just north of Marion in 1953. It’s this small town’s amazing history that called out to Dr. Shane Lee when he was looking to set up a practice.
TUSCUMBIA – When you walk into Dr. Suzanne Blaylock’s office at the Helen Keller Pavilion, there’s a medical journal on her desk, paused and waiting for her to return to continue reading the most recent article. On the wall behind her chair are framed reminders of why she choose anesthesiology as her specialty – awards recognizing her from the Peer Reviewed Professionals, the Consumers’ Research Council of America as one of America’s Top Anesthesiologists, and the Consumers’ Research Council of America’s Top Physicians. Dr. Blaylock always knew she’d have a career in medicine, but what she got was so much more.
MONTGOMERY – Boyde Jerome “Jerry” Harrison, a family practitioner from Haleyville, was formally installed as president of the Medical Association of the State of Alabama during the 2017 Inauguration, Awards Presentation and 50-Year Physician Recognition Dinner on Friday, April 14.
Social Security Disability under Title II of the Social Security Act*
Surveys have shown that most Americans know little about Social Security law and the vital benefits it provides. By far, the least understood Social Security benefit is Social Security Disability Insurance (SSDI). This lack of knowledge has been measured through objective testing in various academic studies. Anecdotally, I know this to be true based on recurring questions and comments I have received from the public and clients alike over the last several decades of my work as a social security disability attorney.
Recycling electronics is a great way to help conserve and reuse valuable resources and materials found in many gadgets, including glass, plastics, and various metals such as copper, gold, palladium, and silver. Many electronics, especially computers and televisions, contain toxic materials such as cadmium, lead, and mercury. Recycling and reusing electronics helps to keep these toxic materials out of our landfills and water supply.
As we women age, we do not always know what is coming next. We think we do, but we may not. We all know the stereotypical changes that happen with menopause, and of course, chronic diseases such as diabetes, heart disease, etc. that can occur with age. I can tell you that many women in their late 40s to late 70s are not expecting pain with intercourse, vaginal pain and discomfort, or both. It is honestly a surprise. And not a good one at that. It can make a healthy sexual relationship go sour very quickly, which not only hurts the woman’s quality of life, but her partner’s as well. This can affect the relationship as a whole, and both parties’ overall health, which can then lead to other medical issues. In our practice, we traditionally have treated men for erectile dysfunction and other sexual issues, but we understand that female sexual health is important as well.
In the last 10-15 years, the use of mid-level providers has increased to expand the base of patients in many practices. The Nurse Practitioner scope of practice is more flexible and there are specialty designations available to foster expertise in certain areas. The insurance companies have expanded the number of plans covering a mid-level provider’s services.
Devices that store information are now everywhere and used multiple times by most people on a daily basis. From PCs, to laptops, to phones and tablets, to USB keys and external hard drives – the amount of data that a person can potentially store has grown exponentially over the past decade. While the convenience of near unlimited storage is very appealing, it also introduces new challenges.
Moving a medical practice can be a daunting task. A medical office move can be a result of needing a bigger space, physician retirement, or practice acquisition. While making patients aware of a major change is most certainly a priority, it is equally important to make sure their documents and all office data and service equipment survives the move as well.
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