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The scoop for ISMS practice management professionals

July 2017
In this Issue

  • 'Ask ISMS' and Get Your Questions Answered


    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  What if a patient calls to book an appointment and that patient has a large balance due?

    A  The best way to handle this situation is to try to avoid it in the first place. Develop formal payment and collection policies, and communicate what they are to patients respectfully, but clearly, at each visit. Make sure your office or appointment staff know what your payment policies are, and train them to help patients be prepared. As part of the overall strategy, make it as easy and convenient as possible for patients to pay their balances. For example, gently advising patients of an outstanding balance at the time of booking and making it easy for them to pay off the balance at that time can help minimize the problem.

    If payment issues persist, your office may decide to stop seeing the patient but must do so appropriately. Check your payer contracts to see if there is any language addressing termination of a patient for unpaid balances. In addition, remember that your medical office has a legal obligation to appropriately transition the care of the patient. Learn more with ISMS’ medical legal guideline, Physician-Patient Relationship: Withdrawal or Termination Guidelines & Forms.

    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.

    Q  What does our office need to do to be in compliance with interpreter requirements?

    A  If your medical office receives federal funding (such as through Medicaid or Medicare, federal grants, or incentive payments), it is then required that persons with Limited English Proficiency (LEP)* have meaningful access and an equal opportunity to participate in benefits and services. This means you need to make sure the patient is able to understand the services and benefits available, and can communicate the relevant circumstances of his or her medical situation to health care professionals.

    The specific actions you need to take to meet the interpreter requirements depend on a wide range of factors that are unique to a practice and its patient population. In evaluating whether a covered entity has met its obligation, the U.S. Department of Health and Human Services considers the "nature and importance" of the health services and takes into account other relevant factors, such as whether the covered entity has developed and implemented an effective written language access plan.

    Learn more with ISMS' Foreign Language Interpreter Requirements, a medical legal guideline covering methods for providing effective communications.

    *LEP refers to individuals who do not speak English as their primary language and who have a limited ability to read, write, speak or understand English.

    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.

    Medical offices can also check out CTS LanguageLink, an ISMS Benefit Partner, to get help with this growing need. CTS LanguageLink offers interpretation and translation services via conference call, video conference or on-site personnel. ISMS members receive a 30 percent discount on per-minute fees, with no monthly minimum and no sign-up fee. Learn more.

  • Prescribers Can Empower Their Staffs to Check the Prescription Monitoring Program


    In the fight to address the opioid epidemic, the use of Illinois' powerful FREE resource – the Prescription Monitoring Program (PMP) – is more important than ever! 

    Although certain restrictions apply, prescribers may delegate authority to their staffs to access the PMP to check patients' prescription histories.  

    This tool can help your medical office find out if a patient may already be getting prescriptions for narcotics, and whether the patient has multiple prescriptions. 

    Questions about the PMP? Call 217-524-1311 or submit a question online via the PMP's Question Form.

  • ISMS Is Ready to Help Your Physician with License Renewal!

    The July 31 deadline to renew medical and controlled substance licenses in Illinois is about two weeks away.   july31

    ISMS offers members easy license renewal services through the deadline. Physicians may call our hotline at 800-632-7478 from 8:30 a.m. to 4:30 p.m. on weekdays.

    In addition to the convenience of renewing over the phone with our friendly staff, physicians won't have to pay the additional Illinois Department of Financial and Professional Regulation (IDFPR) service charges for electronic renewals – but must still pay the license renewal fees:

    • $690 for a three-year medical license 
    • $15 for each controlled substance license

    Your physician should act now – the cost spikes to $920 for a medical license renewed after the deadline!

    Here's what information will be needed to renew:

    • If your physician received the email notification from IDFPR with his or her individual PIN, he or she should have that ready before the call. 
    • If the PIN is not available, renewal can take place by providing the following: medical license number, Social Security Number and date of birth.
    ISMS staff are ready for your call! 

    Questions? Please contact us via email or call 800-632-7478.

  • IL General Assembly Passes Health Insurance Bill to Protect Patients

    You've heard it before – exasperated patients expressing their frustration when they find out their trusted doctor is no longer in their network. How about the urgent phone call from the patient wondering why his or her bill reflects "out-of-network" charges. It might be you who breaks the news: "Your health insurance company made changes to the network without informing you or us."  

    But here’s some good news! Illinois lawmakers recently passed ISMS-backed legislation to protect patients who purchase health insurance, called the Network Adequacy and Transparency Act (NAT Act).

    ISMS fought long and hard to help enact this patient protection bill when we heard from many of our doctors who were concerned that commercial health insurers were increasingly "downsizing" patient options by establishing narrow networks.

    The legislation will now be transmitted to Governor Rauner for signature.

    Learn more about the NAT Act by reading ISMS' News Release

  • July 18 Webinar: Learn How to Maximize Reimbursement Under MACRA/MIPS


    The Centers for Medicare and Medicaid Services recently unveiled the highly anticipated Quality Payment Program (QPP) proposed rule for 2018, which determines payment adjustments for 2020.

    How will QPP affect your medical office’s bottom line? How can you help to ensure maximum reimbursement from Medicare under the new reporting rules?

    Find answers to these questions and learn more by joining ISMS' live webinar onJuly 18 from noon to 1 p.m.

    This program is FREE for ISMS members and YOU, and will be presented by experts from our Member Benefit Partner, CareVitality.

    Click here for more information and to register. 

    Please note: CME will not be provided.

  • Credentialing & Enrollment Made Easy

    To make life easier for our members and their staffs, we recently added a credentials verification organization to our roster of Benefit Partners.

    Introducing ISMS Credentialing and Enrollment Services, a partnership established between ISMS and 3WON to simplify and automate the credentialing process.

    This vetted vendor can assume the responsibility of credentialing and enrollment for physicians by collecting the data once, maintaining its accuracy, and distributing it to authorized parties, significantly reducing the time spent on credentialing.

    3WON's cloud-based product also eliminates the need for a software purchase – so no implementation or maintenance fees. And that’s not all. ISMS members can take advantage of a three-year locked fee structure.

    So don't delay! Contact ISMS Credentialing and Enrollment Services, Powered by 3WON today.

  • Shower Caddy: Check. Laptop: Check. Shots for College? Time to See the Doctor!

    Are some of your patients heading off to college? While they are starting to shop for dorm accoutrements, college-bound students must also make sure they have met Illinois immunization requirements if attending higher education in the state.

    New vaccination requirements recently took effect for students attending Illinois colleges and universities (both private and public), which include:

    • At least one dose of Tdap (tetanus, diphtheria and whooping cough) vaccine within the previous 10 years. 
    • At least one dose of meningococcal vaccine on or after the student’s 16th birthday (applies only to incoming students under age 22). 
    • Immunization or immunity against measles, mumps and rubella (MMR).
    • An existing immunization exemption for students born before 1957 now only applies to MMR vaccinations.

    Some colleges may not allow students to attend classes past a certain date if immunization requirements are not met.  

    For more information, visit ISMS' Immunizations and Vaccinations webpage.

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