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May 2016 BULLETIN Available

Click to read the May issue

Click to read the May issue

Articles

Feature ………………………….. 187
In memoriam: Peter J. Jannetta, MD 1932-2016
Jack Wilberger, MD

Materia Medica ……………….. 200
Genvoya© (elvitegravir, cobicistat, emtricitabine, tenofovir)
Anna Bondar, PharmD
Ashley Campbell, PharmD, BCPS

Legal Report ………………….. 202
Employed physician liability for compliance issues: Contractual,
regulatory and governmental traps
Beth Anne Jackson, Esq.

Special Report ………………. 204
What can I do if I did not meet Meaningful Use in 2015?

Special Report ………………. 205
Gateway Medical Society update

Special Report ………………. 206
ACMS Health Careers Endowed Scholarship

Special Report ………………. 207
Regional Health Literacy Coalition forum: Moving Health Literacy Forward
Kevin Progar

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USI Affinity – Protect yourself with our Health Insurance programs

Bob Cagna – 412-851-5202
bob.cagna@usiaffinity.comUSI
Protect yourself with our Health Insurance programs
With our size, resources and expertise, USI Affinity gives our partners and their members the Access, Advice and Advocacy they need to save money, prepare for Health Care Reform and get the most out of their benefits.

  • Access to unique products and services;
  • Advice on benefits design, compliance and funding options
  • Advocacy to help resolve issues, from administration and claims to complex clinical questions

ACMS members have access to the ACMS Insurance Exchange, a convenient and secure online portal where members can find competitively priced insurance coverage for all their needs, including medical, dental and vision plans. USI Affinity delivers world class benefit solutions for all practices, regardless of size. For more information, call 1-800-327-1550 or go visit http://www.usiaffinityex.com/acms/.

 

Medical Plan Highlights:

  • Multiple Plan Options – USI Affinity offers ACMS members a wide array of medical benefit plans. Members have access to comprehensive medical plans including PPO, HMO and Qualified High Deductible Plans with Health Savings Accounts and Health Reimbursement Accounts. This flexibility lets USI Affinity help members choose the right insurance carrier and design a benefits package that works for members, their families and employees.
  • Met Life Dental Plans – This exclusive USI Affinity Dental program offers three plan options to meet the individual dental needs of medical practices and their employees. Plan designs range from the most comprehensive coverage – with high reimbursement amounts for major services, Orthodontia and an annual maximum of $1,000 – to a basic plan that will cover preventive services for minimal out-of-pocket expenses. USI Affinity also offers a Dental HMO plan called ConcordiaPlus through United Concordia Companies, Inc.
  • Davis Vision – Members can choose from four affordable plans that provide the highest-quality vision care for the lowest out-of-pocket expense. Our Designer option allows for one vision exam per year and a generous allowance toward frames and lenses.
  • Health Care Reform Assistance – USI Affinity’s knowledgeable benefit specialists have the tools to assist members through a thorough policy review and discuss all possible impacts involved with complying with the regulations of the Affordable Care Act.

Additional information and enrollment materials.

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One Minute Survey – Opiods

one_minute_survey_logo

Click for survey results

Click for survey results

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Highmark -Unconfirmed Diagnosis Codes Payments to Primary Care Physicians

Primary Care physicians have the opportunity to earn up to $165 per member for complete and accurate UDC Forms

As announced last week, Highmark has developed a new, higher level of additional compensation for the Unconfirmed Diagnosis Code (UDC) Program.
This allows PCPs to earn additional compensation of up to $165 per member if 75% or more of their UDC Form(s) have been returned, and are deemed complete and accurate, by October 31, 2016.

A Summary of the Additional Compensation Structure for the UDC Program
Level 1: $125 per member for complete and accurate member-level UDC Form(s)
Level 2: Total of $150 per member when 60% or more member-level UDC Form(s) are accurately completed between Apr. 1 – Oct. 31, 2016* ($25 additional multiplier per member)
Level 3: Total of $165 per member when 75% or more member-level UDC Form(s) are accurately completed between Apr. 1 – Oct. 31, 2016* ($40 additional multiplier per member)
* After Providers reach the higher level of additional compensation, they will be paid at that level for all accurate completions received during the full 2016 UDC Program.

The UDC Program is a clinically based Provider/Highmark collaboration to review diagnosis conditions requiring annual evaluation and/or treatment. It includes previously reported and/or suspected diagnosis conditions that may not have been reported to Highmark in the current year.

Questions concerning the UDC program should be directed to:

Diane Berneburg
Director Professional Provider Relations
Highmark Health Services
412-544-4806
412-544-8871 (fax)

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Malachy Whalen and Co., Inc is an endorsed vendor and site sponsor
Allegheny County Medical Society
713 Ridge Avenue
Pittsburgh, PA  15212
412-321-5030  FAX 412-321-5323