Professional Documents
Culture Documents
Today: in This Issue AAOMS Provides OMSF $120,000 To Support Clinical Surgery Fellowships
Today: in This Issue AAOMS Provides OMSF $120,000 To Support Clinical Surgery Fellowships
Volume 1, Issue 2
March /April 2003
In This Issue
TODAY
AAOMS Provides OMSF $120,000 to
A publication of the American Association of Oral and Maxillofacial Surgeons
mary over Medicaid. Furthermore, the custodial parent, placing you in surgery practice. Primary areas of OMS OR 770/442-8633
Tricare will be primary in the event the middle. Therefore, it is imperative practice discussed include trauma care, FAX 770/442-9742 OR ORDER
to know your state’s coordination of anesthesia, orthognathic surgery and ONLINE WWW.AAOMS.ORG
the Tricare patient has purchased a elective cosmetic surgery.
supplemental insurance policy to benefits laws as well as review the
parent’s divorce decree before decid- Tell your story — buy your copy today! American Association
cover their Tricare deductible or cost of Oral and Maxillofacial
share. Keep in mind the following ing which insurance plan to bill first. Member: $50; Nonmember: $150; Surgeons
limitations when Tricare is secondary: Institution: $100
• Tricare will not pay more as a sec- Establishing an office policy address- Order Codes: SCOPE.V (Video)
ing these issues will assist your office SCOPE.DVD (DVD)
ondary payer than it would have
in the absence of other coverage staff when they face these often-chal-
Enteral Sedation
Information Kit
AAOMS has developed an
enteral sedation information kit
in response to the numerous
states considering enteral seda-
tion legislation/regulation. This
kit provides insight on the Dental
Organization for Conscious
Sedation (DOCS), emerging
enteral sedation regulatory trends
as well as ADA/AAOMS sedation
guidelines. The kit is available to
members who need information
to present to state legislators or
administrative board authorities Pictured left to right: Ms. Carol O’Brien, AAOMS associate executive director, Advocacy
considering enteral sedation and Governmental Affairs; Dr. Frank DiPlacido, AAOMS past president; Dr. Lanny
guidelines. For a copy of the kit, Garver, member of the Committee on Health Care and Advocacy; Dr. Larry Nissen,
please contact Bruce Blehart, AAOMS president; Ms. Karin Wittich, AAOMS director of practice management and
manager, Government Relations, reimbursement and director of operations, Advocacy and Governmental Affairs; and Dr.
Richard Mufson of the Florida OMS Society.
at 800/822-6637, or by e-mail at
bblehart@aaoms.org. ■
MAY
FL, Bradenton
FL, Miami North
FL, West Palm Beach
MI, Huron City
MN, St Paul
NC, Charlotte
OK, Oklahoma City
PA, Reading
UT, Salt Lake City
WI, Appleton Fox Cities
JUNE
AZ, Phoenix-Scotsdale
AZ, Phoenix E Valley
CA, Palo Alto
CA, South Bay
FL, Naples
FL, Tampa
KY, Loisville
NY, Erie
OR, Klamath Falls
PA, Lower Bucks
JULY
AL, Birmingham
CA, San Diego East
CA, Fresno-Clovis
FL, Vero Beach
MA, Quincy
MO, Tri-State
OH, Lima
OK, Greater Tulsa
OR, Portland
TX, Houston
AAOMS Today • March/April 2003 11
Practice Management Matters
Suggestions on Claims Audits and Managing Overhead
Although the compliance plan is Is the payer recognizing the modifiers • Currently, AAOMS members can
Question: maintained to determine both the you use? All of these questions and receive up to an 80% discount on
We are implementing a adequacy of your in-house billing many more can be answered simply office products from Office Depot
compliance plan to monitor the policies and standards and the extent by investing a couple hours a week in through their “150 Best Value”
claims development and to which they are being properly reviewing third-party payments. list, and another 3% discount on
submission process, in accordance implemented, a post-payment audit Questions you should ask include: all other items. For more
with the recommendations can also be very beneficial to the information on Office Depot,
outlined in the AAOMS practice. 1. Was the claim processed correctly? please visit the ASI website or
Compliance Plan manual. 2. Have all of the services reported call AAOMS Services, Inc. at
Currently, I have one person Post-payment reviews and audits may been given benefit determination? 800/822-6637, ext. 4319.
assigned to process insurance – be the key to alleviating many of the 3. Were any of the services down- • The AAOMS Platinum Plus for
both electronic and paper claims – frustrations that offices experience, coded? If so, is there sufficient Business MasterCard® sets
but another individual records all including claim denials and decreased information provided on the EOB individual credit lines for staff
insurance payments. Although the reimbursement. Frequently, the to justify this? Does the OMS and increases capital instantly
doctors in our practice do code Explanation of Benefits (EOB) agree with the decision? with low APR. Enroll by calling
each case, we currently do not contains useful information to which 4. Were any modifiers submitted with 800/598-8791 and mentioning the
have any post-payment review many offices do not pay attention. the original claim? If so, were they AAOMS priority code NCVS.
process. Can you give us any For instance, is your office aware of recognized by the payer? • For a low swipe rate in processing
suggestions? what percentage of billed charges 5. Was the reimbursement provided patient charge cards, contact
Answer: actually are paid by insurance what you expected? AmeriBank Credit Card Processing
Congratulations on implementing the carriers? Do you know how the 6. Is the reason for the denial and/or services at 888/480-6804.
compliance plan! While it can be a payers are interpreting the codes reimbursement sufficiently • Avoid extending credit to patients
daunting task, it is an important one. being reported by your practice? communicated? for expensive treatments, and opt
7. Are contracted discounts being instead for patient financing
adjusted properly? programs through CareCredit at
8. Is follow-up with the carrier 800/300-3046, ext. 519.
necessary? • Purchase refurbished and new
medical equipment at a 3%
sign up today and join the AAOMS Group Purchasing Program - there are Keep in mind that post-claim auditing discount, and earn a year-end
no sign up fees - earn discounts and rebates on qualified purchases. is extremely important and should be rebate through D.R.E, Inc at
performed by someone who has not 800/499-5373.
only coding and billing experience • Add another revenue stream to
but also a keen understanding of the your practice while offering
appeals process, managed care patients the convenience of ready-
contract limitations and practice to-dispense OMS medications
policy(ies). It is further recommended from DRx, A Division of Wellinx.
that the OMS become intimately Call 800/999-9379 for a free DRx
involved with the post-payment Demo-Kit.
review process. Only the OMS can • For discounted pricing on in-office
identify inappropriate claims sedation and surgical supplies
adjudication such as down-coding or contact Southern Anesthesia &
denials based on medical necessity. Surgical at 800/624-5926
Remember to pay close attention to • Other personal benefits of being
your diagnosis coding and code to the an AAOMS member include:
greatest degree of specificity. Many discounted car rentals at Alamo
denials based on medical necessity are Car Rental (800/354-2322;
due to improper or insufficient Code:BY-ID #567517) or National
reporting of the diagnosis. Car Rental (800/227-7368; #
5129643); the AAOMS Platinum
Plus Rewards personal
Question:
MasterCard (apply online at
In reviewing my monthly medical
www.aaomsservices.org or call
and administrative expenses, I
866/438-6262; Priority code:
have noticed an increase in our
NBT3) and also get preferred rates
costs in 2002. Can you offer any
for CDs, Money Markets and
suggestions on how to cut back
IRAs through MBNA Deposits
our costs in 2003?
Program (800/900-6693;
Answer: Code: #HA08M). ■
As with any effort to reduce expenses,
comparison shopping is the key.
Don’t forget to take advantage of all
of the cost-saving products and
services approved by AAOMS/ASI for
W W W. S O U T H E R N A N E S T H E S I A . C O M
your business and personal needs:
ONE SOUTHERN COURT • WEST COLUMBIA, SC 29169
PHONE 1.800.624.5926 • FAX 1.800.344.1237
biopsy of lesion code with a low rela- As in other procedures, when submit- On-Line Risk Management Courses
tive value unit (RVU) and 0- or 10- ting for supplies, an invoice for the Specialized Web Site for Insureds
day global period in addition to an materials or supplies should be sub- In-Office Risk Management Reviews
incision and drainage code with a low mitted with the claim. Informed Consent DVD and Videos
W E B
PBHS
D E S I G N F O R T O D A Y ’ S O M S
Article V. Section 10 of the AAOMS also serves as president in the event of
Constitution and Chapter VII of the a vacancy and succeeds to the office
Bylaws provide for the nomination of president without election at the
and election of officers of the next annual meeting following his/her
PBHS is the premier web site design firm American Association of Oral and election as president-elect.
for the OMS community. PBHS creates Maxillofacial Surgeons. The officers
of the association include the presi- Vice president – assists the president
comprehensive, custom, interactive web dent, president-elect, vice president, as required; serves as a member of the
sites that attract attention, promote the treasurer, immediate past president, board of trustees and the Executive
practice and enhance office productivity. and the speaker of the House of Committee; and functions as presi-
Delegates. As in many professional dent-elect in the event of a vacancy.
associations, the president-elect pro-
gresses “through the chairs” to the Treasurer – serves as custodian of all
positions of president and immediate money, securities and deeds belonging
past president as specified in the to AAOMS and holds, invests and
Constitution and Bylaws. The vice disburses these funds subject to the
president and speaker of the House direction of the board of trustees;
are elected to one-year terms of oversees the annual audit of the funds
office, and the treasurer serves a of the association; presents a financial
two-year term. report at each annual meeting; serves
as chairperson of the budget and
At the 85th Annual Meeting, finance committee; serves as a mem-
Scientific Sessions, and Exhibition in ber of the board of trustees and of its
Toronto, Ontario, Canada, this Executive and Building Committees;
September, the AAOMS House of and functions as vice president in the
Delegates will elect a president-elect, event of a vacancy.
vice president, treasurer, and speaker
of the house. Any AAOMS fellow or Speaker of the House of Delegates –
life fellow in good standing may be presides at all sessions of the House
nominated for one of these positions. of Delegates; develops the order of
Fellows and life fellows interested in business for all sessions of the house
running for office may obtain a nomi- of Delegates in consultation with the
• Creative site design and copy writing nation form from Ms. Anne Marie standing House Committee on Rules
Rogowski at AAOMS headquarters. and Procedure and the executive
• Web hosting and maintenance Nominations must be made in writ- director, subject to the approval of
ing and signed by 10 fellows or life the house of delegates; announces the
• Multimedia patient education modules
fellows in good standing and submit- results of any action taken by vote;
• Secure online patient registration with ted to Ms. Rogowski prior to the first appoints, at his/her discretion, a par-
practice management software integration session of the house at 10:45 am, liamentarian for annual meetings,
Tuesday, September 9. The election of subject to the approval of funds by
• Electronic referrals and online collaboration officers will take place Friday morn- the board of trustees; makes final
ing, September 12, during the third decisions on rules and procedure dur-
• Security provisions and HIPAA compliancy session of the house. ing sessions of the house unless an
appeal from such decision is made by
• Search engine advertising programs Individuals elected to one of the open a member of the house, in which case
officer positions will be expected to the final decision shall be made by
attend five board meetings during the majority vote; serves as an ex-officio
Have you seen our complete line of dental year, and serve as an officer liaison to member of all committees of the
implant and third molar marketing products? several standing committees and task house of delegates without the right
forces. The speaker will be invited to to vote; and serves as chairperson of
For information call 800.840.5383 attend the summer and fall meetings the House Committee on Consent
of the board. The duties for each Agendas. The speaker of the house
open position as specified in the shall not be a member of the board of
Bylaws are as follows: trustees.
w w w. p b h s . c o m
President-elect – assists the president Any candidate officially running for
as required; serves as a member of the treasurer is invited, at his/her own
AAOMS Board of Trustees and its expense, to the May 18-19, 2003
Executive and Budget and Finance Budget and Finance Committee meet-
Committees; reports annually to the ing at AAOMS headquarters in
house of delegates on the activities of Rosemont, IL. Any official candidate
the board; and with the approval of for speaker is invited to attend, at
the board of trustees, makes appoint- AAOMS’s expense, a portion of the
ments to all standing committees, June 1-3, 2003 meeting of the board
including the designation of commit- of trustees, also to be held at
tee chairpersons. The president-elect AAOMS headquarters. ■
As we close out the books for 2002, AAOMS would need to “borrow” ance, it appears that AAOMS will not
we are pleased to report AAOMS has approximately $500,000 from need to tap into those reserves.
had another good year financially. As reserves to cover the excess of
you may recall, the original 2002 expenses over revenues. As a result of The key contributor to the favorable
operating budget assumed that the association’s favorable perform- budget performance in 2002 was the
annual meeting, where revenues of
approximately $2.6 million exceeded
budget expectations by over
ANNUAL MEETING REVENUES $600,000. At a time when many
healthcare associations are experienc- Treasurer
$3,000 ing declines in attendance for their Jay P. Malmquist, DMD
meetings and conferences, the 2002
$2,500 AAOMS annual meeting was the
most successful ever in terms of both
member attendance and the popular-
IN THOUSANDS
Over the last few years, insurance Thus, if your net income is $300,000 If you currently have a policy with Finally, with the restricted limits on
companies have dramatically reduced and an additional $30,000 is being another company for $8,000 per the monthly benefits available to the
the amount of disability coverage placed into a profit sharing plan, the month, and you financially qualify dental professional through personal
they will allow dental professionals to base disability policy can be issued at for a total $12,000 benefit, you could disability income insurance, it is
purchase. On new individual policies, $10,000 per month and the add a MassMutual policy for $4,000 imperative that business owners
most companies will not issue more Retireguard rider at an additional per month. More importantly if you purchase business overhead expense
than $10,000 of monthly benefit. As $2,500 per month. Your total cover- are buying coverage for the first time, insurance to cover their fixed business
incomes continue to increase, it is age would be $12,500 instead of the and financially qualify for $8,000 in expenses. This allows the individual
more important than ever to maxi- $10,000 maximum normally allowed. benefits, it would be wise to divide to free up his or her disability policy
mize your disability coverage in order the coverage between MassMutual for personal expenses.
to maintain an adequate amount. Another way to maximize your bene- and MetLife. By combining policies
fits, and ensure future buying capabil- you may provide the ability to As you can see from the above exam-
Recently, MassMutual introduced ities, is to split coverage between two increase your policy to the higher lim- ples, you can maximize your disabil-
Retireguard, a new rider to their companies. As mentioned previously, its while protecting your insurability. ity income coverage through careful
Radius® Disability Income policy. MassMutual will issue a benefit up to If you were to purchase the entire planning. Sitting down with a quali-
Normally, one can insure between $10,000 per month, and they will $8,000 through the MetLife program, fied financial advisor to review your
35% and 65% percent of income. participate with another carrier up to and wait to add the Mass Mutual, disability portfolio on a regular basis
Retireguard allows you to insure your $15,000 per month. (Note, the you could lose the ability to add the is extremely important. To discuss
retirement contributions at 100%, in $15,000 participation limit was second policy should a significant how to maximize your coverage,
addition to the above amount. specifically approved for your associ- change in health occur. contact Treloar and Heisel, Inc. at
ation’s program and is not available 800/345-6040, or visit our website at
to other individuals.) www.th-online.net. ■
AAOMS
Dates to Remember
Please note the following important deadline dates for the
coming year:
May
Annual Meeting registration opens mid-May.
Advertising
June 1
Advertising inquiries other than classifieds should be Deadline for receipt of resolutions from state and
directed to M.J. Mrvica Associates, 2 West Taunton regional societies for publication in 2003 annual reports.
Avenue, Berlin, NJ 08009; telephone: 856/768-9360;
fax: 856/753-0064; e-mail: mjmrvica@mrvica.com. Only July 31
advertisers in the Journal of Oral and Maxillofacial Deadline for Annual Meeting pre-registration.
Surgery will be accepted. The publication of an
advertisement is not to be construed as an endorsement October 1
or approval by the American Association of Oral and Deadline for 2004 annual meeting surgical clinic
Maxillofacial Surgeons of the product or service being applications.
offered in the advertisement unless the advertisement
specifically includes an authorized statement that such March 1, 2004
approval or endorsement has been granted. ■ Deadline for 2004 annual meeting abstract submissions.