NEVADA MEDICAL GROUP MANAGEMENT ASSOCIATION

Latest News in Healthcare

  • 22 Jul 2019 10:34 AM | Cathy Herring

    July 22, 2019

    Probably one of the trickiest parts of any physician practice administratively is understanding and effectively navigating insurance prior authorization requirements. There are many rules and regulations a provider must follow based on payer guidelines.

    Authorization guidelines are among some of the most murky and confusing guidelines of them all.  After 20 years of experience and many mistakes along the way I have outlined key elements of the referral, predetermination, authorization and precertification process. 

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  • 15 Jul 2019 8:18 AM | Cathy Herring

    July 15, 2019

    Physicians Practice highlighted an encounter Ike Devji, JD had with a medical practice owner that illustrated “common mistakes many physicians still make in protecting their wealth and managing their risks.” Devji stated that there are two common mistakes physicians make: failing to adequately insure and acting late.

    The first mistake, failing to adequately insure, “takes many forms and applies to both personal and professional liabilities.” Devji stated that this happened to a medical practice owner “after being in an auto accident in which the other party suffered several serious injuries.” After “her insurance carrier informed her that her liability will almost certainly exceed the limits of her automobile insurance policy,” she called Devji in hopes of getting some asset protection planning. However, her limits were only $250,000 because she was told “‘too much insurance makes you a target and means you’re more likely to get sued’” which is “exceptionally bad advice,” according to the article.

    Devji also couldn’t help this medical practice owner because she had made another mistake: acting too late. It would have been “ethically and legally” wrong to help this physician because she was aware of “the exposure itself and specific notice that her coverage would be inadequate.”

    Want to learn more about risk and compliance? Click on this MGMA Stat.

  • 08 Jul 2019 3:19 PM | Cathy Herring

    July 8, 2019

    Englewood, Colo. (July 8, 2019) – Medical Group Management Association (MGMA) will host its annual conference, MGMA | 19 The Annual Conference (#MGMA19AC), taking place October 13-16, 2019 in New Orleans at the Ernest N. Morial Convention Center. The Annual Conference is designed for healthcare professionals in medical practice management and offers educational content, leadership inspiration and tangible tools to address challenges, improve efficiencies and profitability and foster innovation and positive change in medical practices.

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  • 01 Jul 2019 2:50 PM | Cathy Herring

    July 1, 2019

    A medical group is more likely to create the future it desires by planning strategically. The planning process employed by large, resource-rich organizations consumes more time and energy than most smaller groups can afford. However, there is a simplified, low-investment approach that provides most of the same benefits for a modestly sized medical group. By taking these actionable steps, medical groups can develop a strategic plan:

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  • 24 Jun 2019 3:33 PM | Cathy Herring

    June 24, 2019

    Physicians Practice highlighted an encounter Ike Devji, JD had with a medical practice owner that illustrated “common mistakes many physicians still make in protecting their wealth and managing their risks.” Devji stated that there are two common mistakes physicians make: failing to adequately insure and acting late.

    The first mistake, failing to adequately insure, “takes many forms and applies to both personal and professional liabilities.” Devji stated that this happened to a medical practice owner “after being in an auto accident in which the other party suffered several serious injuries.” After “her insurance carrier informed her that her liability will almost certainly exceed the limits of her automobile insurance policy,” she called Devji in hopes of getting some asset protection planning. However, her limits were only $250,000 because she was told “‘too much insurance makes you a target and means you’re more likely to get sued’” which is “exceptionally bad advice,” according to the article.

    Devji also couldn’t help this medical practice owner because she had made another mistake: acting too late. It would have been “ethically and legally” wrong to help this physician because she was aware of “the exposure itself and specific notice that her coverage would be inadequate.”

    Want to learn more about risk and compliance? Click on this MGMA Stat.

Managing chronic care populations: Improve health & contain costs

April 29, 2019


Healthcare in the U.S. continues to move from volume-based care to value-based care. In the process, managing chronic disease has become both a universal imperative and a foundational element of a patient-focused population health program.

Leaders of many physician groups—including those partnered with multi-hospital systems—look for a solid, practical approach to chronic care management. Though difficult, practices are changing up their organizational structure to support alternative payment models that reward maintaining a healthy population.

This paper, a joint effort between Virence Health and Physicians Medical Center, PC, used a real-world example of how PMC introduced a successful population health program into its culture and, by doing so, made the shift to proactive, team-based care, allowing them to leverage their data and improve the lives of their patients.


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Three Environmental Factors Impacting the PPM Industry and Getting Deals Done

April 23, 2019


The PPM industry is by no means immune to the ebbs and flows of a traditional marketplace. Since the consolidation bubble burst in the 1990s, PPMs have gone from practically extinct to a once-again substantial component of the health care delivery system. But with greater influence comes more pressure to respond, and adapting to today’s complex operating environment requires those in the PPM industry to ensure they are building the foundational structure needed to help practices adapt to external factors and achieve long-term success.and achieve long-term success.

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Social determinants of health in an ACO for better population health

April 16, 2019


Valerie was a 31-year-old woman with uncontrolled diabetes, asthma, hypertension and was morbidly obese; she also had a history of trauma and depression. She increasingly was a no-show for appointments and would go to the emergency room instead of her primary care visits at Massachusetts General Hospital in Boston.

It wasn’t until Mass General implemented a social determinants of health (SDoH) survey that the providers learned that Valerie faced homelessness — until then, a P.O. box and a telephone number gave no indication of the larger issue in her life. They also learned that, despite being born and raised in Boston, Valerie could not read and write in English, her primary language.

Through SDoH work, Mass General staff were able to direct Valerie to emergency housing and ask what her goals were beyond health: Learning English, getting a job, securing an apartment and reuniting with her 3-year-old daughter, who was taken at birth due to Valerie being homeless.

As with most of us, social factors such as housing, education and a safe environment largely lead to better health outcomes.1 In Valerie’s case, her factors meant insufficient healthy food, lack of refrigeration for medication and issues with blood pressure heightened by living in a van and a lower sense of personal safety — all directly affecting the care providers working with Valerie.

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Nevada MGMA
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