V O L U M E I I S S

V O L U M E I , I S S U E 2 Summer 2005 MHHNP Introduces The Professional Discount Program After careful consideration and advice from legal counsel, Memorial Hermann Healthcare System has approved a Professional Discount Policy for physician members and their legal dependents of Memorial Hermann Health Network Providers (MHHNP). The key points of the policy are as follows: • • • The targeted effective date is September 1, 2005. Claims filed prior to that date are not retroactive. Eligible physicians must be members in good standing with MHNNP. Legal Dependents are defined as: 1. Legal spouse: 2. Unmarried child to the date on which he/she turns 19; 3. Unmarried child age 19 to 25, who is dependent upon the physician for support and is registered as a full-time student at an accredited institution of higher learning or licensed trade school; 4. Unmarried child of any age who lives with the physician and is dependent upon the physician for support and is physically or mentally incapable of supporting him/herself due to total disability; and 5. Any child who is required to be treated as a dependent under a qualified support order (QMCSO). The discount will be given for up to 25% of the allowable billed charges, and or 25% of total billed charges for non-insured patients. MHHS must receive written notice from the third party payer approving and or disapproving the extension of the discount to physicians and their legal dependents. This policy does not include waiver of Medicare coinsurance and/or deductible amounts. • • INSIDE THIS ISSUE: CISPC Update CEPC Update CME news Committee Roster • We are pleased that we can offer this professional discount policy. Should you have further questions, please do not hesitate to contact the MHHNP Provider Relations Department at 713-448-6464. NEW PHYSICIAN REFERRAL PROGRAM 2 3 3 4 Jim F. Waldron, MD Awarded The MHH NP Distinguished Service Award to ensure the ongoing value of MHHNP to our hospital system and to each physician member. Jim spoke as a true leader, representing our best interest in the deliberations of MHHS Senior Management. As a result, MHHNP grew under his leadership from a fledgling organization to the largest IPA in southeast Texas. MHHNP brought truly substantial contracting advantages to individual physicians, and the growth of the organization was so successful that more than 90% of all physicians credentialed in MHHS hospital are now members of MHHNP. Currently, MHHNP is playing an increasingly important role in ensuring the growth and success of the entire Memorial Hermann Health Care System, which has recognized the need for a close working relationship with its physicians and the critical role MHHNP plays in solidifying that relationship. More than any other single person, Jim Waldron has been responsible for this success and growth. Jim continues to serve MHHNP, leading the MHHNP Mutual Insurance Company in offering substantially discounted medical malpractice insurance to our physicians, and playing an ongoing role in medical management as well. Practice Improvement Programs In recognition of the many contributions Jim Waldron has 6 p r o v id e d t o M e mo r ia l Hermann Health Network Providers, the MHHNP Board of Directors has awarded Dr. Waldron the first MHHNP Distinguished Service Award. Jim F. Waldron, M.D has been the heart and soul of our organization since its inception 24 years ago. He served with passion, enthusiasm, and vigor MHHNP PAGE 2 WELCOME NEW MEMBERS Amina Ahmed, MD Ashwani Bedi, MD Elizabeth Alvarez, MD Anna Belcheva, MD Ian Angel, MD Sapan Bhatt, MD Faizunnisa Anwar, MD William Black, MD Gregory Appleton, MD Nitzia Cepeda, MD Carlos Araujo Preza, MD Shao-Jen Chang, MD Anand Balasubramnian, Carol Coglianese, MD MD Timothy Deahl, MD Zeba Barlas, MD Robert Fernandez, MD Shelly Broline, MD David Ficklen, MD Kristie Chandler, MD Marvin Garcia, MD Veena Chandrakar, MD Essam Girgawy, MD Philip Chung, MD Nishani Gunasekera, MD Kevin Coupe, MD James Hanna, MD Mary Crow, MD Walter Hawkins, MD Carla Davis, MD Dalton Heath, MD Sharafali Diwan, MD John Hines, MD Timothy Doyle, MD Victor Hsiao, MD Elizabeth Fowler, MD Erin Kennedy, MD Elizabeth Gordon, MD John Knight, MD Lisa Grossheim, MD David Knuth, MD Paul Guttuso, MD Owen Maat, MD Todd Hamel, MD Robert Mahaffey, MD Noushin Hart, MD Khalid Mahmood, MD Krishali DHoffman, DO Frank McGehee, MD Walter Holmsten. MD Gregory McKeever,MD Kirk Kanady, MD Cynthia McNeil, MD Pierre Khoury, MD Charles Monday, MD Mark Kubala, MD Nancy Naghavi, DO Pratibha Kulkarni, MD Josier Nisnisan, MD Erwin Lo, MD David Prier, MD Dimitrios, Mantzoros, DPM Jyoti Rao, MD Howard Ng, MD Glenda Read, MD Sohail Noor, MD Lowell Rollins, MD Janna Nunez-Gussman, MD Urmil Shukla, MD Jayendra Patel, MD Marcus Smith, MD Sumita Paul, MD Subodh Sonwalkar, MD Nguyen Phung, MD Samir Sukkar, MD Manoj Reddy, MD Isnardo Tremor, MD Amir Salim, MD Laura Wang, MD Marco Silva, MD Jesse Ward, MD Vijayaprakash SreenarasimLawrence Wells, MD haiah, MD Walter Toronjo, MD Duyen Tran. MD Catherine Tsai, MD Ifthekar Unnissa, MD Srinivas Vodnala, MD Stuart Wetzel, MD Charles Yen, MD Palliative Planning Clinical last four monthsCare care planning teams from MemorialUpdate Information System PracticeUpdate Council During the palliative Hermann, Northwest and Southwest have accompanied MHHNP leaders on Clinical Information Systems of Wisconsin and the Fairview-University Medical should be visits to the Medical College dering at MHHS. The group determine which Practice Committee (CISPC) hospitals have drafts programs designated by Center in Minnesota. Both reviewed mature of the kept. addresses ClinicCare4, Care Leadership Centers. We gained valuable insight into CAPC as Palliative phar- “eOrdering Guiding Princimacy alerts and eOrdering. financeples”operations from theseas Finally, the CISPC will be program development, and that will be used visits. At Hermann, a the roadmap for receiving consultations as membership to palliative care certified nurse, Nancy Walter, is this project expanding the include structurEarlier this year, consult team evolves. years to come. palliative care the CISPC in the Katy and Northwest have begun additional representatives a formal endorsed ClinicCare4teamsan Southwest has begun the development of for each hospital ing palliative care as and important strategic initiative service. Preliminary initiatives areMEC underway at CRMC In part of the preparation palliative care consultative also and from the for HNP. MHHS hospitals. the for eOrdering, the group specialty subcommittees. other ClinicCare4 is ambulatory contact Dr. Robert Wallis @ MHHNP (robert_wallis@mhhs.org; 713Please components of the heard a presentation from Cerner (Care4) for questions or Perry Flowers, AVP, Syscomment. 448-6472) platform. After completing a survey of its tem Pharmacy Operations, members, HNP discovered that with data an the numbers of many physicians desired an alerts that are firing in pharoffice EMR but price and on- macy at present. In an effort going support are the biggest to build more specificity barriers. The Finance Commit- and prevent “alert fatigue,” tee and Board will be consid- the CISPC approved the ering funding pilot sites this recommendation to disable year. moderate and mild alerts, to The CISPC will take a leading retain the severe alerts, and role in the planning for eOr- to January 1, moderates to HNPMIC began writing business review the 2004, and already provides malpractice insurance to over 100 MHHNP members. HNPMIC was created to provide a stable and predictable alternative insurance program for In Memory of Jack W. Scott, MD, members of Memorial Hermann Health Netwho served MHHNP for 22 years work Providers. Only MHHNP members are eligible to apply for coverage and HNPMIC is offering policies only to members in the Warren M. “Jack” Scott, M.D., the first president of Greater Houston area. MHHNP, died At the Annual Meeting of the HNPMIC policy on Memorial Day. All of you who knew Jack and worked with him miss him greatly. Jack holders, the following physicians were elected remained committed to MHHNP over many years as he to HNPMIC’s Board of Directors : Richard Garza, MD, Vascular Surgery practiced at the original Memorial Hospital downtown, (Southeast); William Grinstead, MD, and at the then new Memorial Northwest Hospital Cardiology when it opened. As he began to wind down his cardi (Southwest); and Trang Thrin, MD, Family ology practice Practice. (Katy). We are pleased to have them in recent years, he took on increasing responsibilities at MHHNP, and became Medical serve as Directors and look forward to their participation and their leadership. Director of our Medical Management department. Although it is not a cure, it’s certainly an option In that capacity, he worked closely with the to review as you make your decision on who utilization review nurses and physicians in ensuring that MHHNP was adhering to cost. will provide your coverage and at what best practice standards as we performed third party administration functions a rate comparison, For further information orboth in the Memorial Hermann Sisters of Charity and within MHHNP. Jack was also a (Program Underplease contact Tessie Vare,loyal and devoted contributor to the Memorial Hermann Hospital System, a distinguished writer) at 713-448-6513. member of the Medical Staff, and served terms on several of the Memorial Hermann Boards of Directors. When Jack retired last year, MHHNP named one of the large medical management conference rooms in his honor. It was an honor to know Jack and his presence with us will be sorely missed. PAGE 3 Clinical Ethics and Palliative Care The Clinical Ethics and Palliative Care committee met on March 22, and in June 2005. Lengthy discussion was held regarding the committee’s future direction. Members agreed that the primary areas of focus should be: • Education of physicians, hospital staffs and consumers on ethical issues and the law regarding end-oflife care • • • • Improved consistency of critical policy adoption, i.e. futility, DNR, artificial nutrition ICU medical directors to lead multi-disciplinary ICU rounds in order to ensure consistent care quality & efficient utilization of this rare resource Development of Palliative Care services at Memorial Hermann Hospitals Education of hospital ethics committee members Doug Ardoin, M.D. reported on the early successes of the ICU multi-disciplinary rounds pilot at MHNW. Nancy Walter, R.N. reported on the $10,000 donation by Memorial Hermann volunteers for bereavement program development at MHH and the $45,000 donation to Memorial Hermann Children’s NICU in memory of Marnie Rose, M.D. Richard Castriotta, M.D. discussed a DNR order sheet developed at Memorial Hermann. It was recommended by the committee for dissemination to the hospital MECs for consideration of adoption. Robert Wallis, M.D. announced the selection of Linda Tavel, M.D. to lead the Palliative Care consultation service at MHSW. Dr. Tavel is board-certified in Family Medicine as well as Hospice and Palliative Medi- Continuing Medical Education Hermann Healthcare system has prepared a series of Continue Medical Education programs for MHHNP physicians . several quarterly half-day specialty conferences designed to offer practicing physicians the opportunity to spend a Saturday morning focusing on the latest information in specific areas of practice. In the past, many of the CME programs throughout our system have been offered in one-hour increments at the noon hour for physicians that can spare their noon hour for educational lectures. However, many MHHS physicians work outside hospital campuses in community practices and find it difficult to attend the lunchtime sessions. Future specialty conferences will highlight diagnoses and treatment issues in cardiology, diabetes, pediatrics and other specialty areas. Conferences will be offered in many venues in order to make them accessible to the widest range of MHHS physicians. For more information about regularly scheduled CME programs offered by Memorial Hermann Hospital System, please visit our web site at www.mhhs.org . Go the tab “For Physicians” and under the link for Continuing Medical Education you may search for events or print a transcript of the credits that you have received. We welcome your comments and suggestions. (713) 448-5101 or (713) 448-5914. Upcoming Events Infections Disease Symposium Sept. 17th, 2005 8:00 – 1:00 Houston City Club Evaluation of the Red Eye Sept. 20th, 2005 12:30 – 1:30 Northwest Hospital Memorial VOLUME I, PAGE 4 MHHNP Committee Members Clinical Information Systems Practice Committee Richard Blakely, M.D. - Chairman Doug Ardoin, M.D. ......................................MHNW Charles Conlon, M.D. ..................................MHSW Paul Cook, M.D. ..........................................MHMC Keith Fernandez, M.D. .................................MHKH Richard Garza, M.D. .....................................MHSE Adam Kawley, M.D. ....................................MHMC Lucy Kormier, M.D.......................................MHSW Valerie Moore, M.D......................................MHSW Richard Nixon, M........................................MHNW Bhadresh Shah, M.D.....................................MHSW Medical Care Management Committee Keith Fernandez, M.D. – Chairman Manohar Alloju, M.D...........................................MHSE Doug Ardoin, M.D. .............................................MHNW David Bauer, M.D.................................................MHSW Vinod Bhuchar, M.D. ..........................................MHNW Paul Bing, M.D.....................................................MHKH Kimberly Brady, M.D...........................................MHMC Richard Brown, M.D. ..........................................MHSW Christine Cocanour, …............................................MHH Charles Conlon, M.D............................................MHSW Mary Cross, M.D. .................................................MHSE Cornelius Davis, M.D..............................................MHH Mazen Ganim, M.D. ...............................................MHH Jon Heine, M.D. ..................................................MHMC Ron Henry, M.D. .................................................MHWD Matthew Hogan, M.D. ........................................MHWD Bruce Kone, M.D. ...................................................MHH Dudley Koy, M.D. ................................................MHKH Stefan Kreuzer, M.D............................................MHMC Basil Leiman, M.D. .............................................MHMC Jack Lesch, M.D..................................................MHWD Jordon Lovy, M.D....................................................MHH Sanford Lubetkin, M.D.........................................MHSW Kimberly Monday, M.D. .......................................MHSE Roberto Montoya, M.D. ......................................MHNW Mahmood Moradi, M.D. .....................................MHMC William Parks, M.D. ...........................................MHWD Edwin Parsley, D.O..................................................MHH William Riley, M.D...............................................MHFB Greg Starr, M.D. ...................................................MHFB Donald Stillwagon, M.D......................................MHWD Linda Tavel, M.D..................................................MHSW Ted Tenczynski, M.D...........................................MHNW Manoj Vakil, M.D................................................MHNW Carl Vartian, M.D.................................................MHSW Bob Viles, M.D. ....................................................MHFB Brenda Wainscott, M.D......................................MHKH Clinical Ethics and Palliative Care Committee Keith Fernandez, M.D. - Chairman Madhureeta Achari, M.D..............................MHMC Steve Allen, M.D. ............................................MHH Manohar Alloju, M.D.....................................MHSE Doug Ardoin, M.D. ......................................MHNW Paul Bing, M.D..............................................MHKH Richard Castriotta, M.D. .................................MHH Charles Crumb, M.D. .....................................LTAC Liliana Diaz, M.D. ..........................................LTAC Keith Fernandez, M.D. .................................MHKH Bob Herman, M.D........................................MHMC Alan Hubbard, M.D. ....................................MHWD Bruce Kone, M.D. ...........................................MHH Basil Leiman, M.D. ......................................MHMC Jack Lesch, M.,D..........................................MHWD Jorge Luengas, M.D. ...................................MHNW Kimberly Monday, M.D. ...............................MHSE Arun Mukhopadhyay, M.D. ..........................MHSE Christine Myatt, M.D. .....................................LTAC Louis Neff, M.D. ..........................................MHSW Bill Riley, M.D. .............................................MHFB Christopher Salcedo, M.D. ..........................MHNW Larry Scott, M.D. ............................................MHH John Sparks, M.D. ...........................................MHH Martin Steiner, M.D. ....................................MHSW Linda Tavel, M.D..........................................MHSW Carl Vartian, M.D. ...........................................LTAC VOLUME I, ISSUE 2 MHHNP PAGE 5 MHHNP Committee Members Clinical Resource Management Committee Raymond Martin, M.D. - Chairman Joel Abramowitz, M.D.....................................MHMC Jeff Alford, M.D. ................................MH - Beaumont Steve Allen, M.D. ................................................MHH Manohar Alloju, M.D..........................................MHSE Doug Ardoin, M.D. ..........................................MHNW Philip Berman, M.D..........................................MHMC Vinod Bhuchar, M.D. .......................................MHNW Paul Bing, M.D..................................................MHKH Michael Boyle, M.D..........................................MHSW Wainscott Brenda, M.D. ...................................MHKH Richard Brown, M.D. .......................................MHSW Joseph Cali, M.D...............................................MHMC Alexander Charlotte, M.D.................................MHSW Christine Cocanour, M.D......................................MHH Charles Conlon, M.D. .......................................MHSW Sharon Crandell, M.D. .........................................MHH Susan Denson, M.D. ............................................MHH Liliana Diaz, M.D. ............................................MHCC Keith Fernandez, M.D. ....................................MHNW James Ferrendelli, M.D. ......................................MHH Ben Harvey, M.D...............................................MHSW W. Lin Jones, M.D.............................................MHSW Stan Jones, M.D.................................................MHSW Bruce Kone, M.D. ................................................MHH Dudley Koy, M.D. .............................................MHKH Humberto Lara, M.D..........................................MHFB David Lawrence, M.D. ......................................MHSE Basil Leiman, M.D. ..........................................MHMC Jack Lesch, M.D...............................................MHWD Raymond Martin, M.D......................................MHSW Roberto Montoya, M.D. ...................................MHNW Barnes Nathaniel, M.D.......................................MHSE William Riley, M.D............................................MHFB Edward Septimus, M.D.....................................MHSW J.B. Tang, M.D..................................................MHMC Petar Turcinovic, M.D......................................MHWD Carl Vartian, M.D..............................................MHSW Bob Viles, M.D. .................................................MHFB Finance Committee A.J. Haddock, M.D. – Chairman Richard Andrassy, M.D.......................................MHH Ronald Baden, M.D. .........................................MHSE Kulvinder Bajwa, M.D. ....................................MHFB J.R. Cali, M.D..................................................MHMC Jose Diaz, M.D. ...............................................MHKH Benjamin Edery, M.D........................................MHSE James Field, M.D. ...........................................MHWD Richard Garza, M.D. ........................................MHSE Kevin Giglio, M.D...........................................MHNW Miguel Gomez, M............................................MHMC Charles Pehr, M................................................MHSW Enrique Quintero, M.D....................................MHWD Max Reddick, M.D..........................................MHMC Charles Stiernberg, M.D. ....................................MHH J.B. Tang, M.D. ..............................................MHNW Frank Wellborne, M.D. ...................................MHMC Credentials Committee W. Lin Jones, M.D. – Chairman Doug Ardoin, M.D..........................................MHNW Philip Berman, M.D........................................MHMC Mary Cross, M.D……... ...................................MHSE Paul Cook, M.D. .............................................MHMC Joseph Edralin, M.D. ......................................MHWD Bob Ezell, M.D. ..............................................MHSW Hartwell, Beth, M.D….......................................MHH David Korfin, D.P.M........................................MHSW David Lawrence, ..............................................MHSE G.S. Ramesh, M.D. .........................................MHMC Oscar Rosales, M.D. ...........................................MHH Christophe Salcedo, M.D................................MHNW Mary Van Sickle, M.D. ...................................MHSW Heena Thakkar, M.D.......................................MHNW Robert Viles, M.D.............................................MHFB Paul Vitenas, M.D. ...........................................MHSE MHHNP PAGE 6 Valuable resources for your practice MHHNP and Memorial Hermann Healthcare System have enjoyed a relationship with Practice Management Institute (PMI) for almost 20 years in the Houston area. PMI provides MHHNP members with special, exclusive discounts for the non-clinical educational needs for themselves and their staff. PMI is a leading provider of continuing education for medical office professionals. PMI offers a broad curriculum of educational seminars, workshops and certification programs that address all areas of medical office management. Reimbursement and business management topics, along with specialty programs are presented in 400 of the nation’s leading hospitals, health care systems, medical societies and colleges. Ask your Provider Representative for a copy of the 2005 Program Schedule booklet or contact Donna Alwais, Houston Learning Center Coordinator, 713-448-6787, for more information. Be sure to take advantage of the discounts available to MHHNP members. The following is a list of topics scheduled for the remainder of 2005: September: ♦ Certified Medical Coder ♦ CPT Coding Workshop ♦ ICD-9-CM Coding Workshop ♦ Managing Today’s Medical Practice October: ♦ Certified Medical Office Manager ♦ Coding by Specialty: Cardiology Surgery OB/GYN Orthopedics Primary Care/Internal Medicine ♦ Certified Medical Insurance Specialist November: ♦ Advanced Coding Workshop ♦ Chart Auditing Workshop ♦ HIPAA Compliance Officer Training Clinic December: ♦ Reimbursement Update 2006 Please join us for an exciting day of “EXTREME PRACTICE MAKEOVERS” This year’s conference will focus on moving towards the future. Learn how to make your office practice more efficient through the use of electronic medical records and integrated information system strategies, hear from industry leaders on techniques to improve patient satisfaction, reduce costly overhead, and streamline office processes. *Plus, we will announce the 10 physician offices that have been selected to receive an “extreme practice makeover”. These pilot offices will experience a transformation from the office of today, to the modern physician’s office of tomorrow. As with our past PIVOT conferences, there is no cost for MHHNP physicians and their office staff to attend. CME credit will be available as well as a chance to win a Dell PC, a Samsung I-730 and other prizes. Please register at www.mhhnp.org or by calling your provider relations representative at 713-448-6464. VOLUME I, ISSUE 2 MHHNP PAGE 7 9301 SW Freeway, Ste 5000 Houston, Texas 77074 Dated Material: Deliver By: March 31, 2005 Postmaster send address changes to above return address Mailing Mailing Mailing Mailing Mailing Address Address Address Address Address Line Line Line Line Line 1 2 3 4 5 PHYSICAN REFERRAL STATISTICS: March 2005: 3,494 referrals to MHHNP physicians through 222-CARE April 2005: 3,259 referrals to MHHNP physicians through 222-CARE May 2005: 3,047 Referrals to MHHNP physicians through 222-CARE June 2005: 3,565 Referrals to MHHNP physicians through 222-CARE Workers’ Compensation Reform Effective September 1, 2005 significant changes to the Texas workers’ compensation system will go into effect. If you currently treat workers’ compensation patients, these changes will effect your practice. Have you seen our website lately? Log on to: www.mhhnp.org • • Track your claims online Enroll in group purchasing programs File your claims electronically Update your office profile and much more... If you would like additional information regarding these changes please contact your provider relations representative or Danielle Barrera at: 713-448-6518. You may also find detailed information on the Texas Department of Insurance website: http://www.tdi.state.tx.us/wc/transition/ twcc.html • •