GLMS HOSTS MULTI-PAYER ROUNDTABLE
Payer representatives also stressed that customer service employees do have the power to put callers in touch with a supervisor. If
there is difficulty doing so, collect the name of the employee and
contact GLMS.
“The biggest thing practices can do is document, track and report,”
said Jessica Williams, PEPS Director. “If we don’t have specific
examples, the issues won’t get resolved.”
For a list of many questions and answers provided during the meeting, visit www.glms.org and look under the education tab for “practice advocacy initiatives.” To report a claim discrepancy or customer
service issue, please contact GLMS at physician.education@glms.org.
The GLMS Physician Education and Practice Support Department
hosted a multi-payer roundtable meeting on the morning of October 30 with representatives from Humana, Anthem and Kentucky
Health Cooperative attending to answer questions from physicians
and office managers.
The PEPS Department holds roundtable events several times per
year to better facilitate working relationships between health care
providers and physicians. One of the larger concerns for health care
professionals in the October meeting was means of contact.
Several practices said they were having trouble finding definitive
answers regarding claims filed and are often dissatisfied with their
service experience. Representatives urged callers to take the name
of the person they speak to, the time stamp and reference number,
then submit those to the payer or the GLMS PEPS Department when
they are having a poor experience.
(top left) The GLMS PEPS Department welcomed a panel of physician and payer
representatives. (bottom) Rajeth Sheth, MD, asked a question of payers during a Q&A
session.
GLMS OFFERS MAINTENANCE OF
CERTIFICATION REQUIREMENTS GUIDE
The GLMS Physician Education & Practice Support (PEPS) Department
is developing a Maintenance of Certification (MOC) requirements,
milestones and information guide for physicians.
New MOC requirements have become increasingly frequent and
more complicated. More than 95 percent of GLMS members belong
to at least one member board of the American Board of Medical
Specialties. Depending on the specialty, some of the new milestones
require a patient experience audit, a quality improvement portfolio
and a patient safety and voice component. Physicians who do not
meet these new milestones will be listed and credentialed as “Board
Certified, NOT meeting MOC.”
To be certain of their MOC status, physicians should visit their respective boards’ websites. Even physicians with a “grandfathered”
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certification may be listed on the website as “NOT meeting MOC”
if they do not enroll and participate in the program. Physicians
also need to determine who will be responsible for tracking their
requirements, and develop a tracking mechanism to ensure that all
requirements are met over the 10 year period. Especially in a time
of practice mergers and movement, it is essential that physicians
identify the staff person(s) who is assisting in this process to ensure
that nothing falls through the cracks.
To access the GLMS MOC Requirements Guide, members can log
in to www.glms.org and click the Education Tab. If you have any
questions about the MOC process or suggestions to make it less of
an administrative burden, please contact our PEPS department at
physician.education@glms.org or 502-736-6354.
GLMS NEWS OCTOBER 2014