What Every Orthopaedic Practice Should Know About Denials from Insurers & Health Plans
NYSSOS hosted an informational webinar on November 15th with the New York State Department of Financial Services (DFS), the state’s top watchdog concerning insurance and financial matters, and leadership from its Consumer Assistance Unit (CAU).
The webinar provided members with guidance on the agency’s ability to respond to complaints from patients and physicians including those related to prior authorization and utilization review. In addition the presenters summarized what is permissible under NYS law and regulation regarding Prior Authorizations/Utilization Review/Clawbacks; and showed members how to navigate and execute a DFS complaint.
If you missed the webinar you can view it at your convenience.
Altfest Personal Wealth Management
The purpose of this program is to provide you with an overview of private equity deals, what you need to consider, what questions you should ask, and how you can better assess whether this is a right move for you and your practice.
Barry B. Cepelewicz, M.D., Esq.
Partner / Director
Kimberly Kempton-Serra, Esq.
originally presented on June 24, 2021.
> Watch on Demand
New York will end the state disaster emergency declared on March 7, 2020 to fight COVID-19. Given New York's dramatic progress against COVID-19, the state of emergency will expire after Thursday, June 24.
So what does this mean for you, your practice and your patients?
During this 60-minute complimentary webinar sponsored by MLMIC Insurance Company, an attorney from Fager Amsler Keller & Schoppmann, LLP will provide an overview of the recent legislative, regulatory and case law developments that impact the provision of healthcare.
originally presented on June 2, 2020.
> Watch on Demand
On behalf of the NYS Society of Orthopaedic Surgeons, we are pleased to
offer members the following presentation provided by MLMIC.
After listening to this program, viewers will be able to:
- Understand regulatory requirements associated with COVID-19.
- Recognize resources necessary to reopen.
- Develop infection control measures for protecting patients and staff.
- Create new workflows and prioritize patient backlog.
- Identify areas of need in anticipation for a future surge.
UNDERSTANDING VALUE BASED PAYMENTS
originally presented on February 27, 2019> Watch on Demand | Copy of the Presentation
Ms. Silverman provided attendees with an overview of the payment structures that comprise value based payment (VPB) arrangements and how orthopedic surgeons fit into the various paradigms. Additionally, she discussed alternate health care delivery models like accountable care organizations and independent practice associations (IPAs) and answered the following questions:
Debra A. Silverman represents hospital systems, teaching and community hospitals, faculty practice plans and physician group practices, with an emphasis on managed care contracting, health care delivery networks, accountable care organizations, clinical integration, physician arrangements, antitrust and regulatory matters.
Your Employment Agreement: How To Be Best Protected
Barry B. Cepelewicz, M.D., Esq. provided attendees with guidance on how to review and construct a comprehensive employment agreement that will protect both the employer and employee. Key provisions he focused on:
Reducing Nerve injuries in joint replacementsoriginally presented on December 5, 2019 > Watch on Demand
Working together, NYSSOS and MLMIC designed a multi-modal, statewide educational opportunity to help identify risks for nerve injuries in hip/knee joint replacement surgical cases in the office, surgical and postoperative settings.