Membership Has Its Benefits - Santa Clara County Medical Society

SEPTEMBER / OCTOBER 2009 | VOluME 16 | NuMBER 5 

Membership 

Has Its Benefits

Now, more than ever. 

Becoming disabled could stop your income. Do you have 

a reliable financial source to help replace it? 

Three in ten entering the workforce today will become 

disabled before retiring 1 . A disabling injury will sideline 

one in five Americans for at least a year before they 

reach age 65 2 ; one in seven for five years or more 3 . 

Santa Clara County Medical Association members can 

turn to the SCCMA-sponsored Long Term Disability 

Insurance Plan. This plan is designed to provide a 

monthly benefit of up to $10,000 if you become Totally 

Disabled. Members age 50–59 are eligible to apply for 

up to $6,000 per month. 

Visit www.MarshAffinity.com/ 

cmadownload.html for more 

information and an enrollment kit. 

Administered by: 

Underwritten by: 

Please call a Client Service 

Representative at 800-842-3761 

or visit www.MarshAffinity.com/ 

cmadownload.html to download an 

enrollment kit. 

Let us show you how your 

membership in the Association 

can save you money. 

1 Social Security Administration, Fact Sheet January 31, 2007 

2 Life and Health Insurance Foundation for Education, November 2005 

3 ”Commissioners Disability Table, 1998,” Health Insurance Association of 

America, the New York Times, February 2000 

Sponsored by: 

43391 (9/09) ©Seabury & Smith Insurance Program Management 2009 

d/b/a in CA Seabury & Smith Insurance Program Management • CA License #0633005 

777 South Figueroa Street, Los Angeles, CA 90017 • 800-842-3761 • CMACounty.Insurance@marsh.com • www.MarshAffinity.com 

Marsh is part of the family of MMC companies, including Kroll, Guy Carpenter, Mercer and the Oliver Wyman Group (including Lippincott and NERA 

Economic Consulting). 

Hartford Life and Accident Insurance Company, Simsbury, CT 06089. The Hartford® is The Hartford Financial Services Group, Inc., and its subsidiaries, 

including issuing company Hartford Life and Accident Insurance Company. All benefits are subject to the terms and conditions of the policy. Policies 

underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the 

policies may be continued in force or discontinued. (AGP-5719) • #3-924

America’s Affordable Health Care 

Choices Act of 2009 (H.R. 3200) in 

1,000 Words or Less 

More on page 6 

MCMS and SCCMA members are 

entitled to a host of discounts from 

both local and national vendors 

that provide a range of products 

and services. 

Physicians should become familiar 

with what to embrace and what 

to shun when taking steps to 

automate records and improve 

work flow prior to taking the EHR 

plunge. 

THE 

BULLETIN 

Official magazine of the Santa Clara County Medical Association and the Monterey County Medical Society 



From the Editor’s Desk ................................................................................5 

Joseph S. Andresen, MD 

America’s Affordable Health Care Choices Act of 2009 (H.R. 3200) in 

1,000 Words or Less ..................................................................................6 


MCMS/SCCMA Member Benefits and Services .........................................8 

2009-2010 MCMS/SCCMA Seminars & Events ........................................12 

Your MCMS/SCCMA Staff is Here to Help! ...............................................14 

CMA’s Legislative Accomplishments & On-Call Library .........................16 

A Look at the Financial Challenges of Practicing Medicine ..................20 

NORCAL Mutual Insurance Company 

MEMBER BENEFIT: Insurance Products and Services .............................22 

Marsh 

MEMBER BENEFIT: Reimbursement Advocacy Program .......................24 

Do It Yourself or Seek Help With Your Collections and Billing ..............25 

Mark Christiansen, BME General Manager 

MEMBER BENEFIT: TPO Human Resource Management .......................26 

Legacy Wealth Advisors, LLC – Q & A ......................................................28 

Edwin K.S. Ryu 

Bridging to the Eventual EHR ...................................................................32 

Sourcecorp Deliverex 

Time to Explore Options in Your Practice’s Banking and Check 

Processing Activities...............................................................................34 

Conomikes Associates, Inc. 

Are You Compliant With the New HIPAA Regulations? .........................36 

PrivaPlan 

Alliance News.............................................................................................38 

Classified Ads .............................................................................................40 

Welcome 34 New Members! .....................................................................43 

MEMBER BENEFIT: Regulatory Compliance Partner ..............................44 

EnviroMerica Q & A 

PAGE 3 | THE BULLETIN | SEPTEMBER / OCTOBER 2009

the santa clara cOunty MeDical assOciatiOn 

Officers 

President 

Howard Sutkin, MD 

President-Elect 

Thomas Dailey, MD 

VP-Community Health 

Cindy Russell, MD 

VP-External Affairs 

William Lewis, MD 

VP-Member Services 

Judith Dethlefs, MD 

VP-Professional Conduct 

Jim Crotty, MD 

Secretary 

Sameer Awsare, MD 

Treasurer 

Martin L. Fishman, MD 

chief executive Officer 

William C. Parrish, Jr. 

THE 

BULLETIN 


Printed in U.S.A. 

Editor 


Managing Editor 

Pam Jensen 

Opinions expressed by authors are their own, and not 

necessarily those of The Bulletin or the Santa Clara County 

Medical Association and the Monterey County Medical 

Society. Acceptance of advertising in The Bulletin in no 

way constitutes approval or endorsement by the Santa 

Clara County Medical Association or the Monterey County 

Medical Society of products or services advertised. 

Address all editorial communication, reprint requests, and 

advertising to: 

Pam Jensen, Managing Editor 

700 Empey Way 

San Jose, CA 95128 

408/998-8850, ext. 3012 

Fax: 408/289-1064 

pjensen@sccma.org 

© Copyright 2009 by the Santa Clara County Medical Association. 

hOuse Officer representative 

Jacob Ballon, MD 

aMa trustee - sccMa 

James G. Hinsdale, MD 

Tanya W. Spirtos, MD (Alternate) 

sccMa/cMa DelegatiOn chair 

Tanya W. Spirtos, MD 

cMa trustees - sccMa 

Martin L. Fishman, MD 

(District VII) 

Susan R. Hansen, MD 

(Solo/Small Group Physician) 

James G. Hinsdale, MD 

(District VII) 

John D. Longwell, MD 

(Hospital Based Physician) 

PAGE 4 | THE BULLETIN | SEPTEMBER / OCTOBER 2009 

cOuncilOrs 

El Camino Hospital of Los Gatos: 

Rives Chalmers, MD 

El Camino Hospital: 

Michael Curtis, MD 

Good Samaritan Hospital: 

Eleanor Martinez, MD 

Kaiser Foundation Hospital - San Jose: 

Efren Rosas, MD 

Kaiser Permanente Hospital: 

Allison Schwanda, MD 

O’Connor Hospital: 

Jay Raju, MD 

Regional Med. Center of San Jose: 

Emiro Burbano, MD 

Saint Louise Regional Hospital: 

John Saranto, MD 

Stanford Hospital & Clinics: 

Peter Cassini, MD 

Santa Clara Valley Medical Center: 

Patrick Kearns, MD 

the MOnterey cOunty 

MeDical sOciety 

Officers 

President 

William Khieu, MD, MBA 

Secretary 

Eliot Light, MD 

Treasurer 

John Clark, MD 

chief executive Officer 


DirectOrs 

Valerie Barnes, MD 

Ronald Fuerstner, MD 

David Holley, MD 

R. Kurt Lofgren, MD 

Oguchi Nkwocha, MD 

James Ramseur, Jr., MD 

Scott Schneiderman, DO 

cMa trustee – McMs 

Valerie Barnes, MD

By Joseph Andresen, MD 

After 1,017 pages, we all breathed 

a sigh of relief. Our ambitious task of 

reading through, summarizing, and taping 

a television presentation of America’s 

Affordable Health Choices Act of 2009 

(H.R. 3200) was accomplished in advance 

of legislators reconvening in Washington, 

D.C. on September 7, 2009. 

Nancy Farber, CEO of 

Washington Hospital Health System in 

Fremont, California, organized a panel of 

physician leaders to participate in this task. 

Dr. Anmol Mahal, former CMA President 

and internist; Dr. Dan Morgan, retired 

orthopedist and former co-chair of the 

Bioethics Committee; and I joined together 

in this challenge. The objective was to read 

through H.R. 3200 in its entirety and give 

a public presentation of what is actually 

written in the bill. Hopefully, this would 

provide the opportunity for more informed 

and constructive discussion within and 

among our community members. 

It is clear that H.R. 3200 is 

only one of five separate bills under 

consideration that is concerned with 

health care reform. It will inevitably go 

through multiple amendments. However, 

H.R. 3200, to date, has the most detailed 

description of proposed changes to our 

health care delivery system that will 

potentially affect every American. Many of 

the key elements may well be incorporated 

into a final bill that reaches the President’s 

desk and is ultimately signed into law. 

With the level of media attention, 

misinformation, and controversy raised, it 

FROM THE EDITOR’S DESK 

health care refOrM 

was apparent that a thoughtful and factual 

discussion was needed. 

What did I discover? There are 

no “death panels.” An “essential benefits 

package” would create a uniform safety 

net of health insurance coverage for 

all consumers. Pre-existing conditions 

exclusions and rescissions of coverage 

would no longer be permitted. The public 

option is just that, an option. Primary 

care doctors will see their reimbursement 

rise. Medicare is predicted to go broke in 

eight years. There is an attempt to fix this. 

Medicaid will have national standards by 

2013 and direct funding from the federal 

government. There is a marked increase 

in graduate medical education support, 

residency slots, and nursing programs. 

This is in response to the increasing and 

alarming shortage of primary care doctors 

and nurses. This is good news for all of us 

aging baby boomers, who will undoubtedly 

see our need for quality medical care rise in 

the years to come. 

Is it perfect? Far from it. The 

public option remains controversial. 

(If it had just been named the optional 

public plan.) The Health Choices 

Commissioner will yield significant 

power under the executive branch of 

government. Introduction of Accountable 

Care Organizations (ACOs) bring up 

some of the same fears of HMOs with 

financial incentives for potentially less 

care. Cutbacks in Medicare and Medicaid 

disproportionate share hospital (DSH) 

payments worry hospital administrators, 

who now are treading water to meet the 

costs of keeping their doors open. 


Joseph Andresen, 

MD is the editor of 

The Bulletin. 

He is board certified 

in anesthesiology 

and is currently 

practicing in the 

Santa Clara valley 

area. 

However, for the most part, H.R. 

3200 is an ambitious and forward-thinking 

piece of legislation with two primary goals: 

1) to provide affordable, quality health care 

for all Americans, and 2) to reduce the 

growth in health care spending. 

H.R. 3200 is divided into three 

broad sections: Division A entitled 

“Affordable Health Care Choices,” 

Division B “Medicare and Medicaid 

Improvements,” and Division C “Public 

Health and Workforce Development.” 

I have attempted to summarize the key 

points in an accompanying article entitled 

“America’s Affordable Health Care Choices 

Act of 2009 in 1,000 Words or Less” with a 

list of informative references. The television 

broadcast, “InHealth,” discussion can be 

viewed directly online at www.whhs.com 

or by contacting Washington Hospital 

Community Relations Department at 

510/791-3417. 

I encourage you to study these 

important issues carefully. Form your 

own opinions. Talk with your patients, 

colleagues, CMA, and legislative 

representatives. Ensuring that your voice is 

heard will give us all the best opportunity 

to see that wise and viable solutions prevail 

in health care reform.

HEalTH caRE REFORM 

aMerica’s affOrDable health care chOices act 

Of 2009 (h.r. 3200) in 1,000 WOrDs Or less 

By Joseph Andresen, MD 

Division A is entitled 

“Affordable Health Care 

Choices.” 

This section is concerned 

with health insurance market reform, 

whereby a uniform standard of health 

care benefits is defined. A Health 

Insurance Exchange would regulate this 

process giving consumers the option 

to keep their current policy, obtain a 

different policy through their employer, 

or purchase insurance directly through 

the Exchange. As mentioned earlier, there 

would be an elimination of pre-existing 

condition exclusions and limitations on 

rate adjustments of premiums. All citizens 

would be required to enroll in coverage or 

pay a tax. Employers would be required 

to offer insurance to employees through 

the Exchange or contribute 8% of the 

employee’s salary in lieu of coverage. Small 

businesses would be exempt and would 

receive a 50% tax credit for any funds 

spent insuring employees. Rules would 

prohibit employers from steering employees 

away from employer-based coverage and 

into the Exchange. Affordability credits 

would be available for those who do not 

qualify for Medicaid and have an income 

up to 400% of the federal poverty level 

($22,050 for a family of 4), to ensure 

that all citizens receive coverage. The 

public option is a plan that is designed 

to promote competition in the health 

insurance marketplace by acting as a nonprofit 

alternative. It would receive startup 

funding from the federal government 

providing a reserve for the 

first 90 days that would be 

paid back through premiums 

over time. Thereafter, the 

plan would be required to 

compete on a level playing 

field with private insurance 

providers. All physicians who 

are Medicare participants 

would be included in the 

network, but would have the 

option to opt out. A health 

care surcharge tax is also included on highincome 

earners to partially fund the Health 

Insurance Exchange. 

Division B is entitled “Medicare 

and Medicaid Improvements.” 

Medicare Part A is projected 

to be insolvent in 2017. This portion of 

the bill attempts to meet this budgetary 

challenge in a number of areas. This 

includes refinement of Medicare payment 

reimbursement to better recognize 

improvements in productivity and 

incentives to reduce preventable hospital 

readmissions. There is also phasing out 

Medicare DSH (disproportionate share 

hospital) payments, as the number of 

uninsured is reduced. The Medicare 

Advantage (HMO) program that has been 

costly, compared to fee-for-service care, 

will be phased out. This alone will save 

about $150 billion over ten years (nearly 

30% of total savings) as estimated by the 

Congressional Budget Office. Permanent 

reform of the sustainable growth rate 

reimbursement for physicians will occur 

with its repeal. A new system of rates will 

raise reimbursement at a faster rate of 


growth for primary care physicians and 

maintain current Medicare support for 

all others. Encouragement of physicians 

to form Accountable Care Organizations 

(ACOs) is made. Reform of Medicare Part 

D includes elimination of the “donut hole” 

or co-pay currently required of enrollees. 

Preventative services will be covered. 

Perhaps the most controversial 

and fear-inspired debate is centered on the 

added benefit of advance care planning 

consultation, Section 1233, page 424. The 

intent here is to help patients discuss their 

views regarding end-of-life care with their 

families and doctors before the need for 

such care arises and to learn what they 

must do to ensure their wishes are carried 

out if they become incapacitated. The end 

result will be an increase in each patient’s 

autonomy in his or her medical care. 

Division B continues with 

establishment of an Agency of Comparative 

Effectiveness Research that will promote 

work in the area of evidence-based 

medicine. Tele-health services are an 

additional area of development to aid in 

the quality and access of medical care in 

rural areas. A significant section is devoted

to program integrity to fight waste, fraud, and abuse. Lastly, there 

is a significant section devoted to Medicaid and CHIP reform. 

Preventative services will be covered. There are broad changes to 

bring Medicaid under a national standard with federal funding by 

2013. This would include matching the essential benefits package 

offered through the Health Insurance Exchange, elimination 

of eligibility hurtles for those with incomes under 133% of the 

federal poverty level, and an increase of primary care physician 

reimbursement to 100% of Medicare within three years. 

Division C is entitled “Public Health and 

Workforce Development.” 

This final section focuses on strengthening our health 

care system by establishing a Public Health Investment Fund 

with $89 billion dollars for use over the next 10 years. This 

would support community health centers, Nation Health Service 

Corporation programs, and the promotion of primary care and 

dentistry. Emphasis on adapting the workforce to evolving health 

system needs is made with scholarships for disadvantaged students, 

cultural and linguistic training for health care professionals, and 

interdisciplinary care training such as medical home models. A 

$35 billion Prevention and Wellness Trust is created from the 

Public Health Investment Fund mentioned above. This will be 

responsible for developing a national strategy to improve the 

nation’s health through evidence-based clinical and communitybased 

prevention and wellness activities. There is establishment of 

a Center for Quality Improvement to focus on quality improvement 

by identifying best practices and new innovation. An assistant to 

the Secretary of HHW will be responsible for gathering information 

of key health indicators and facilitate improved data sharing. 

There is also a provision for creation of a National Medical Device 

Registry for all class III medical devices and class II devices that are 

permanently implantable, life supporting, or life sustaining. This 

would be linked to provide safety and outcome data. 

Some terms and concepts: 

Division A: Protecting choice of existing policy holders, 

Health Benefits Advisory Committee, Health Insurance Exchange, 

Health Choices Commissioner, medical loss ratio, essential benefits 

package, basic, enhanced, premium and premium plus, public 

health insurance option, individual affordability credits, shared 

responsibility including individual and employer, health care 

surcharge tax. 

Division B: Market basket updates, skilled nursing 

facility transparency, Medicare DSH (disproportionate share 

hospital) payments, sustainable growth rate reforms, Accountable 

Care Organizations (ACO), preventable hospital readmissions, 

Medicare Advantage reforms, advance care planning consultation, 

promotion of primary care, mental health services, prevention 

of fraud, waste and abuse, Part D donut hole, Tele-health, 


comparative effectiveness research, graduate medical education 

support, CHIP. 

Division C: Preventative services and access, Public 

Health Investment Fund, National Health Services Corporation, 

promotion of primary care and dentistry, nursing program support, 

Prevention and Wellness Trust, National Medical Device. 

References 

1. Full version of H.R. 3200 http://energycommerce.house.gov/ 

Press_111/20090714/aahca.pdf 

2. Defining Key Terms of the Health Care Debate http://www. 

latimes.com/news/nationworld/nation/healthcare/la-na-healthglossary6-2009sep06,0,2720250.story 

3. For Many Consumers, Few Insurance Choices http:// 

prescriptions.blogs.nytimes.com/2009/08/19/how-muchcompetition-among-insurers/?nl=pol&emc=pola1 

4. 

Private Health Insurance: Number and Market Share of 

Carriers in the Small Group Health Insurance Market http:// 

www.gao.gov/new.items/d02536r.pdf 

5. The Unwitting Birthplace of the “Death Panel” Myth http:// 

www.washingtonpost.com/wp-dyn/content/article/2009/09/03/ 

AR2009090303833.html 

6. 

T.R. Reid: Looking Overseas for the Healing of 

America http://www.npr.org/templates/story/story. 

php?storyId=112172939 

AMA Supports H.R. 3200 

7. http://www.ama-assn.org/ama/pub/ 

news/news/ama-supports-hr-3200.shtml

cOVER STORY 

McMs/sccMa MeMber benefits & services 

PRACtICe MAnAgeMent 

CMA’s Reimbursement Help Line: Trouble getting paid? Call 

CMA’s Reimbursement Help Line for personal assistance with 

contracting or reimbursement issues. Not available to nonmembers. 

888/401-5911. 

Amerinet: Members are eligible for a 

variety of discount programs, including 

a 22% discount at Verizon Wireless, 

after joining Amerinet. As a leading group purchasing organization, 

Amerinet strategically partners with health care providers to 

reduce costs and improve quality. Health care providers can access 

contract information, purchasing history, and financial information, 

all online! To learn more about the available web-based practice 

management tools, visit www.amerinet-gpo.com. To sign-up, call 

MCMS/SCCMA Membership Department today at 831/455-1008 

or 408/998-8850 Ext. 3010. 

Conomikes: Members offered 10% 

discount on their on-site practice 

management consultation. The 

nationally-recognized practice consultants at Conomikes Associates 

have undertaken over 1,500 assignments with medical practices – 

showing them ways to improve their performance and profitability. 

Most of the assignments of the San Diego-based firm are in the 

range of $5,000 to $10,000, depending on your practice size. 

Contact: Regina Reading, Admin. Assistant, Conomikes Associates, 

800/421-6512 or email: rreading@conomikes.com. Please visit 

conomikes.com. 

Practice & Liability Consultants, 

LLC: Members receive $10 off the 

regular hourly consulting fees. Since 

1985, Practice & Liability Consultants have worked with over 1,400 

practices as practice management and malpractice prevention 

specialists. Services include practice assessments, valuations, 

benchmarking, mergers, operations/personnel issues, partnership/ 

group formation/improvements, and seminars. Benefits include 

greater productivity, increased gross and net income, greater patient 

satisfaction, and a more pleasant work environment. Fees are 

based on either a flat fee or an hourly basis and, where possible, a 


minimum and maximum fee is quoted. Please call 415/764-4800 or 

csm@practiceconsultants.net. 

enviroMerica: Bay Area-based private 

company that has helped hundreds of 

medical and dental offices in Northern 

California with all of their regulatory 

compliance issues for the past 12 years. 

They assure their clients are up to all standards, keeping their 

offices, patients, and staff safe and keeping them clear from hefty 

fines that are often levied by the regulatory agencies – such as 

CAL/OSHA, the Department of Health, the EPA, as well as the 

Medical Board of California. Services include annual training, 

up-to-date and customized safety manuals, all appropriate office 

documentation including complete and compliant MSDS books, 

plus complete physical compliance of the office. Via an insurance 

policy, EnviroMerica guarantees all of their clients against any 

and all fines they may receive from any of the regulatory agencies. 

MCMS/SCCMA members receive a complimentary CAL/OSHA 

inspection given by EnviroMerica (valued at $275). Call 888/323- 

0583 for more details. 

the Personnel Office (tPO): TPO is 

an award-winning HR consulting firm 

serving primarily the Bay Area. Typical 

services include, general HR consulting, 

employee handbook development, 

neutral third-party investigations into 

employment matters including harassment, managerial training on 

HR regulatory and leadership skill-building, and helping employers 

maintain current best HR practices. How we work with SCCMA 

and MCMS members: Over the past 15 years, TPO has provided 

HR support to SCCMA as well as the members of SCCMA and 

MCMS. TPO has facilitated numerous HR training programs for 

members to attend and has provided many articles throughout the 

years. MCMS/SCCMA members receive a free initial consulting 

call ($50 Savings) and then 10% off the initial work, products, 

and services with TPO. Contact Melissa Irwin, Sr. Consultant: 

831/688-4196 or cmelissai@tpohr.com.

OfficeWorksRX: Members receive 

preferred pricing and FREE working 

interview. When your office is short 

staffed, are you getting the help you 

really need? OfficeWorksRX is your 

employment remedy! They specialize in 

placing medical assistants, receptionists, 

transcriptionists, and records clerks, as well as biller/collectors, 

coders, and office managers. Whether you require full- or parttime 

employees, permanent or temporary placement, vacation or 

maternity leave coverage—THEY CAN HELP! OfficeWorksRX 

provides pre-screened candidates, that have a health care 

background, within 24-48 hours. Call Kristen Biernat at 408/452- 

1125 for more information. 

LegAL SeRvICeS 

CMA On-Call: CMA On-Call is an online library with over 

4,500 pages of up-to-date legal information on a variety of subjects 

of everyday importance to practicing physicians. Free to CMA 

members ($2 per page for nonmembers). Accessible online at 

www.cmanet.org/member or by calling CMA Member Help Line, 

800/786-4262. 

Legal Help Line: CMA legal help line provides immediate 

assistance for HR, medical, regulatory, or legal questions. Free to 

CMA members. Not available to nonmembers. 800/786-4262. 

PrivaPlan: Receive discount on a complete do-it-yourself HIPAA 

privacy and security compliance toolkit (CD-ROM). Call David 

Ginsberg at PrivaPlan at 877/218-7707. 

FInAnCIAL SeRvICeS 

Financial Planning: Members get a 

free portfolio checkup (a $250 value) and 

$500 off Mercer’s “Economic Freedom 

Program,” a comprehensive program 

that includes financial planning, investment management, and 

retirement and estate planning. Mercer Advisors, 800/898-4642. 

CMA Credit Card: Physicians can show their CMA pride 

with CMA-branded credit cards from Bank of America. Bank of 

America, 800/789-6701. 

Practice Financing: Members get 

reduced loan administration fees from 

Banc of America Practice Solutions (a 

subsidiary of Bank of America) for software upgrades, practice 

expansion, and equipment purchasing. A members-only coupon 

code is required to access this benefit. Get your code at www. 

cmanet.org/benefits or call CMA’s Member Help Line, 800/786- 


4262. Banc of America (subsidiary of Bank of America), 800/497- 

6076. 

Merchant Services/Payroll Services/ 

Check Management: Members receive 

exclusive discounts and a three-year 

rate guarantee on Heartland Payment System’s suite of financial 

services, which includes credit card processing, payroll processing, 

and check management. Heartland offers a full suite of services to 

meet the needs of the health care market, including ConfirmPay, a 

PC-based tool that processes credit card and ACH transactions with 

real time insurance verification and patient responsibility estimator 

for over 400 insurance carriers. Heartland Payment Systems also 

has local sales and service professionals who specialize in the health 

care industry and a 24/7/365 live customer service team. Heartland 

Payment Systems, 866.941.1477 or www.heartlandpaymentsystems. 

com 

ComericA Bank: 

• 

• 

• 

• 

$500 credit towards nonrecurring 

closing costs at close of escrow. 

1/4% higher than posted CD rate over $50,000. 

1/2% discount off posted rate along with no fee. 

For more information, call Jo Matheson, vice president of 

banking, at 408/556-5261. 

Legacy Wealth Advisors, LLC: 

• 

• 

• 

Provides financial planning, retirement planning, professional 

money management, and more. 

One-hour complimentary consultation for MCMS/SCCMA 

members (over a $300-dollar savings). 

For more information, call Lisa Goss at 408/452-7700. 

Bureau of Medical economics 

(BMe): Receive a 5% discount off the 

basic rate for collections. (Rate based on 

volume—you only pay if they collect.) 

The billing rate is based on provider 

productivity. For more information 

regarding BME’s collection and billing 

services, call Karen Jorgenson for Collections, Ext. 3034, and 

Yolanda Rubio, CMC, for Billing, Ext. 3002. 408/998-5811. 

Coding and Reimbursement Hotline: Access a wealth of coding 

and billing information by calling Sandie Becker, CMC, MCMS/ 

SCCMA’s coding/reimbursement specialist at 831/455-1008 or 

408/998-8850 Ext. 3007 or email: sandie@sccma.org. This service 

is FREE-of-charge to our members and their staff. 

Continued on next page

McMS/SccMa MEMBER BENEFITS & SERVIcES, from page 9 

InSuRAnCe 

Medical, Workers’ Comp, Life, 

Disability, Long-term Care and 

More: Members receive discounted 

rates on insurance products for solo, small, medium, and large 

groups. Marsh Affinity Group Services, 800/842-3761 or www. 

marshaffinity.com/assoc/cma.html. 

Auto and Homeowners Insurance: 

Discounted auto and homeowners 

insurance for CMA members. Mercury 

Insurance Group, 888/637-2431 or www. 

mercuryinsurance.com/cma. 

nORCAL Mutual Insurance 

Company: Formed by physicians in 

1975 to provide the highest quality 

medical professional liability insurance products and services to 

its policyholder-owners. NORCAL Mutual insures nearly 20,000 

physicians and other health care professionals in solo practice, 

medical groups, hospitals, clinics, and allied health care facilities 

in California, Alaska, and Rhode Island. More than three-quarters 

of NORCAL Mutual policyholders have been with the company 

longer than five years. They stay with NORCAL Mutual because 

it stands with them, providing vigorous defense to the standard of 

care, unparalleled risk management, and personalized local service. 

In 1984, NORCAL received their first “A+” rating from A.M. Best. 

They have maintained an “A” or better rating every single year since 

then. NORCAL offers a variety of FREE on-line CME courses 

for members of NORCAL. For more information, visit www. 

norcalmutual.com or call Jeanne Zosky at 800/652-1051. 

PROFeSSIOnAL DeveLOPMent 

CMe tracking/Credentialing: CMA’s 

Institute for Medical Quality certifies CME 

activity for credentialing purposes to the Medical 

Board of California, as well as to hospitals, health 

plans, specialty societies, and others. CME 

certification is $29 a year for members, $49 for nonmembers. IMQ, 

415/882-5151 or www.imq.org. 

CMA Webinar Series: CMA’s webinar series gives physicians 

the opportunity to watch live presentations on important topics 

of interest and interact with legal and financial experts from the 

comfort of their homes or offices. The webinars are free to CMA 

members and their staff. www.cmanet.org/calendar. 

PAGE 10 | THE BULLETIN | JULY / AUGUST 2009 

MCMS/SCCMA Seminar/Webinar Series: Member physicians 

and their office staff often attend FREE-of-charge seminars 

(including office managers) covering legal issues, HIPAA, risk 

management issues, contract negotiations, reimbursement, billing, 

OSHA compliance, how to open/close/how to determine the value 

of a medical practice, HR requirements/guidelines, and much more. 

Check out www.sccma.org or www.montereymedicine.com or The 

Bulletin for more information. 

HeALtH InFORMAtIOn teCHnOLOgy (HIt) 

HIt Resource Center: CMA is closely monitoring the standards 

development process, and will be updating this resource center as 

new information becomes available. www.cmanet.org/hit. 

eHR Webinar Series: To help 

members begin to assess their HIT 

needs, CMA has partnered with Maxwell 

IT to provide members with complimentary registration to the EHR 

Best Practices Series webinars. Maxwell IT is a national education/ 

consulting program endorsed by state medical associations to help 

physician practices learn how to select and implement EHRs. A 

members-only coupon code is required to access this benefit. Get 

your code at www.cmanet.org/benefits or call CMA’s Member Help 

Line, 800/786-4262. 

epocrates: CMA members save 30 to 

50% on Epocrates, which provides pointof-care 

access (via the Web, PDA, or smartphone) to information on 

drugs, diseases, and diagnostics. Visit www.cmanet.org/benefits to 

access the members-only discount link. 

PuBLICAtIOnS 

CMA Alert newsletter: CMA’s biweekly e-newsletter provides 

up-to-date information on many issues of critical importance 

to California physicians. Advertising opportunities available. 

Distributed via email or fax to all CMA members. Subscribe online 

at www.cmanet.org/news/alert_sub.asp or call 800/786-4262. 

CMA’s Legislative Hot list: CMA’s Legislative Hot List, 

distributed weekly during the legislative session, follows the progress 

of CMA-sponsored bills and other bills of interest to physicians as 

they move through the legislative process. Subscribe online at www. 

cmanet.org/news/hotlist.asp or call 916/551-2887. 

CMA’s In the news: CMA’s daily news roundup, “In the News” 

provides a quick, but meaningful, overview of the day’s health care 

news. Subscribe online at www.cmanet.org/news/press_clips.asp or 

call 916/551-2072.

the Bulletin: Members receive a FREE subscription to the 

voice of Monterey and Santa Clara County physicians. This bimonthly 

publication includes medical articles, classifieds, new 

member benefits, coding/billing/collection advice, CME classes and 

webinars, seminars, new members listing, and more! 

MCMS/SCCMA Pictorial Membership Directory: Appear in 

MCMS/SCCMA’s annual pictorial membership directory! Receive 

a FREE directory each year ($60.00 value) and receive a 50% 

discount off each additional directory purchase by member. Contact 

Maureen at 831/455-1008 or 408/998-8850 Ext. 3001 for details. 

AutOMOtIve SeRvICeS 

Autobahn Los gatos: Members, 

family, and staff receive a 10% discount 

on labor. Specializing in BMW and 

Mercedes Benz repair. Call Dave or 

Gary at 408/356-5985 to set up your appointment today. 

Car Rentals: Save up to 25% on car 

rentals for business or personal travel. 

Members-only coupon codes are 

required to access this benefit. Get your 

code at www.cmanet.org/benefits or call 

CMA’s Member Help Line, 800/786- 

4262. Avis, 800/331-1212; Hertz, 800/654-2200. 

MeMBeR ReSOuRCeS 

Mailing Lists/Labels: To send new practice announcements, 

inform your colleagues of a particular legislation or upcoming 

event. Members can order mailing labels by specialty, zip code, or 

total membership. Members receive a 50% discount by calling Pam 

Jensen, MCMS/SCCMA, at 831/455-1008 or 408/998-8850 Ext. 

3012. 

Physician Referral Service: Our physician referral service 

handles around 1,200 calls per month. Patients can select a 

physician by city, specialty, language, Medicare or Medi-Cal, 

and gender. Call Jean Cassetta, MCMS/SCCMA, at 831/455- 

1008 or 408/998-8850 ext. 3010 for a “Physician Referral Service 

Participation Agreement” or to sign up today. 

Discounted tickets & See’s Candies Certificates: Discounted 

tickets available for members, their staff, and families to: California 

Great America, Gilroy Gardens, Monterey Bay Aquarium, Raging 

Waters, and Six Flags Discovery Kingdom. Gift certificates also 

available for See’s Candies. For more information, call Jacquelyn 

Mentz, MCMS/SCCMA, at 831/455-1008 or 408/998-8850 Ext. 

3008. 

PAGE 11 | THE BULLETIN | JULY / AUGUST 2009 

the Alliance: Members of the Alliance 

work together to promote quality 

health in Santa Clara County through 

education, community service programs, 

and legislative advocacy. Benefits of 

membership include advocacy for quality 

health care, legislative awareness and 

action, lifelong friendships, active local, 

state, and national projects, and close support for the medical 

family. For more information, call Debbi Ricks at 408/358-0855, or 

Siggie Stillman at siggiestillman@aol.com, or visit www.sccma.org. 

OtHeR SuPPLIeS AnD ReSOuRCeS 

Staples: Save up to 80% on office supplies 

and equipment from Staples, Inc. Visit 

www.cmanet.org/benefits to access the 

members-only discount link. 

MedicAlert: MedicAlert is a nonprofit 

foundation with over 50 years of 

lifesaving experience identifying and providing vital medical 

information to emergency personnel for over 4 million members 

worldwide. CMA members and their patients save $10 on new adult 

enrollments and $2.95 on Kid Smart enrollments. MedicAlert, 

www.medicalert.org/cma or 800/253-7880. 

Security Prescriptions: Get 15% off 

tamper-resistant security prescription 

pads and printer paper. RX Security, 

www.rxsecurity.com/cma.php. 

Magazine Subscriptions: 50% off subscriptions to hundreds of 

popular magazines. Subscription Services Inc, www.buymags.com/ 

cma or 800/289-6247. 

Breveon: The leader in developing and marketing the most 

accurate medical speech-recognition tools for health care 

professionals use in dictation, transcription, and clinical data 

management. Discount given to members. For more information, 

call 650/691-2061. 

Copyland/Zip 2 Print: Members 

receive excellent quality service with 

a 10% discount on all printing needs, 

from prescription pads, new practice 

announcements, brochures, etc. FREE shipping or delivery 

depending on your office location. Call Frank at 408/971-9800.

McMS/SccMa MEMBER BENEFITS & SERVIcES 

2009-2010 McMs/sccMa seMinars & events 

Note: All members may attend events held in Monterey and Santa Clara counties regardless of location of membership. 

Month Date Day time Description 

October 6 Tuesday 9:00am – MOnteRey: Employment in Today’s Economy… Options to Reduce 

10:30am Employment-Related Expenses in Medical Offices 

TPO 

October 7 Wednesday 6:30pm – SCCMA: FREE Investment Symposium @ DoubleTree Hotel 

8:30pm Legacy Wealth Advisors 

Dinner Provided (MDs only) 

October 14 Wednesday 12:30pm – SCCMA/MCMS: FREE Webinar: “Avoiding Embezzlement” 

1:30pm Practice Liability & Consultants 

October 17 - 19 Saturday – 

Monday 

All Day House of Delegates @ Disneyland Hotel 

October 21 Wednesday 12:30pm – MCMS/SCCMA: FREE Webinar: “Avoiding Embezzlement” 

1:30pm Practice Liability & Consultants 

October 28 Wednesday 9:00am – SCCMA: “MBA in 3 Days” (Finance) 

12:00pm Physicians and Practice Managers 

Practice Liability & Consultants 

November 4 Wednesday 9:00am – SCCMA: “MBA in 3 Days” (Operations) 



November 11 Wednesday 9:00am – SCCMA: “MBA in 3 Days” (Human Resource Management) 



November 12 Thursday 12:00pm – SCCMA: What Every Office Manager Should Know About 

2:00pm Running a Practice (ARs, Collections, Billing) 

Frank Navarro/CMA’s Center for Economic Services 

November 12 Thursday 6:00pm – SCCMA: What Every Physician Should Know About 

8:30pm Running a Practice (ARs, Collections, Billing) 

Frank Navarro /CMA’s Center for Economic Services 

November 12 Thursday 9:00am – MOnteRey: Telephone Techniques, Patient Relations, Customer Service 

12:00pm Practice Managers 


December 3 Thursday 12:00pm – MOnteRey: OSHA Refresher Seminar (Office Managers Forum) 

2:00pm EnviroMerica 

December 10 Thursday 6:00pm – 

8:00pm 

Young Physicians Mixer 


Month Date Day time Description 

January 27 Wednesday 9:00am – 

4:00pm 

January 29 Friday 10:00am – 

12:00pm 

January 29 Friday 12:15pm – 

1:30pm 

February 4 Thursday 12:00pm – 

2:00pm 

February 4 Thursday 6:00pm – 

8:30pm 

February 10 Wednesday 1:00pm – 

4:00pm 

February 17 Wednesday 12:30pm – 

1:30pm 

March 8 Monday 6:00pm – 

8:30pm 

March 15 Monday 6:00pm – 

8:30pm 

April TBD 6:00am – 

6:30pm 

May 12 Wednesday 10:00am – 

12:00pm 

May 13 Thursday 12:30pm - 

1:30pm 

SCCMA: Repairing Leaks in Your Practice “Strategies to Boost Profits 

in 2010 thru Better Billing & Coding” 


MOnteRey: Managing Up! 

Practice Managers 


MOnteRey: Magnificently Managing Your Manager 

Practice Managers 


MOnteRey: What Every Office Manager Should Know About 

Running a Practice (ARs, Collections, Billing) 


MOnteRey: What Every Physician Should Know About Running a Practice 

(ARs, Collections, Billing) 


MOnteRey: Webinar 

MOJO Management & “Learn Management Magic” for Workplace/Workforce 

SCCMA: Diversity in Today’s Medical Practices… Beyond the Prevention of 

Harassment and Discrimination 

TPO 

MOnteRey: Retirement, Recruiting, Buying, Selling & Transitioning Your 

Practice (Physicians only) 


SCCMA: Retirement, Recruiting, Buying, Selling & Transitioning Your Practice 

(Physicians Only) 


CMA’s 37th Annual Legislative Day @ Sacramento 

(Bus Trip) 

MOnteRey: Diversity in Today’s Medical Practices… Beyond the Prevention 

of Harassment and Discrimination 

TPO 

Webinar 

Mojo Management 



yOur sccMa/McMs staff is here tO help! 

We are available to help you with everything important about your profession and your practice, as well as with 

services and discount programs for your home and personal use. Whatever you need – be it legal information, 

help with a problematic payor, or details about your member discounts and services – just call! 


Chief Executive Officer 

Executive Director 

T: 408/998-8850, ext. 3006 

or 831/455-1008, ext. 3006 

E: bill@sccma.org 

Contact Bill should you have questions about 

what SCCMA or MCMS are doing locally, in 

Sacramento, and in Washington, DC, on the 

political advocacy front, or with questions about 

finances and operations. You may also contact 

Bill if you have general questions, complaints, 

or concerns about what SCCMA or MCMS are 

doing or can do for you as a Santa Clara County 

or Monterey County physician. 

Jean Cassetta 

Membership Director 

T: 408/998-8850, ext. 3010 

or 831/455-1008, ext. 3010 

E: jean@sccma.org 

Contact Jean to enroll a 

physician, resident, or student to membership, 

or for information regarding the SCCMA/ 

MCMS Young Physician Program, Resident 

Section, Medical Student Section, or member 

benefits. Also, contact Jean if you have ideas 

or suggestions as to how we can increase the 

value of your membership and thus serve you 

better, or if you need assistance with external 

affairs, SCCMA’s Political Action Committee, or 

SCCMA Council business. 

Jacquelyn Mentz 

Membership Coordinator 

T: 408/998-8850, ext. 3008 

or 831/455-1008, ext. 3008 

E: jmentz@sccma.org 

Contact Jackie should you have 

questions about your membership status or dues, 

or for entertainment discount tickets. 

aNSWERS FOR YOU aND YOUR STaFF 

Sheila Foley 

Executive Assistant 

T: 408/998-8850, ext. 3024 

or 831/455-1008, ext. 3024 

E: sfoley@sccma.org 

Contact Sheila should you have 

questions about the House of 

Delegates, Executive Committee, Nominating 

Committee, or Monterey County activities. Also, 

provides high-level administrative support and 

scheduling for the CEO. 

Pam Jensen 

Managing Editor 

Peer Review Committees 

Coordinator 

T: 408/998-8850, ext. 3012 

or 831/455-1008, ext. 3012 

E: pjensen@sccma.org 

Contact Pam should you have questions about 

The Bulletin magazine, our website, the annual 

pictorial membership directory, or if you need to 

change or update your contact information. Also, 

contact Pam should you like to place a classified 

ad, display ad, or order a database mailing list (all 

discounted for member physicians).You may also 

contact Pam for any business related to physician 

or patient complaint referrals, Annual Awards 

Banquet, Physician Well-Being issues, History 

Committee, and Peer Review Committees. 

Steven Brazeau 

Administrative Assistant 

T: 408/998-8850, ext. 3009 

E: sbrazeau@sccma.org 

Contact Steven for any 

business related to the 

Environmental Health Committee. 


Maureen yrigoyen 

Administrative Assistant 

Catering Coordinator 

T: 408/998-8850, ext. 3001 

or 831/455-1008, ext. 3001 

E: maureen@sccma.org 

Contact Maureen for physician referrals, to order 

additional copies of the membership directory, 

or should you need any information regarding 

SCCMA’s meeting facilities/conference room 

rental or catering. 

Sandie Becker, CMC 

Coding/Reimbursement 

Specialist 

T: 408/998-8850, ext. 3007 

or 831/455-1008, ext. 3007 

E: sandie@sccma.org 

Contact Sandie should you need assistance with 

coding, billing, compliance, or for any economic 

advocacy issue you’re facing. Also, contact 

Sandie if you would like to receive the advocacy 

e-newsletter or for business pertaining to the 

Bioethics Committee. 

Shannon Landers 

Lead Bookkeeper 

T: 408/998-8850, ext. 3026 

or 831/455-1008, ext. 3026 

E: slanders@sccma.org 

Contact Shannon should you 

have questions about invoices, statements, or 

accounting business.

San Jose Medical Office For Sale 

1991 Park Ave., San Jose 95126 

(408) 261-7767 

. 5050 sq ft 


Rose Garden Corner Building 

Built in 2000 

Close to Hwy 880 

Possible Financing Assistance 

Private Owner Sale 

$1,800,000 

Visit LoopNet.com 

for a more complete listing 

Deal directly with me, Dr Santucci DC, and save about $100K in broker’s fees. I bought this building from Dr 

Prolo and want to sell it directly to the next buyer. Please call my office at (408) 261-7767 to set up a tour 

on a Tuesday or Thursday morning. 

. 

. 

. 

. 

. 

Image and Efficiency

GOVERNING MEDIcINE 

cMa’s legislative accOMplishMents 

CMA is the unifying 

voice of doctors. When decisions 

affecting health care are being 

made at the state and federal 

levels, we are at the 

table to represent all 

California doctors. 

Your membership 

strengthens our 

representation 

and advocacy 

efforts at the 

table to 

create 

and 

maintain a physician-led, patient-centered 

health care system in California. The 

following legislation is just a small, albeit 

noteworthy, portion of CMA’s advocacy 

efforts. The victories were achieved despite 

an often-hostile environment for physicians 

and medicine; victories made possible by 

CMA, you, and your dues dollars. 

Aggressive Advocacy 

AB 1324 (De La torre) 

Sponsored by CMA and signed by the 

Governor, this bill protects patients and 

physicians by prohibiting HMOs and 

insurance companies from retroactively 

rescinding or modifying authorizations 

after the treatment has been provided 

by the physician in good faith. 

Professional Liability 

Rate Protection 

Defending 

MICRA: The 

trial lawyers 

will never 

give up 

in their 

attacks 

to 


overturn MICRA – the Medical Injury 

Compensation Reform Act that keeps 

professional liability rates affordable for 

California doctors. Recently, the trial 

lawyers tried to overturn the non-economic 

damages award in MICRA ($250,000 cap). 

CMA’s arguments and amicus filing before 

the 5th District Court of Appeal were 

validated when the court agreed with CMA 

and rejected each of the trial attorneys’ 

constitutional arguments. 

State Can’t Cut Medi-Cal Fees 

A federal court has ruled that 

California acted illegally by trying to cut 

Medi-Cal fees by 10% last year for doctors 

and others who treat 7.1 million poor 

people. The ruling means that doctors will 

be retroactively paid in-full for claims that 

were paid at 90% during the 6 weeks that 

the 10% cut was in effect. CMA’s legal 

efforts last year helped reverse the cuts and 

restore more than $1 billion to California’s 

health care system, including the $121 

million to California physicians who 

provide care to the poor. CMA attorneys 

are already consulting and working with 

Supreme Court experts to prepare for any 

challenge that could be mounted by the 

state to overturn this ruling. 

Streamlining Medi-Cal 

Medi-Cal’s costly Treatment 

Authorization Request (TAR) process 

is set for an audit, thanks to CMA. The 

TAR program costs the state $1.5 billion 

to administer and creates considerable 

added paperwork for physicians serving 

Medi-Cal patients. Since 92% of TARs 

are granted, the process does little

more than delay treatment and increase 

administrative costs in nine out of ten 

cases. CMA is advocating that those 

funds be spent on providing actual health 

care, like maintaining the state’s Healthy 

Families program, rather than wasteful 

administration, particularly given the 

state’s budget situation. 

Stopping Health Insurance 

Company Abuses 

AB 2 (De La torre) Sponsored 

by CMA, this bill will protect patients from 

losing health insurance when they get sick 

by preventing the outrageous industrywide 

practice of health plans wrongfully 

rescinding coverage for patients through 

requirements that health insurers obtain 

final approval for an independent reviewer 

before they can rescind a health plan or 

insurance policy. 

Protecting Against Fraud 

CMA has filed a class action 

lawsuit against health insurance company 

WellPoint, Inc. The lawsuit alleges that 

WellPoint colluded with Ingenix, a unit of 

United Health Group, on a price-fixing 

scheme that relied on an obscure database 

to set artificially low reimbursement rates 

for out-of-network care. WellPoint – 

which operates as Blue Cross in California 

– is legally bound to pay the usual and 

customary amount for care provided 

to their enrollees by an out-of-network 

physician. 

Other CMA Sponsored 

Legislation 

AB 526 (Fuentes) This bill will 

create the Patient Protection and Physician 

Health Program in California. The bill 

will allow physicians with mental health or 

addiction problems to seek help, leading 

to appropriate treatment and monitoring, 

prior to harming a patient. With the 

closure of the Medical Board Diversion 

Program, there is not a sufficient program 

available for physicians seeking help. 

AB 583 (Hayashi) CMA 

is co-sponsoring this bill with the 

California Society of Plastic Surgeons. It 

is becoming increasingly difficult for the 

public to identify the license, education, 

and training of health care professionals 

who practice in the state and many are 

unable to distinguish between physicians 

and non-physicians. To protect the 

public’s health and safety, this “truth in 

advertising” legislation will require a health 

care professional to disclose information in 

various health care settings to help patients 

understand who will be helping them with 

their health care, such as information about 

A federal court has ruled 

that California acted 

illegally by trying to cut 

Medi-Cal fees by 10% 

last year for doctors 

and others who treat 7.1 

million poor people. 

their license, education, and recognized 

board certification. 

AB 1201 (M. Perez) CMA is 

co-sponsoring this bill with the American 

Academy of Pediatrics and the California 

Academy of Family Physicians. The 

bill requires plans/insurers to adequately 

reimburse for both the acquisition and 

administrative costs of giving shots, 

such as purchasing the vaccine, storage, 

inventory, staff time, supplies, etc. This 

bill also prohibits plans from applying copays, 

deductibles and other cost-sharing 

mechanisms to immunizations. 

CMA Opposed Corporate Bar 

Legislation - DeFeAteD 

SB 726 (Ashburn) This bill, 

as amended in the Assembly Health 

Committee, will allow virtually all health 


care districts and rural hospitals to directly 

employ up to five physicians in a pilot 

program. The CEO of a facility must show 

they have been unsuccessful in recruiting a 

physician for 12 months, that no currently 

contracted physician or physician with 

privileges will be supplanted, and the 

physician was not recruited from an 

FQHC. Employment contracts can be up 

to 10 years, but may be renewed if signed 

prior to December 31, 2017. (This bill was 

defeated). 

AB 646 (Swanson) This bill 

would authorize a health care district 

that is located in a rural area, or a public 

or nonprofit hospital or clinic located in 

a health care district serving medically 

underserved urban populations and 

communities, to employ physicians. (This 

bill was defeated). 

AB 648 (Chesbro) This bill will 

allow rural general acute care hospitals to 

employ an unlimited number of physicians 

and surgeons. The bill requires an 

employed physician and surgeon to sign a 

contract to exercise independent medical 

judgment and to notify the Medical Board 

of any action or event that compromises 

that independent medical judgment. (This 

bill was defeated). 

Legislation to Watch 

AB 542 (Feuer) In the face 

of strong CMA opposition, this bill was 

dramatically narrowed by the author 

before its first committee hearing. The bill 

now applies only to hospitals and merely 

requires the state to adopt regulations 

establishing uniform policies and practices 

governing the nonpayment to and reporting 

by hospitals of substantiated adverse events 

by public and private payers, consistent 

with those developed by the federal Centers 

for Medicare and Medicaid Services 

(CMS). CMA will continue to provide 

suggestions to further improve this bill and 

will stay engaged in the discussion.

MEMBER BENEFIT: PRacTIcE RESOURcES 

cMa On-call 

The California Medical Association’s FREE Information-on-Demand Service 

Access the answers to all 

your medical-legal questions — free 

of charge — with CMA’s On-CALL 

documents. 

CMA ON-CALL is the 

California Medical Association’s 24hour 

information-on-demand service 

for physicians. All CMA ON-CALL 

documents are available free to MCMS- 

SCCMA-CMA members. Members may 

access CMA ON-CALL documents on 

CMA’s website as follows: 

Go to www.cmanet.org. In the 

upper right-hand corner, click on the blue 

box that reads “CMA Members Enter 

Here.” Enter your username and password. 

If you are entering the “Members’ Section” 

for the first time, you will need to register 

by clicking on the words “Click here” 

inside the “Sign In” box. Fill in the three 

blank fields with: 

Your California medical license 

number (make sure to leave out the leading 

zeroes in your license number, e.g., if your 

license number is “AOOO12345,” enter 

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• 

ADA/Discrimination 

Adverse Events 

Advertising 

AIDS and HIV 

Allied Health Professionals 

Ancillary Services 

Antitrust 

Business Prohibitions/Disclosure 

Requirements 

Clinical Laboratories 

Consent 

Death/Organ Donation 

Decisions Regarding Life-Sustaining 

Treatment 

Drug Prescribing/Dispensing 

Drug Testing 

eMedicine/HIPAA 

Emergency Transfer 

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A12345”); your six-digit CMA ID number; 

your last name. Click “Register.” Next, 

follow the prompts to personalize your 

username and password, and record this 

information for future use. Be sure to give 

CMA your preferred email address when 

registering, so that they can send you your 

username and password via email should 

you misplace them. 

Once in the “Members’ Section,” 

slide your cursor over the words “CMA 

ON-CALL” on the left side of the 

homepage, and click on the link that says 

“CMA’s online medical-legal information 

library.” From this page, you can search 

by general topic headings, which parallel 

the chapters included in CMA’s California 

Physician’s Legal Handbook. To see a list 

of documents by topic, simply select that 

topic. 

You can also search CMA 

ON-CALL by document number or by 

keyword search. To do this, scroll down 

to the bottom of the page and click on the 

“Search” button in the lower left-hand 

general topic Headings: 

Expert Witness Issues 

Fraud and Abuse 

Fraud and Abuse: Referral Issues 

Managed Care: Overview 

Managed Care: Contract Termination/ 

Exclusion 

Managed Care: Risk Arrangements 

Managed Care: Utilization Review and 

Management 

Medical Board: Discipline and 

Licensing 

Medical Board: Reporting To 

Medical Practice: Employment Issues 

Medical Practice: Groups, IPAs, MSOs 

Medical Records: Management 

Medical Records: Requests for Access 

Medical Records: Special 

Confidentiality Rules 


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corner. Under step one, check the box 

next to CMA ON-CALL. Under step 

two, select “Enter Search Criteria.” To 

search by document number: If you know 

the specific document for which you are 

searching, enter the document number 

into the search box. Click on the document 

title and number and follow the prompts 

to download the document. To search by 

keyword search: Type a keyword(s) search 

into the search box. When searching for 

two or more words, use “and” or “or” 

(e.g., needles or syringes, point and of and 

service). Do not use “and/or.” 

To view the documents, you 

will need the Adobe Acrobat program. If 

you do not have Adobe Acrobat on your 

computer, you may download the program 

at no charge by clicking on the Adobe icon 

to the right of your screen before you click 

on the blue “Download PDF” button. 

If you have questions about CMA ON- 

CALL or how to access documents, please 

call CMA’s Legal Information Line at 

800/786-4262. 

Medical Staffs 

Medicare and Medi-Cal 

OSHA/Office Safety 

Outpatient Facilities/Surgicenters 

Peer Review 

Physician/Patient Relationship 

Professional Liability 

Reimbursement: From HMOs and 

Other Private Payers 

Reimbursement: From Patients 

Reimbursement: Other Issues 

Reporting Abuse/Violence 

Reporting Diseases, Conditions, & 

Events 

Reproductive Issues 

Warning Obligations 

Workers’ Compensation

Ave. 

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Lawrence Expwy. 



237 

Patrick Henry Dr. 

Monroe St. 

Great America Parkway 

Lafayette St. 

Mission College 

Scott Blvd. 

San Tomas Expwy 

Martin Ave. 

Scott Blvd. 

101 

N. First St. 

Montague Expwy. 

Lafayette St. 

Tasman Ave. 

De La Cruz Blvd. 

Zanker Rd. 

Trimble Rd. 

MINETA/SAN JOSE 

INT'L 

Coleman Ave. 

880 

Central Expwy. 

Santana Kifer Road Atrium Professional Center 

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Welcome San Jose 

Eye Institute! 

Available Walsh for Ave. Lease 

100 N. Winchester Blvd, Santa Clara 

Bowers Ave. 

One Half Mile to O’Connor Hospital 

New Owner and New Management 

Located Close to Retail Amenities: Santana Row & 

Valley Fair Mall El Camino Real 

On-Site Common Conference Room and Lunch 

Room 

Major Upgrades 

Completed 

Garden Atrium 

Covered Parking 

Two Elevators 

Santana Atrium Professional Center 

Pruneridge Ave. 

Beautiful Valley 

Views 

Pruneridge Ave. 

Forest Ave. 

O’CONNOR 

HOSPITAL 

Near Highways 

280 & 880 

Stevens Creek Blvd. 

Saratoga Ave. 

280 

San Tomas Expwy. 

Saratoga Ave. 

Moorpark Ave. 

N. Winchester Blvd. 

De La Cruz Blvd. 

W. Hedding St. 

AIRPORT 

Scott C 

Junction Ave. 

N. First St. 

O’Toole Ave. 

Charcot 

280 

Ave. 

Milpitas Blvd. 

Old Oakland Road 

880 

Ringwood Ave. 

680 

Colliers International - San Jose 

450 W. Santa Clara St • San Jose, CA 95113 

Trade Zone Blvd. 

Lundy Ave. N. King Rd. 

Brokaw Rd. Murphy Ave. Hostetter Rd. 

Willams Road For further 17 information contact: 

Payne Ave. 

S.Winchester Blvd. 

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The Alameda 

Naglee Ave. 

W. San Carlos St. 

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(408) 282-3808 • ateng@colliersparrish.com 

CA License No. 01777216 

Parkmoor Ave. 

Moorpark Ave. 

Bascom Ave. 

Southwest Expwy. 

W. Hamilton Ave. E. Hamilton Ave. 

• 

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87 

Berryessa Rd. 

Taylor St. Mabury Rd 

Alum Rock Ave. 

11th St. 

Keyes St. 

Monterey Rd. 

N. Capitol Ave. 

610-650 E. Santa Clara St. San Jose 

For Lease or Sale 

Ideal for Medical and Dental Uses 

Space available for Lease: 840SF - 1,180SF 

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MEMBER BENEFIT: PROFESSIONal lIaBIlITY INSURaNcE 

strappeD: a lOOk at the financial 

challenges Of practicing MeDicine 

Reprinted by permission of NORCAL Mutual 

Insurance Company 

Since the mid-1990s, physicians’ 

annual incomes have declined steadily. 

According to researchers at the Center for 

Studying Health System Change, “between 

1995 and 2003, average physician net 

income from the practice of medicine 

declined about 7%.” 1 

Although many factors have 

contributed to the drop in physician 

incomes over the past decade, three trends 

in particular appear to be the primary 

drivers: the nationwide growth in managed 

care, cuts in public program payments to 

physicians, and the rise in practice costs 

brought about by the increase in medical 

malpractice suits. 

The ever-changing health care 

climate is yet another factor contributing 

to physicians’ financial pressures. 

Many physicians cite high overhead as 

one of their most pressing problems, 

particularly the prohibitive cost of hiring 

and maintaining a staff to manage daily 

operations. According to one study, 60% 

of physicians surveyed reported that they 

spend between 40% and 70% of their 

revenue on overhead alone. 2 

Add to this the fact that as the 

health care climate has changed, so too 

have consumer attitudes. The high cost 

of American health care has an impact 

on the consumer as well as the physician, 

leading many consumers to seek more 

affordable ways to access care. More and 

more health care consumers are seeing 

health care extenders (HCEs), visiting the 

ER, or seeking out alternative medicine 

practitioners, in an attempt to minimize the 

drain on their own wallets. As consumers 

seek alternative health care options, many 

physicians, especially primary care doctors 

and other generalists, find themselves in 

a position where they must compete with 

more aggressive, better-funded providers 

for insured patients. 

grasping at Solutions 

Because more and more 

physicians are forced to compete for 

insured patients, some have begun to avoid 

treating low-income and/or uninsured 

patients altogether. Others are increasing 

their patients’ fees, refusing to take call 

in hospital EDs, or are demanding extra 

pay from hospitals for taking call. 3 Some 

physicians are even declining to participate 

in the Medicare and Medicaid programs 

due to low reimbursement rates, leaving 

many elderly and disabled patients with 

limited health care options. 4 

Conversely, some physicians have 

attempted to enhance revenue by taking 

on greater patient loads, increasing the 

volume and prices of services, investing 

COMPAny: nORCAL Mutual Insurance Company 


in ancillary services, and/or marketing 

products directly to consumers. Though 

these strategies have in many cases proven 

to be effective revenue generators, they can 

also be problematic. Larger patient loads 

often equate to less time spent with each 

individual patient and can lead to patient 

dissatisfaction. Investing in nontraditional 

services can be profitable, but only if the 

physician or practice can afford the initial 

capital outlay and additional staff that is 

required. 

Clearly, today’s physicians need 

a wider variety of solutions to help them 

deal with the financial challenges they’re 

facing—solutions that are less likely to 

jeopardize the standard of care, pose 

liability concerns, or put them at even 

greater financial risk. 

experts’ Suggested Remedies 

Health care researchers have 

proposed a number of solutions to 

physicians’ escalating revenue crisis, 

ranging from the personal to the 

institutional, the simple to the complex. 

Many experts suggest that financially 

strapped physicians can begin to improve 

MCMS/SCCMA MeMBeR BeneFIt: MCMS/SCCMA has partnered with 

nORCAL Mutual Insurance Company, premier provider of professional 

liability insurance for physicians, medical groups, community clinics, 

hospitals, and medical facilities. In 1984, nORCAL received their first “A+” 

rating from A.M. Best. they have maintained an “A” or better rating every 

single year since then. nORCAL offers a variety of FRee on-line CMe 

courses for members of nORCAL. 

COntACt: Call Jeanne Zosky at 800/652-1051.

the bottom line by simply taking the 

time to write business plans and develop 

budgets. According to health care 

consultant Paul Angotti, a well-thoughtout 

budget can be the key to maintaining 

a financially sound practice. “Think of 

your practice’s budget as a mini business 

plan covering this year and next,” counsels 

Angotti. “This helps you establish a plan 

and adds a level of discipline to operations 

and spending.” 5 

Physicians may also improve 

practice finances by examining ways to cut 

basic operating costs. Experts’ suggestions 

include revisiting costly business contracts, 

addressing delinquent patient accounts, 

offering staff time off instead of cash 

bonuses, cross-training staff to perform a 

variety of duties, and buying in bulk rather 

than retail. 

endnotes 

1. 

2. 

3. 

Tu, Ha T. and Paul B. Ginsburg. 

“Losing Ground: Physician Income, 

1995 – 2003.” Issue Brief, Center for 

Studying Health System Change. 

Available at http://hschange. 

org/CONTENT/851/. Accessed 

September 20, 2006. 

Moore, Pamela. “Finance: What’s in 

Your Wallet?” Physicians Practice, 

July 1, 2006. Available at http:// 

www.physicianspractice.com/ 

index.cfm?fuseaction=articles. 

details&articleID=859. Accessed 

August 30, 2006. 

Health Affairs, “New Studies Show 

Financial Challenges Lead Physicians 

to Cut Back in Services and Increase 

Costs, Making it More Difficult 

for Patients to Obtain Care.” Press 

release, March 9, 2004. 


4. 

5. 

Reinberg, Steven. “AMA Seeks 

Delay in Medicare Payment Cuts.” 

Yahoo! Health, September 6, 2006. 

Available at http://health.yahoo.com/ 

news/166301;_ylt=AqxTCNvz4s9 

d6gTTZbahmXBLvs8F. Accessed 

September 20, 2006. 

Angotti, Paul. “Budgeting 

101.” Physicians Practice, May 

2005. Available at http://www. 

physicianspractice.com/index. 

cfm?Fuse action=articles. 

details&articleID=658. Accessed 

August 30, 2006. 

Printed by permission of NORCAL Mutual 

Insurance Company. NORCAL is the premier 

provider of professional liability insurance for 

physicians, medical groups, community clinics, 

hospitals, and medical facilities. To access 

additional articles published by NORCAL, 

visit www.norcalmutual.com.

MEMBER BENEFIT: INSURaNcE PRODUcTS aND SERVIcES 

insurance prODucts anD services 

Workers’ Compensation 

Special Discount for Association Members! 

As workers’ compensation rates begin to increase, 

membership in MCMS/SCCMA provides savings through lower 

rates for workers’ compensation insurance. 

• Members receive a 5% discount on their Workers’ 

Compensation premiums through the association-sponsored 

program. 

• Depending on where you place your group health insurance, 

groups of 2-250 employees may qualify for a 15% discount. 

• Check your policy renewal date and contact Marsh for a 

premium indication. 

Medical Insurance 

Reduce your expenses! 

• 

• 

• 

5% premium discount for groups of 2-50 

If you are currently insured with Blue Shield, or are considering 

them, MCMS/SCCMA membership can earn you a 5% 

premium reduction on any small group plan. 

Mercer Select HRKnowHow 

If you play a role in your medical group’s health care and 

benefit plan decisions, you know that staying current on the 

issues is challenging, especially with today’s increasingly 

complex marketplace and regulatory conditions. Mercer Select 

HRKnowHow may be the perfect solution for you. Access is 

included at no charge for members who purchase group health 

insurance through Marsh: 

• Mercer Alerts provide timely news and analysis of 

important benefit issues. 

• Compliance Link tool to assist with health care and group 

benefit plan administration on topics such as: Cafeteria 

Plans, ERISA, COBRA, FMLA, Domestic Partnership 

and HIPAA. 

• Notices and Forms Connection for the topics above to help 

you complete employer requirements. 

Health Savings Accounts 

With a high deductible health plan, you can reduce premiums 

significantly and use the savings to contribute to a health 

savings account that belongs to you. Contribute up to $3,000 


• 

as an individual or $5,950 with family coverage. Add another 

$1,000 if you are between the ages of 55-64. Unused funds 

rollover from year to year. 

Investigate RAF Sales 

Health plans are still very interested in growing enrollment. 

They offer incentives through discounts off their rate 

adjustment factors (RAFs) for you to change health plans. 

Instead of your medical rates increasing this year, we might be 

able to help you lower them. 

group Dental Program 

Open enrollment for January 1 

This program helps you maximize your out-of-pocket 

savings by using network dentists, but also allows you to use any 

dentist you like and receive lower benefits. Following are many 

valuable benefits that can save you money: 

• Annual Benefits of $2,000 per person for dental care, using 

network providers ($1,500 if you use non-network providers). 

• During Open Enrollment only, members may join as an 

individual or as a group with your employees. 

• Low calendar year deductible of $50 per person ($100 per 

calendar year maximum for families). 

• Pay no deductible on oral exams, x-rays, and routine cleanings. 

• A Rollover Benefit that allows for the unused portion of the 

maximum benefit amount from one year to roll over and be 

used in the following calendar year. 

The open enrollment period is available once per year. To 

be eligible for coverage, applications must be received during the 

special open enrollment period that ends on December 31, 2009. 

employment Practices Liability - $750 minimum 

premium 

Risk management plus Insurance 

Employment-related claims tend to increase during 

difficult economic times. Smaller employers generally do not 

have coverage for claims related to wrongful termination, sexual 

harassment and discrimination claims under their business owners, 

general liability, or professional liability policies. If they do, it 

provides limited coverage for defense costs only.

Highlights: 

• 

• 

• 

• 

Limits of up to $1,000,000 available. 

Low minimum premiums start at $750. 

Coverage for defense costs and judgments. 

On-line training. 

My Marsh advisor - www.marshaffinity.com 

new Marsh website features resources for all members on a 

generational basis. 

Not only does My Marsh Advisor provide helpful information about 

the MCMS/SCCMA-sponsored insurance programs with examples of how 

members save everyday, it contains many other useful resources that may 

assist you in your every day business and personal life. Look for guidance on 

issues involving: Life events - such as what to consider when moving a loved 

one into an assisted living facility or getting married; career planning; savings 

and finance and buying a home; or planning for retirement. 

Health Savings Account Limits for 2010: 

• Individual coverage: 

federally tax-deductible contributions up to 

$3,050. 

• Family coverage: 

federally tax-deductible contributions up to $6,150. 

• Catch-up between the ages of 55-64: 

an additional $1,000 to the 

above amounts. 


COMPAny: Marsh serves as the insurance 

advisor for members of the Monterey County 

Medical Society, the Santa Clara County 

Medical Association and the California 

Medical Association. they design, develop, 

and implement insurance plans available 

only to members – with discounted pricing, 

enhanced coverage, or both. they assist 

members and their office managers by 

providing information, programs, and 

guidance to assist with insurance buying 

decisions. 

MCMS-SCCMA-CMA MeMBeR BeneFIt: 

MCMS-SCCMA-CMA has partnered with 

Marsh to provide members with discounts 

or enhanced coverages on a comprehensive 

portfolio of insurance products and services. 

COntACt: Call 1-800/842-3761 

We are Wealth Advisors and Financial Planners to high net worth individuals, 

families and institutions. By Managing Wealth by Design, we create a 

unique �nancial plan for each client, addressing their retirement, estate and 

investment planning needs. 

LWA is proud to announce Edwin K.S. Ryu’s has been again 

named to the Medical Economics list of �e Top 150 

Best Financial Advisors for Doctors. 

(September 2009 Issue, www.memag.com) 

�e LWA team includes Lisa Goss, CFP as a specialist 

in �nancial planning and portfolio administration.

MEMBER BENEFIT: REIMBURSEMENT aDVOcacY PROGRaM 

reiMburseMent aDvOcacy prOgraM 

Reimbursement Advocacy Program 

(RAP) is a benefit available only to 

members of the Monterey County 

Medical Society and Santa Clara 

County Medical Association. through 

RAP, association members gain 

leverage in collecting payments 

from managed care plans (and other 

payers) slow in honoring claims. 

the RAP program also provides 

physicians, their office managers, 

and/or billing staff with coding and 

billing guidance. 

Contact RAP for Assistance 

With: 

Carrier Failure to Process “Clean 

Claims” in Accordance With State Law (30 

days for PPO plans and 45 days for HMOs) 

• Habitual Downcoding 

• Treatment Authorization and 

Subsequent Denial 

• Payment Inconsistent With the 

Physician’s Contract and CPT 

Guidelines 

• Coding Guidance 

Follow these Steps to expedite 

In-Office Collection: 

Step #1: Collect Accurate Data 

Remember—collection of 

accurate data is vital to your practice. 

Verify the information below at every 

patient encounter: 

• 

• 

• 

For coding questions and reimbursement issues, contact Sandie at 408/998-8850 or MCMS 831/455-1008 or email 

sandie@sccma.org. Also, contact Sandie if you would like to receive the Economic Advocacy newsletter by email. 

HMO or IPA affiliation 

Name of insurance company 

Name of Primary Care Physician 

(PCP)—with some plans this 

information can change monthly 

• 

• 

• 

• 

Patient’s home address. Do not accept 

a P.O. Box, in lieu of a home address 

Patient’s phone number 

Address and phone number of 

patient’s current employer 

If the patient visit requires a referral 

from a PCP, secure the referral 

number prior to the patient visit 

Step #2: Discuss Fees and Billing 

Procedures With your Patients 

It is very important to inform 

new patients about billing policies, when 

they call for an appointment. Place a sign 

at the check-in area advising patients that 

co-pays and deductibles are due at the time 

of service. Also, incorporate these policies 

in your patient registration form. Collect 

any applicable co-pays and/or unmet 

deductibles at patient checkout. Strict 

adherence to the foregoing will eliminate 

the additional expense of follow-up billing. 

Consistent observance of the “pay at 

time of service” policy not only reduces 

overhead, but reinforces the custom with 

patients, resulting in their readiness to pay 

prior to leaving the office. 

Step #3: electronic Billing 

Claims should be filed 

electronically, whenever possible. This 

practice will significantly expedite 

payments and save resources, i.e. staff 

time, supplies, postage. In order to ensure 

timely reimbursement, whether billing 

electronically or via submission of paper 

claims, it is imperative that claims are 

“clean” and accurate, i.e. employ proper 

use of CPT procedure codes, modifiers, 

and ICD-9 diagnosis codes. The 


availability of up-to-date coding manuals, 

familiarity with current coding literature, 

augmented with attendance at billingrelated 

seminars, are essential tools for 

precise billing. 

Step #4: Obtain “Physician Claims 

Inquiry” Forms From MCMS/ 

SCCMA 

These bright green forms, 

identified with the MCMS/SCCMA logo, 

garner excellent results when affixed to 

claims that seem to be “hung-up” in the 

system. Attach this attention-getting form 

to a copy of the original claim(s) and 

resubmit to the carrier—30 days after the 

first submission for PPOs and 45 days for 

HMOs. 

Step #5: Request Help From MCMS/ 

SCCMA RAP 

After 30-45 days, if there is 

no response to the “Physician Claims 

Inquiry,” complete and sign an RAP form, 

and attach a copy of the claim, the patient’s 

insurance card, along with any related 

correspondence, and mail to: 

Monterey County Medical Society or 

Santa Clara County Medical Association 

700 Empey Way 

San Jose, CA 95128 

To request “Claims Inquiry” & 

“Reimbursement Advocacy” forms, Please 

contact one of the following: 

Fax 408/289-1064 

Call 408/998-8850 Ext. 3007 

Web www.sccma.org 

or www.montereymedicine.com 

Mail See above address

MEMBER BENEFIT: MEDIcal BIllING, cOllEcTIONS, & OFFIcE MaNaGEMENT SERVIcES 

DO it yOurself Or seek help With yOur 

cOllectiOns anD billing 

By Mark Christiansen, BME General 

Manager 

More Patient Accounts Are 

going Delinquent 

Uncompensated care, which is 

made up of charity care and unpaid patient 

bills, cost U.S. hospitals $34 billion in 

2007, according to the American Hospital 

Association. In addition, in 2007, 41% of 

working-age adults had trouble paying 

medical bills or medical debt, up from 34% 

in 2005, according to a Commonwealth 

Fund Biennial Health Insurance Survey. 

The volume of delinquent health 

care debt has undoubtedly increased in 

the last few years. When it comes to the 

number of patients that are either unable 

or unwilling to pay their medical bills, 

the pond has grown larger, and in terms 

of patient ability to pay, the pond has also 

grown shallower. 

Cost Cutting by Doing It 

yourself 

In these trying economic times, 

many providers are tempted to take on the 

jobs of collections and billing in-house, 

rather than “pay” someone else. Cost 

cutting is something all of us are doing. 

As the attorney for the Bureau of Medical 

Economics (BME), physicians often ask 

what steps they can take to file suit in small 

claims court. Whether suing a patient 

for services rendered or suing for proper 

compensation from an HMO involving a 

balance billing issue, I believe time is better 

spent by our members creating wealth in 

the venue for which they trained. 

Physicians are completely capable 

of successfully prosecuting their cases in 

small claims court. That is not the issue, 

but rather whether it is a good use of a 

physician’s time and resources. Aside from 

spending a morning or afternoon in court, 

once a judgment is rendered in favor of 

the physician, the judgment must then be 

enforced in order to collect monies owed 

and requires additional uncompensated 

time by the physician or his or her staff. 

The results are not always an indicator of 

success. Only 30% of health care accounts 

yield 90% of cash collections. 

Why Pay a Billing Company? 

When it comes to billing, many 

are turning to practice management 

systems as the “cure all” for their billing 

needs. These systems are definitely useful, 

especially if set up and monitored by a 

competent biller who is also a certified 

medical coder (CMC). These systems do 

not replace the expertise of a qualified 

medical biller, preferably one that is also a 

CMC. 

According to a Standard and 

Poor’s Industry Survey dated March 27, 

2008, of Hospital Net Revenue Collected, 

COMPAny: Bureau of Medical economics (BMe) 


a little over 90% came from insurance, 

50% to 60% was recovered after insurance, 

and only 8% to 10% was recovered from 

the uninsured. These figures emphasize 

the importance of a qualified medical 

biller, who understands the ins and outs of 

the insurance industry, to identify issues 

in order to properly bill and appeal your 

claims for full reimbursement. 

How Do I Choose a Collection 

Agency? 

Physicians should look for a 

collection agency that has training and 

experience in medical collections. Health 

care debt is a type of debt people don’t 

choose to incur. A good collection agency 

should be able to empathize with the 

patients. It should be friendly and firm, 

but not a “friend” to the patient. After all, 

recovery for the physician is the goal. BME 

has been in the collections business for 

over 60 years and specializes in medical 

collections. 

No physician should ever pay 

for services prior to results. Fees should 

only be charged after monies have been 

collected. Most collection agencies 

Continued on page 39 

MCMS/SCCMA MeMBeR BeneFIt: An affiliate of SCCMA, BMe has a 

recovery rate approximately twice the national average. Members receive a 

5% discount off the basic rate for collections. (Rate based on volume—you 

only pay if they collect.) the billing rate is based on provider productivity. 

COntACt: For billing information, contact yolonda Rubio, CMC at 408/998- 

5811 ext. 3002. For Collections, contact Karen Jorgenson at 408/998-5811 ext. 

3034.

MEMBER BENEFIT: TPO HUMaN RESOURcE MaNaGEMENT 

Who we are: TPO is an award-winning HR Consulting Firm serving primarily 

the Bay Area. Typical services include general HR consulting, employee 

handbook development, neutral third-party investigations into employment 

matters including harassment, managerial training on HR regulatory and 

leadership skill-building, and helping employers maintain current best HR 

practices. 

How we work with SCCMA and MCMS Members: Over the past 15 years, TPO has provided HR support 

to SCCMA as well as the members of SCCMA and MCMS. TPO has facilitated numerous HR training programs 

for members to attend and has provided many articles throughout the years. SCCMA and MCMS members 

receive a free initial consulting call and then 10% off the initial work with TPO. 

SCCMA/MCMS Members receive a FREE initial telephone 

consulting call (up to 15 minutes) with a qualified HR Consultant. 

Examples of Common Consulting Calls: 

“An employee just told me she is pregnant and gets 7 months off…is that right?” 

“I have an employee with poor performance…how do we get him ‘on-board?’” 

“I want to terminate an employee, but am not sure if we can…help!” 

“An employee is demanding back overtime pay…we paid him a salary to avoid this!” 

-Contact Melissa Irwin, Sr. Consultant: 831/688-4196 or melissai@tpohr.com- 

Two Common Questions Medical Practice Management Ask: 

Q: In light of the holidays that are just around the corner, what are my obligations as an employer? 

A:  There are two important points to remember: 

1. Private employers are not required to be closed on holidays, nor are they required to provide premium 

pay to employees in non-exempt positions when employees work on holidays. The typical number of 

holidays provided ranges from 6-10 days. 

2. Overtime is based on actual hours worked, therefore, hours paid as holiday pay where the employee 

was not working are not considered when calculating hours worked. 

When determining holiday policies, TPO works with each client to help them consider a number of issues, 

including the following: 

• Will your business close on certain holidays or remain open? 

• Who is eligible for holiday pay? Only 40+ hours per week employees? Or, is it prorated to part-time 

workers? What about introductory status (typically those working less than 90 days) employees? 

• When an employee works on a holiday, what will the premium rate in addition to their regular rate 

be? None? A total of 1.5 times the regular rate? A total of 2.0 times the regular rate? Other? 

• When an employee is not working on a holiday, will the employee receive holiday pay? Will it be a 

flat amount? An average daily amount? The number of hours otherwise worked on that day? 

• Does it make sense to eliminate “holiday pay” and instead put extra days into vacation or Paid Time 

Off (PTO) that can then be “cashed-out” to receive extra compensation on a “holiday” of the 

employee’s own choosing? This is an especially important question if an employer provides “floating 

holidays,” since they may be considered the same as vacation by the State of California, which will 

be discussed in our next tip. 

Remember that employees in exempt positions do not get holiday premium pay, rather, their salary 

continues uninterrupted on that day. An exempt employee who works on a holiday might be allowed to 

take another day off, if the employer chooses. 


Welcome MCMS members! 

With TPO’s main office in Monterey, we look forward to providing HR information to you! 

Q: I know that in California, vacation is a vested benefit that must be paid upon separation of 

employment, but I am confused about PTO, floating holidays, and personal days: are these vested, too? 

A: In California, when employers allow employees to take days off with pay and the 

employee can choose when and/or why they want to take that time off, the days off are an 

earned (vested) benefit and the accrued portion must be paid out upon separation of 

employment (vacation and paid time off (PTO) are the classic examples). 

When employers require the paid time off to be taken for a specific reason and/or day, that 

time is not an earned (vested) benefit and, therefore, it need not be paid out upon 

separation of employment (sick leave and holidays are the classic examples). 

How the company defines “floating holidays” and “personal days” will determine if such time 

is “vested” and if it must be paid upon separation of employment. 

√ Example 1 – Personal Days: Employees at XYZ Company each calendar year are given three 

“personal days” to take whenever they want in the year. On October 31, employment separates 

and the employee had not used any of the three days. In this situation, the final paycheck must 

include 2.5 days of the accrued, but unused floating holidays (10/12 of 3 days). 

√ Example 2 – Birthday: Employees at ABC Company are given their birthday off with pay each 

calendar year (if the birthday falls on a day usually not worked, the employee can take the usual day 

worked before/after off). An employee whose birthday is December 10 separates employment on 

October 31. In this situation, the final paycheck does not need to include a prorated portion of the 

birthday day off. 

√ Example 3 – Floating Holidays: Each calendar year, employees at LMN Company are given a 

sheet listing the dates of 12 holidays and employees are allowed to take any eight of the 12 off. On 

October 31, employment separates and the employee had not used all of the eight days. In this 

situation, the final paycheck does not need to include a prorated portion of the floating holidays not 

taken. 

What “Vested” Means: Time that is “vested” has been earned by the employees and cannot be taken away. 

However, you may institute a “reasonable cap” in compliance with California law. Such a cap is typically 1.5 – 

2.0 times the current accrual rate. Once employees reach the cap, they do not earn any more time until they 

take time and reduce the bank below the cap. This is the most common option. Remember that the bank of time 

(up to the cap) must be paid out upon separation of employment. 

TO DO: Make sure that your actual practices match your written policies! In today’s economic climate, many 

employers want to take a look at their benefit policies to make sure they are appropriate for today’s medical 

practice. 

Use your “free consulting call” for being an SCCMA and MCMS member 

and contact TPO at: 831/647-7292. 

www.tpohr.com 

©2009 TPO – This information is designed to be accurate in content. TPO provides human resources support services and is not 

engaged in rendering legal, accounting, or other professional services. Readers are advised to consult legal counsel on matters 

involving employment law or important personnel policies and practices before adoption or implementation. 


Is the current economic crisis over and the worst 

behind us? 

This has been the most popular question and of course, 

the most difficult to answer! 

Back in early March investors and analysts were actively 

debating whether the US would fall into another Great Depression. 

The financial system was seizing up, few had faith in our policy 

makers, and the markets continued to spiral lower. However, 

beginning in mid-March it became apparent that the authorities had 

the tools (and were willing to use them) to prevent a repeat of the 

Depression and the panic began to ebb. We came perilously close to 

a systemic breakdown. 

Based on the opinions of economists and financial market 

analysts who we respect economic activity and credit conditions 

appear to be stabilizing, and even the national housing markets 

show some signs of bottoming. 1 This is not to say that it is easy 

sailing from here on out. There are huge issues such as inflation/ 

deflation, fiscal policy against a backdrop of a $12 trillion national 

debt, deleveraging and more that remain unresolved. 

Nouriel Roubini, Professor of Economics of NYU, 

and an economist who correctly anticipated the Crash of 2007- 

2009, suggests that we may experience a “W” style or double-dip 

recession where we get to 2010 and then potentially undergo a 

second down-leg before getting back onto the road to recovery. 2 

Other analysts like Nobel Prize winner Paul Krugman think we 

are in for a long period of anemic growth, perhaps like Japan in the 

1990’s. 3 And then there are some highly pessimistic writers like 

Martin Weiss who suggest we are on the verge of a Second Great 

Depression. No matter what, this economic downturn is unlike any 

other we have experienced. Its advent was much quicker and the 

decline much deeper than anything we have seen before, so we need 

to be circumspect as to what shape the recovery will take this time. 

What is the “Lost Decade” financial writers refer to? 

Some are referring to Japan during the 1990s; most are 

referring to the fact that the stock market in the United States lost 

money during the period between January 2000 and June 2009. On 

an annualized basis, the S&P 500 lost 3.2% per year over this entire 

period. The chart below illustrates this point quite clearly. It shows 

MEMBER BENEFIT: FINaNcIal PlaNNING 

legacy Wealth aDvisOrs 

Questions and Answers 


the S&P from 1997 through June 2009, and as you can see, the 

index is back to late 1997 levels. 

At least historically, most decades in the U.S. have shown 

positive overall returns for stocks. Obviously, equities did very 

well during the decades of the 1980s and 1990s, but even during 

the turbulent 1970s, the S&P grew at an annualized 5.9% per year. 

One has to go back to the Great Depression era of the 1930s to find 

another decade where stocks lost ground over the entire period. 

During the 1930s, stocks lost an annualized 0.1% per year. 

We probably shouldn’t lose sight of the fact that even 

though the S&P hasn’t generated returns during this decade, other 

areas of the markets have performed reasonably well. The table 

below illustrates this point: 

Asset Class Returns – 1/1/2000 to 6/30/09 

Index Annualized Returns 

S&P 500 -3.2% 

Vanguard Emerging Mkts Index +7.3% 

Natural Resource Stocks* +7.2% 

Vanguard Intermediate Bond Index +6.6% 

Vanguard REIT Index +6.4% 

Commodities** +4.6% 

* Goldman Sachs Natural Resources ** Goldman Sachs Commodity Index 

Almost always the media focuses on the main domestic 

indexes with little coverage of the overseas or alternative asset 

classes. So, from the perspective of an investor in only S&P 500 

index funds this has certainly been a lost decade. However, for those

invested in bonds, alternative assets, and other equity asset classes 

this decade has been far from a disaster. 

What will the economic picture in the u.S. look 

like going forward? 

Anyone attempting to answer this question must first 

acknowledge that we live in a highly uncertain global environment. 

Certainly, the financial and economic crisis of the last couple years 

has highlighted a number of flaws in the U.S. and global economic 

structure that can help with predicting the future, but given the 

number of moving parts, any economic and market view must 

remain flexible. As we noted earlier, the second half of 2009 will 

show modest economic growth in the developed world, due in 

part to the massive fiscal and monetary stimulus of the last several 

months. However, by past standards, the recovery in the U.S. and 

the rest of the developed world will be subdued as unemployment 

rates are likely to stay unusually high for quite some time. This 

will continue to pressure wages and consumer spending just as 

consumers are being pressured to rebuild their savings. 

Looking beyond the next 6-12 months, the developed 

world appears to be headed for a roller-coaster economic and 

financial environment that looks nothing like the last decade. A 

normal economy, as we used to know it, requires easily-available 

credit and, on the other side, a willingness of consumers and 

businesses to borrow. This decade’s boom was characterized by 

a massive credit overshoot, fueled by optimistic assumptions on 

the part of both borrowers and lenders. The pendulum has now 

swung the other way and the credit environment, the need to reduce 

debt, and almost certainly higher taxes will represent structural 

headwinds for the next several years. This doesn’t preclude a 

cyclical recovery over the next year, but it adds huge uncertainty to 

the magnitude and durability of any longer-term recovery. 

We wouldn’t be shocked to see the continuation of what 

is called a Secular Bear Market in the U.S. and Europe. Looking 

back at history, there have been relatively long periods where equity 

COMPAny: Legacy Wealth Advisors, LLC 

SCCMA MeMBeR BeneFIt: Legacy Wealth 

Advisors, LLC has been managing SCCMA’s and 

BMe’s reserve investment accounts since 2000. Legacy, 

along with its predecessor organizations, has been 

endorsed for financial planning by the SCCMA since 

1986. they provide financial planning, retirement 

planning, professional money management, and more. 

they will be hosting a symposium (no cost to members) 

on tactical versus buy & hold investment strategies on 

Wednesday, October 7, 2009 at the Double tree Hotel 

in San Jose from 6:30 PM-8:30 PM. Members also 

receive a one-hour complimentary consultation (over a 

$300-dollar savings). 

COntACt: Call Lisa goss at 408/452-7700. 


markets have trended sideways for long periods of time. The decade 

of the 1930s is one example, as is the period of 1966 to 1982, as you 

can see below. 

What are some financial planning implications 

following the Crash of 2007-2009? 

On a national level, this has been a sobering, thoughtprovoking 

experience with some lessons to take to heart. 

In the years leading up to the 2007-2009 recession, many 

people found themselves adopting a get-rich-quick mentality, 

where homes were appreciating rapidly and jobs and income were 

plentiful. Many people leveraged themselves with abandon, used 

their homes and credit cards like ATM machines, and bought things 

they really couldn’t afford. Our national savings rate got close to 

zero, when the bubble burst. 

However unpopular the message may be, now the mantra 

needs to be: consume a little less and set aside a little more for the 

retirement nest egg and other needs, including education funding 

and wants, such as charitable giving. In our opinion, what used 

to be viewed as enough to retire on, unfortunately, may not be 

sufficient. Thanks to continued advances in medicine, we’re living 

longer and our children and grandchildren will be living longer. 

The downside is that our wealth has to last longer, as well. In the 

meanwhile, expenses will continue to go up, not down. Two of our 

primary national security blankets, Social Security and Medicare, 

are grossly underfunded. According to the Economist, the 

unfunded liabilities for these two systems total nearly $480,000 per 

household. 4 Retirement planning projections that we run on behalf 

of clients are increasingly minimizing the likelihood of receiving 

full, inflation-adjusted benefits. These projected benefits will have 

to be pared back, as our national debt continues to spiral out of 

control. And on the tax front, the outlook is equally daunting, as we 

witness local sales taxes reaching 10% and federal and state income 

taxes heading towards 50% for top bracket earners. 

The major lesson from this experience is that we should 

return to the basics and go forward with the credo that we need to


legacy, continued from page 29 

save more and spend less. Inflation wreaks havoc on fixed budgets 

and, whether we like it or not, we will all reach the age where that 

is the case. All of the federal deficits we are running will ultimately 

exact a dear price. Feathering the nest egg needs to be a top priority 

and that may include planning to work a few extra years. 

What are some of the lessons, investment-wise, 

from the 2007-2009 Bear Market? 

What we experienced in October 2007 through March 

2009, when the key benchmark S&P 500 fell nearly 57%, was 

unprecedented in so many ways. 5 Balanced, diversified portfolios 

that were supposed to benefit from having low-correlating assets 

still went down in value. Historically, when stocks went down, bonds 

went up to some degree; when domestic stocks have gone down, 

internationals have gone up, etc. Outside of a few asset classes such 

as Treasuries and cash, most assets went straight down during this 

market correction. It was only an issue of how much, not if they 

went down in value, as there were few places to hide in the “perfect 

investment storm” of our lifetimes. 

However, for those who held on through the recent rally, 

balanced, diversified portfolios, they weathered things fairly well. 

And even those who couldn’t stomach it anymore because of their 

specific risk tolerance and lightened-up equity positions still came 

through the crisis. Also, if our outlook for a continuation of the 

Secular Bear Market is correct, investors should continue to add 

some tactical or active strategies to supplement core buy-and-hold 

portfolios. Even during flat markets there are asset classes that 

prosper, as the period from January 2000 to June 2009 can attest. 

Complementing a buy-and-hold approach with other asset classes 

(bonds, high-yield, commodities, real estate, etc.) will lead to a 

much more diversified portfolio and one that can prosper over the 

coming decade. 

Last of all, the addition of satellite strategies, including 

the selective addition of proven third-party tactical managers who 

avoided the ravages of the 2007-2009 and 2000-2002 bear markets 

and performed well during market upswings, should be considered. 

References 

1. S&P/Case-Shiller Index, April 2009 

2. Financial Times, August 23, 2009 

3. Return of Depression Economics,Krugman 

4. The Economist, June 13, 2009 

5. www2.standardandpoors.com 

Note: This Q & A resulted from recent interviews with Medical 

Economics, Goldline Research, and other organizations. Thanks to 

Gemmer Asset Management with providing some key data.

MICRA: 65,389 REASONS 

WHY DR. JOHN IS A MEMBER 

Since 1975, the Medical Injury Compensation Reform Act (MICRA) has been California’s model professional liability law. MICRA 

works by compensatng injured patients and keeping our premiums stable. Every year, the trial attorneys try to undo MICRA. 

Every year CMA and its county medical socieities protects MICRA. 

2009 MICRA SAVINGS CHART 

Specialty Monterey / 

Santa Clara 

* This is not a weighted average. 

Dade 

County, FL 

Long Island 

New York 

Wayne 

County, MI 

FL-NY-MI 

Average 

Note: Comparison reflects mature annual premium costs for $1 million maximum per case/$3 million maximum for all cases in a given year. 

Wayne County, MI rates are for $1 million/$4 million, coverage levels typically made available at no extra charge to the Michigan policyholders 

of American Physicians Assurance Corporation. 

Sources: NORCAL Mutual Insurance Co. (San Francisco, CA) effective 1/1/2009; First Professionals Insurance Company (Dade County, FLeffective 

3/1/2009-2/28/2010- includes both FIGA assessments totaling 3.61%); American Physicians Assurance Corporation (Wayne County, MI) 

- Rates effective January 1, 2009; Medical Liability Mutual Insurance Company (Long Island, NY) - policy year ends June 30, 2009. 

MICRA 

Savings 

Allergy $3,283 $20,963 $9,265 $16,909 $15,712 $12,429 

Anesthesiology $8,641 $48,913 $32,223 $41,697 $40,944 $32,303 

Cardiology (Invasive) $9,857 $96,079 $40,738 $66,711 $67,843 $57,986 

Cardiovascular Surgery $24,899 $174,690 $100,550 $174,918 $150,053 $125,154 

Dermatology (Lipo/Cosmetic) $23,031 $55,027 $31,472 $23,797 $36,765 $13,734 

Emergency Medicine $14,163 $96,079 $48,737 $87,121 $77,312 $63,149 

Family Practice (Non-Surgical) $8,284 $45,419 $22,948 $33,893 $34,087 $25,803 

General Surgery $23,031 $202,640 $150,824 $143,445 $165,636 $142,605 

Internal Medicine (Non-Invasive) $6,869 $50,660 $31,472 $34,350 $38,827 $31,958 

Neurosurgery $42,902 $251,554 $275,289 $201,512 $242,785 $199,883 

OB/GYN $30,463 $202,640 $167,812 $135,935 $168,796 $138,333 

Ophthalmology (LASIK/Cosmetic) $6,869 $50,660 $31,179 $37,955 $39,931 $33,062 

Orthopaedics $23,031 $148,486 $125,004 $144,667 $139,386 $116,355 

Otolaryngology (Cosmetic) $23,031 $61,141 $97,378 $81,556 $80,025 $56,994 

Pathology $4,781 $45,419 $22,311 $19,524 $29,085 $24,304 

Pediatrics (Non-Surgical) $6,869 $31,444 $22,948 $28,928 $27,773 $20,904 

Plastic Surgery $23,031 $96,079 $97,378 $91,565 $95,007 $71,976 

Proctology $23,031 $69,876 $55,005 $53,751 $59,544 $36,513 

Psychiatry (Non-Shock) $4,781 $24,457 $9,264 $17,853 $17,191 $12,410 

Radiology (Non-Invasive) $6,869 $96,079 $50,496 $45,293 $63,956 $57,087 

Thoracic Surgery $24,899 $174,690 $100,500 $154,089 $143,093 $118,194 

Urology $9,857 $61,141 $55,005 $55,655 $57,267 $47,410 

Average - All Specialties $16,021 $95,643 $71,718 $76,869 $81,410 $65,389 


Monterey / Santa Clara 

physicians are saving 

an average of $65,389 

this year. 

Are you a member?

In the May/June issue of The 

Bulletin, the article, “Electronic Health 

Record Buyers Beware” by Stephen H. 

Carson, MD, described current pitfalls 

to avoid and challenges to face with the 

purchase and installation of an EHR 

system. The following points should help 

physicians become familiar with what to 

embrace and what to shun when taking 

steps to automate records and improve 

work flow prior to taking the EHR plunge. 

• 

Develop a written retention schedule 

of records that meets the needs of 

patients and other legitimate users and 

complies with legal and regulatory 

requirements. The schedule should 

identify what information should be 

kept and for how long, and in what 

form (paper, optical disk, microfilm, 

data repository, etc.). When the 

MEMBER BENEFIT: DOcUMENT MaNaGEMENT SERVIcES 

briDging tO the eventual ehr 

• 

• 

• 

schedule calls for destruction, those 

records must be documented by date, 

method of destruction, description of 

the disposed records, a statement that 

records were destroyed in the normal 

course of business, and a certificate of 

destruction. 

Except in certain circumstances, 

keep in mind the goal is to eventually 

migrate patient records to the EHR. 

Activity is the acid test. It need not be 

done at once, so begin with a section 

at a time. All or part of the process can 

be done in-house or outsourced. When 

doing the work in-house, factor in the 

cost of equipment and its maintenance, 

the cost of employee time, and 

completion date scheduled. 

If outsourcing all or part of the 

conversion process, cost-savings 

can be achieved by having your 

office staff do document preparation 

such as staple removal, repair of 

torn edges, un-pronging sheets, 

etc. Staff can even perform the 

scanning itself, outsourcing to the 

records management vendor only 

the important detail of indexing. If 

using an outside records management 

company to do some or all of the 

process, records that are off-site at the 

center should be easily retrieved, as 

necessary. 

Scanning years and years of inactive 

records is more costly than storing 

paper. The same 40 patient charts in 

a standard storage box housed at a 

record center for under $5.00 a year 

could cost fifty times that amount to 


• 

• 

• 

scan. Here’s how: at a typical cost 

range between $0.06 and $0.13 per 

image to prep and scan a page – and a 

page printed on both sides equals two 

images – scanning records that are 

seldom, if ever, accessed can quickly 

eat into the operations budget. Heavily 

detailed indexing can drive costs even 

higher. 

When total divestiture of business 

obligations is sought due to retirement 

or the sale of a practice, and after 

records which can be destroyed are no 

longer a part of the picture, scanning 

inactive files is something to consider. 

Chances are that the physician buying 

the practice will find it more attractive 

to log onto than to wade through 

mounds of paper files. Other reasons 

to consider scanning old charts are if 

they are used for longitudinal studies 

or necessary in litigation. 

Determine how the online chart is 

to be organized. The granularity of 

electronic chart organization can be 

as detailed as paper-based charts with 

sections for lab reports, notes, billing 

information, RX, and such. This is 

where work flow considerations come 

into play, since more than one set of 

eyes can be on a chart at any time. 

Choose the electronic option. 

Decide if the office will benefit best 

from charts scanned to CD, DVD, 

hard disk drive, FTP site, or to an 

outsourced secure data center. Will 

the scanned records be uploaded to 

the office share drive or kept solely on 

media? Will both billing and clinical

• 

• 

staff benefit from simultaneous access 

to the records? The electronic solution 

should integrate well with users’ 

current work styles and require the 

shortest learning curve. Whichever 

deliverable option is chosen, the 

importance of user friendliness is 

second only to information security. 

A security checklist for CDs, DVDs, 

and hard disk drives is short: make 

sure the disk is encrypted and requires 

strong password login. Once the 

information is downloaded to the 

office system, however, data must 

be protected via internal controls. If 

charts are to be uploaded to an FTP 

site, the conversion vendor should use 

Secure Sockets Layer (SSL) 256-bit 

encryption to transmit via the internet. 

Providing for redundancy is part of 

making sure that records are secure. 

Backup media needs to be securely 

When faced with an illness such 

as my husband Paul’s, some 

seek to travel to far away places 

to fulfill personal dreams. Paul 

had traveled and experienced 

many wonderful adventures in 

his 44 years. In the end with the 

love, compassion, and guidance 

from our Hospice of the Valley 

“family,” we as a family met 

our goal and were exactly where 

we needed and wanted to be... 

at home. 

— Mary S. 

Brad Leary, director social services 

and counseling 

Pam Nates, chaplain 

Deni Wingate, RN 

• 

stored off-site. If archiving to a thirdparty 

data center fits best with your 

practice’s business model, make sure 

the vendor manages its own security 

infrastructure elements, such as 

firewalls and system management 

which involve daily security validation. 

Records archived to a data center 

are only as secure as the viewer used 

to display the images. Not all data 

viewers are created equal, so make 

sure the data center’s viewer is HIPAA 

compliant. 

An ideal data repository archival 

option requires no user licenses and 

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Margarita Vizcaya, 

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offers a low monthly cost for stored 

images. Migration of records from the 

data center to the chosen EHR system 

is a cooperative effort between the data 

center’s IT team and the EHR vendor. 

There are hurtles to clear before 

installing an EHR and solutions to bridge 

the gap between now and then. The takeaway 

from all this is that until your fully 

integrated and interoperable EHR goes live, 

take time to examine your current records 

management processes and make the basic 

decisions that pave the way to an EHR. 

Then begin a conversion program that 

improves work flow and pay as you go. 

MeMBeR BeneFIt: SOuRCeCORP Deliverex has provided 

comprehensive document management services to the health care industry 

since 1973, including medical record imaging and electronic record 

conversion services for over 13 years. 

COntACt: Judy Chandler, CDIA+, at 800/957-5051 x 137 

Hospice of the Valley Celebrating 30 Years of Community Service 

When your patients are coping with advanced illness, they require expert care, compassion and 

personal attention. Whether it is spending time with loved ones, fulfilling dreams, or simply remaining 

comfortable and independent for as long as possible, Hospice of the Valley guides patients and their 

families to meet their goals. 

• The hallmark of hospice care is that it serves 

your patient wherever they live—be it in their home, 

nursing home, hospital or assisted living facility 

• Our interdisciplinary team members consist of 

physicians, nurses, social workers, chaplains, 

hospice aides, volunteers, and grief counselors 

who are experts in palliative and hospice care, 

and who are here to assist you in the 

management of your patient’s 

end-of-life care needs 

• For those dealing with grief and loss, our Community 

Grief and Counseling Center provides families and 

individuals with one-on-one counseling and loss- 

specific support groups to adults, teens and children 

• Since 1979, Hospice of the Valley’s legacy 

of compassionate care, community 

education, advocacy and outreach 

has set the standard for quality 

hospice care state-wide and 

nationally, and we are a locally 

based, run, and supported 

non-profit organization 

For more information please 

contact us. 

Monique Kuo, MD, 

medical director

there are ways to save time and 

money with new services. 

Many practices, after having all 

mailed-in checks recorded, and checks 

from that day’s scheduled patients, produce 

a bank deposit slip; effectively closing the 

day’s banking needs. 

What happens at this point can 

vary: at some practices a key employee or 

manager takes either that day’s, or the prior 

day’s, deposit to the bank; some do it at the 

bank’s night depository on their way home 

from work. Add to this, dealing with checks 

presented by your patients, at the time of 

their office visits. 

As a prelude to doing the daily 

deposit, most practices have received 

mailed-in checks from plans, Medi care 

and Medicaid, Workers Comp, etc. This 

requires the daily tedium of opening the 

mail, sorting out the checks, endorsing the 

backs of the checks to the practice, and 

the preparation of the deposit slip – often 

preceded by someone making copies of all 

the checks. 

Practices should be exploring 

ways to reduce all the effort just explained. 

What follows are options that, singly, and 

in combination, could reduce your labor 

costs, your potential error factors, and the 

temptations of embezzlement by one of your 

staff. 

Here are the options: 

• Direct 

deposit by plans 

• Lock-box service 

• Remote Deposit 

• Courier service 

A. Direct Deposit by Plans 

All practices should have Direct 

Deposit of payments from as many plans 

as possible. Medicare carri ers were the first 

to offer this ser vice a number of years past. 

More recently the major plans, and a great 

MEMBER BENEFIT: PRacTIcE PlaNNING & cONSUlTING 

tiMe tO explOre OptiOns in yOur practice’s 

banking anD check prOcessing activities 

Reprinted with the permission of Conomikes. Contact conomikes@conomikes.com or 800/421-6512. 

number of the smaller plans, are offering 

this service. Basically, you authorize the 

plan to make a direct deposit of their 

payments to your bank—instead of mailing 

you a check, with back-up documenta tion. 

With Direct Deposit you still receive, via 

Internet, documenta tion to back up the 

deposit. 

Advantages to your practice: 

• Immediate 

deposit of funds to your 

account 

• Less mail to open, less work for your 

daily deposit slip 

• Security. No staff member can 

embezzle these high-ticket checks. 

Lock-Box Service 

This is an option for receiving 

your payments securely. 

A number of practices use a lockbox 

service and find it convenient, especially 

for group practices with a lot of checks 

coming in on a daily basis. They also like 

the fact that incoming checks no longer 

provide a temptation for embezzlement at 

the practice: instead, checks go to the bank 

lock-box. 

Here are some highlights. Most 

banks provide lock-box services, so you 

want to talk with your bank representative 

about this service. The way it works is that 

the bank provides you with a P.O. Box at 

your local post office. Your pay ers—patients 

and plans—send their payments to the 

P.O. Box, instead of your office. Your bank 

accesses your P.O. Box at least daily and 

retrieves all the checks and attach ments 

(EOBs and Remittance Advices) that are 

addressed to your practice. 

The bank processes the checks 

and provides you with copies of all the 

documents related to the mailing. In 

other words, they: (1) replace the work of 

opening any mail that has your checks and 


documents; (2) they copy all documents 

and send them along to you, along with 

a receipt for your day’s deposits; and (3) 

they deposit all the checks to your account. 

Obviously the banks are bonded and do this 

for thousands of clients throughout the U.S. 

Advantages to your practice 

• Less clerical work of opening all 

mailed in checks and segre gating the 

paperwork. 

• Less work creating the daily deposit 

slip for mailed-in trans actions 

• Immediate credit of your checks that 

day to your account 

Costs 

The following are estimates and will vary 

from bank to bank: 

• Monthly fee—can range from $150– 

$250 

• 

• 

Transaction fees—30–40 cents per 

item 

Copying fee—10 cents per item. 

There is a new trend with 

banks. They will create an image file of 

your documents so that this data can be 

transmitted to you electroni cally. This 

should reduce the costs somewhat. 

Guidelines: Based on the costs 

charged for a lock-box service, it is probably 

not economical for the smaller practice that 

is processing less than 1,000 checks per 

month. But, when doing your cost analysis, 

ask your bank to provide you with copies of 

recent statements to lock-box clients based 

upon your pre dicted volume of checks. 

Then, you also need to determine if some 

jobs will have to be redesigned. Those 

individuals currently involved in opening 

mail and preparing depos its will now have 

the opportunity to perform other tasks. The 

manager’s job is to determine if the time 

saved can be put to other productive uses.

quickly C. Remote passed Deposit Congress and was 

signed into Check law 21 legislation, by the President. creating 

Remote Deposit services, resulted from the 

Simply stated, the law requires 

banks 9-11 attacks, to which accept forced image the temporary replacement 

shut down checks of airline in flights. lieu Since of the paper original 

checks check travel the issued airways en by route the to the maker 

for drawee payment. bank, the attacks This means exposed this that vul- any 

business, nerability in our able payments to create system. an As image a 

of an original check, can submit 

result Check 21 legislation quickly passed 

check images to its bank, instead 

of Congress having and was to deposit signed into the law by original the 

checks President. themselves. This allowed 

banks, which Simply stated, were the willing law requires to invest 

in 

banks 

image 

to accept 

technology, 

image replace 

the 

ment 

ability 

checks 

to 

do so—because all banks were now 

required 

in lieu of the 

to 

origi 

accept 

nal check 

at least 

issued 

a 

by 

picture 

the 

of maker the for check payment. printed This means on paper that any from 

an business, electronic able to create image. an image of an 

original check, can submit check images to 

Larger its bank, instead banks of with having a to huge deposit stake the in 

the check clearing business quickly 

original checks themselves. This allowed 

saw the cost advantages of moving 

checks banks, which electronically were willing to invest rather in image than 

paying technology, couriers the ability and to do airlines so—because to cart all 

paper banks were to and now required fro across to accept the country. at least a 

Soon picture the of the large check banks printed were on paper exchang- from 

ing an electronic checks image. with one another electronically 

and more and more banks 

began to Larger move banks to with electronic a huge stake image 

processing in the check clearing both business to save quickly money as 

well saw the as cost preserve advantages their of moving stake checks in the 

clearing electronically system. rather than As paying more couriers and more 

banks 

and airlines 

become 

to cart paper 

image 

to and 

capable 

fro across 

for 

receiving as well as sending images, 

fewer 

the country. 

and 

Soon 

fewer 

the large 

checks 

banks were 

must be 

printed exchang ing for checks clearing. with one another electronically 

and more and more banks began 

Remote to move to Deposit electronic image is the processing service both now 

being to save money offered as well by as many preserve banks. their stake This 

is 

in the 

a new 

clearing 

and 

system. 

unique 

As 

way 

more and 

of making 

more 

check deposits to your account at 

your 

banks 

bank. 

become 

No 

image 

longer 

capable 

will 

for receiving 

you need 

to as well make as sending trips images, to the fewer bank and to fewer make 

your checks check must be deposits. printed for clearing. 

Remote Deposit is the service now 

Here’s how it works. At your office, 

being offered by many banks. This is a new 

a scanner is attached to your PC. 

Checks and unique are way of fed making into check the deposits scanner to 

which your account captures at your bank. a digitized No longer image will 

of you the need check. to make Upon trips to completion the bank to make and 

balancing, your check deposits. you click on “transmit” 

and your deposit is made. Deposits 

can be Here’s made how up it to works. 7:00 At p.m. your with 

virtually office, a scanner next is attached day availability to your PC. on 

the Checks deposited are fed into funds. the scanner which 

captures a digitized image of the check. 

There Upon completion are two and processing balancing, you options click 

with any bank’s Remote Deposit. 

on “transmit” and your deposit is made. 

1. The checks are processed as 

digitized Deposits can be images made up of to 7:00 checks. p.m. 2. 

The with virtually second next option day availability is to on convert the 

the deposited checks funds. to Automatic Clearing 

House (ACH) payments. Once this 

happens, There the are checks two processing are no options longer 

a with legal any instrument, bank’s Remote but Deposit. now become 

electronic 1. The ACH checks payments are processed and as fall 

under the rules for ACH, which are 

digitized images of checks. 2. The second 

different than for checks. Also, with 

this option option, is to convert certain the checks types to of Automatic checks 

cannot Clearing be House converted: (ACH) payments. Postal Once Money 

Orders, this happens, Government the checks are checks, no longer certain a 

business legal instrument, checks, but now and become third electronic party 

checks ACH payments like those and fall from under credit the rules card for 

accounts. In any case, the choice is 

ACH, which are different than for checks. 

yours. 

Also, with this option, certain types of 

If checks you cannot decide be to converted: do Remote Postal Deposit, Money 

you Orders, would Government want to checks, keep copies certain of the 

originals, business checks, at your and third practice, party checks for a few 

days, like those until from you credit receive card accounts. your In bank any 

report verifying their deposit. 

case, the choice is yours. 

Exhibit A 

Fees for Remote Deposit services: 

Set-Up Fees 

Scanner options: 

TS215 single feed . . $800 

TS230-65 (65 items 

per minute) . . . . . .$1,215 

TS230-100 (100 items 

per minute) . . . . . .$1,400 

Scanner warranty: 

Year 1 included with price 

of scanner 

Year 2 . . . . . . . . . . . $172 

Year 2 & 3 . . . . . . . . $275 

Year 2, 3, & 4 . . . . . $395 

Remote Deposit one time 

set up fee . . . . . . . . . $100 

Processing Fees 

Remote Deposit monthly 

maintenance . . . . $75/mo 

Check image capture 

0–500 per mo. . . . $.11/ea 

01–2500 per mo. . $.09/ea 

Over 2500 . . . . . . $.07/ea 

ACH capture 

(if chosen) . . . . . $.06/ea 

Internet Image Access (up 

to 5 users) . . . . . . $25/mo 

Over 5 users . .$10/ea/mo 

CD ROM 

(optional) . . . . . . . .$25/ea 

Source: UMB 


Fees. Exhibit If you A decide displays to do Remote the fees that 

the Deposit, banking you would chain, want UMB, to keep copies charges 

for of the their originals, Remote at your Deposit practice, services. for a few 

When days, until investigating you receive your Remote bank report Deposit 

with 

verifying 

your 

their 

bank, 

deposit. 

be sure to get similar 

itemization. Your scanner costs 

and your Fees. monthly Exhibit A check displays imaging the fees 

costs that the will, banking of course, chain, UMB, be dictated charges by 

your for their volume Remote of Deposit check services. activity. When 

investigating Remote Deposit with your 

D.Courier Pick-Up at Your 

bank, be sure to get simi lar itemization. 

Office 

Practices Your scanner could costs and consider your monthly talking check 

with imaging their costs will, bank of course, representatives 

be dictated by 

about your volume a daily of check courier activity. service. Your 

bank could provide this service or 

D. Courier Pick-up at your Office 

contract it out to a courier service, 

for a daily Practices pick-up could consider of your talking bank 

deposit with their at bank your representatives office. about a daily 

courier service. Your bank could provide 

This this service is an alternative or contract it out to to consider, a courier in 

the following situations: 

service, for a daily pick-up of your bank 

1. deposit If the at your fees office. for a Lock-Box service 

This and/or is an Remote alternative Deposit to consider, ser- 

in the vice following are too situations: daunting for your 

volume of activity. 

1. If the fees 

for a Lock-Box ser vice and/ 

2. You do not want any of your 

or Remote Deposit ser vice are too 

employees involved in the risk 

of 

daunting 

going 

for 

to 

your 

the 

volume 

bank 

of 

on 

activity. 

a daily 

2. basis. You do not want any of your employees 

3. You involved do not in want the risk your of going manager, to the bank or 

key on a employee, daily basis. taking time away 

3. from You do work not want to go your to manager, the bank. or key 

employee, taking time away from work 

Fees: to One go to the bank bank. quoted the following 

fees Fees: for One a daily bank quoted pick the up follow- by a 

courier: 

ing fees for a daily pick up by a courier: 

Monthly—$90–$100, i.e. i.e. $5 per per 

day. Does not not pick pick up cash, up cash, 

Armed courier—monthly—$250 

Armed courier—monthly—$250 

–300, i.e. i.e. $15 $15 per day. per Will day. also Will pick up also 

pick cash. up cash. 

Bank Charges Are negotiable 

Bank Charges Are 

Negotiable In this feature article are quotes of 

In fees this that some feature individual article banks are quoted quotes us. 

of Your fees bank that charges some will, individual typically, be banks in the 

quoted same ranges us. as Your those bank quoted. charges However, will, keep 

typically, 

in mind that 

be 

your 

in 

fees 

the 

will vary 

same 

depending 

ranges 

as those quoted. However, keep 

in upon mind your activities that your with fees the bank. will The vary 

depending larger your activities upon your – borrowing, activities daily with 

the deposit bank. balances, The larger etc – the your less your activities bank 

– is borrowing, likely to charge. daily It may deposit pay to discuss balances, 

etc these – services the less with your other bank banks is in likely your to 

charge. It may pay to discuss these 

community. They may be wiling to offer 

services with other banks in your 

community. you lower fees They to get you may to change be wiling to their to 

offer bank. you lower fees to get you to 

change to their bank

Many physicians and their 

staff are not aware of the changes to 

HIPAA created by the HITECH Act 

(American Recovery and Reinvestment 

Act of 2009). Among other things, 

the Act strengthens requirements for 

business associates, creates new rules 

on how breaches of either paper or 

electronic protected health information 

must be handled, and even defines 

new obligations for providing patients 

access to their medical records if you 

use an EMR! 

For many years, the Monterey 

County Medical Society and Santa 

Clara County Medical Association 

have worked with and endorsed 

PrivaPlan Associates as official HIPAA 

experts. Many association members use 

the CMA/PrivaPlan HIPAA Privacy 

and Security ToolKit on CD-ROM 

which is updated annually by PrivaPlan 

and CMA to reflect changes in HIPAA 

and California law. (For example, last 

year California passed new regulations 

governing handling of electronic 

medical information and responding 

to possible medical identity theft.) 

PrivaPlan also produces a multimedia 

HIPAA training program that provides 

an affordable way to keep your practice 

trained on HIPAA. PrivaPlan users 

who maintain their annual subscription 

also benefit from a regular newsletter 

with information, tips, and training, as 

well as a free hotline or email service to 

contact with your HIPAA questions. 

MEMBER BENEFIT: HUMaN RESOURcE MaNaGEMENT 

are yOu cOMpliant With the 

neW hipaa regulatiOns? 

Many newer association 

members may be unaware of the value 

and benefits of using PrivaPlan, so we 

encourage you to purchase the CD. 

Existing members who have purchased 

PrivaPlan, in the past can obtain 

updates for a very affordable price. 

PrivaPlan will be releasing an 

update in the next 45 days to cover the 

HITECH Act changes. All medical 

practices should be sure to understand 

these changes and appropriately update 

policies and procedures. 


Monterey County Medical 

Society and Santa Clara County 

Medical Association will be sponsoring 

additional programs in the near future 

with PrivaPlan to ensure you have as 

much education as possible. 

To purchase the CD or 

multimedia training, please call 

PrivaPlan directly at 877/218-7707. 

Be sure to mention you are a CMA 

member, so you can get your discount. 

Tracy Zweig Associates 

A REGISTRY & PLACEMENT FIRM 

Physicians 

Nurse Practitioners ~ Physician Assistants 

Locum Tenens ~ Permanent Placement 

Voice: 800-919-9141 or 805-641-9141 

FAX: 805-641-9143 

tzweig@tracyzweig.com 

www.tracyzweig.com

We fight frivolous claims. We smash 

shady litigants. We over-prepare, and 

our lawyers do, too. We defend your 

good name. We face every claim like 

it’s the heavyweight championship. 

We don’t give up. We are not just your 

insurer. We are your legal defense 

army. We are The Doctors Company. 

Robert D. Francis 

Chief Operating Officer 

The Doctors Company 

The Doctors Company built its reputation on the aggressive 

defense of our member physicians’ good names and livelihoods. 

And we do it well: Over 82 percent of all malpractice cases 

against our members are won without a settlement or trial, and 

we win 87 percent of the cases that do go to court. So what do 

you get for your money? More than a fighting chance, for starters. 

To learn more about our medical professional liability program, 

call The Doctors Insurance Agency at (415) 506-3030 or 

(800) 553-9293. You can also visit us at www.doctorsagency.com. 


The Santa Clara County Medical 

Association Alliance is the philanthropic 

and volunteer arm of SCCMA that consists 

of physicians, physician spouses, students 

in training, and friends of medicine. 

Bettering the health in Santa Clara 

County is the main focus of the Alliance. 

In collaboration with other community 

groups, the Alliance provides health 

education, underwriting of projects, and 

legislative support for medical issues. To 

join, please visit the website at http://www. 

sccmaa.clubexpress.com. You will also 

find the most current updates and contact 

information on that site. 

Highlights of 2008-2009: 

The year was an eventful 

one, beginning with the May 2008 

installation of Debbi Ricks as two-year 

president of the statewide organization, 

the California Medical Association 

Alliance (CMAA). Highlighted state 

and county events included participation 

at the April State Legislative Day, the 

Gardner Family Health Fair, Sundaes on 

Sunday, the speakers’ series, the CMAA 

Fall Leadership Conference, the annual 

tree decorating event at Valley Medical 

Center, assistance of medical students at 

their career day workshop for high school 

students, and a trip to the DeYoung 

Museum. Dr. Madhur Bhatnagar received 

the CMAA’s Excellence Award at the 

CMA Foundation dinner (as well as the 

2008 Dedicated County Alliance Member 

Award). Carolyn Miller was recognized 

as the 2009 Dedicated County Alliance 

Member of the Year at the June 2009 

SCCMA Awards Banquet. Interspersed 

with these events were organizational 

meetings, coffee, and luncheon gatherings. 

upcoming events: 

May 2009 brought the installation 

of the 2009-2010 officers: Mary Hayashi, 

President; Kathleen Miller, Secretary; 

Carolyn Miller, Treasurer; Siggie Stillman, 

Membership; Meg Giberson, Legislative 

Representative; and Jean Cassetta, Health 

Promotion. Two ongoing projects include 

SaNTa claRa cOUNTY MEDIcal aSSOcIaTION allIaNcE 

sccMa alliance neWs 

September, 2009 

rapid progress toward a 501(c)(3) nonprofit 

status for our organization and a 75- 

Year Celebration Book, which will provide 

a visual and verbal summary to mark our 

75th anniversary. 

Although all future events are 

described in detail on the website, some 

upcoming events are listed below. Please 

join us! For more information, contact 

Dedicated County Alliance Member 

Dr. Madhur Bhatnagar 

CMAA President Debbi 

Ricks’s Installation 


Mary Hayashi, 408/395-4661 or Jean 

Cassetta, 408/998-8850 Ext. 3010. 

October 16-19, 2009: Fall 

Leadership Conference, Anaheim. 

november tBA: Holiday Tree 

Decorating, Valley Medical Center. 

December 14, 2009: Holiday 

Luncheon, 11 AM-2 PM. 

Santa Clara County Medical Association Alliance 

2008-09 

Sundaes on Sunday 

Joint Medical Association/Alliance Event 

Suzanne & Steve Jackson’s home 

Annual Tree Decorating at Valley 

Medical Center 

Wayne Miller, Courtney Lewis, 

Carolyn Miller, SCCMAA President 

Dr. Bhatnagar 

Receives 

CMAA’s Excellence 

Award 

at the 

CMA 

Foundation Dinner 

SCCMAA President Carolyn Miller’s Installation 

Kathleen Miller, Siggie Stillman, Mary Hayashi, 

Carolyn Miller, and Meg Giberson 

Gardner Family Health Fair 

Carolyn Miller, Jean Cassetta, Kathleen Miller, 

Debbi Ricks, Siggie Stillman 

CMAA Fall Leadership Conference Committee 

Jean Cassetta, Heather Goodman, Suzanne Jackson, 

Debbi Ricks, Kathleen Miller, Meg Giberson, Mary Hayashi 

Ladies’ Day Out in San Francisco 

Limo Ride to Yves Saint Laurent at the DeYoung Museum 

Pat Baker, Sarah Stillman, Siggie Stillman, Kathleen Miller, 

Carolyn Miller, Mary Hayashi, Mila Mitchell 

!

Do It Yourself or Seek Help With Your collections…, continued from page 25 

will charge a percentage of the recovery. BME only charges a 

percentage on monies recovered and has discounts for members 

of the Santa Clara County Medical Association and the Monterey 

County Medical Society. 

In previous issues of The Bulletin, you have seen changes in 

the Health Insurance Portability and Accountability Act (HIPAA), 

the recently enacted Health Information Technology for Economic 

and Clinical Health (HITECH) act, as well as the enactment of 

Red Flag rules for medical identity theft. Your collection agency 

should comply with all of these laws and regulations. BME is fully 

compliant with each. 

You should be able to freely communicate with your 

collection agency. Your questions shouldn’t go unanswered. BME 

has a full-time dedicated client relations director to address the 

questions and concerns of its clients. 

How Do I choose a Billing Company? 

One should choose a billing company with qualified 

medical billers that are Certified Medical Coders (CMCs). Full 

reimbursement only comes after diligent follow-up and, when 

RECORD MANAGEMENT SOLUTIONS 

Electronic Document Management 

• Application Services 

• Business Process Automation Solutions 

• Scanning & Conversion Services 

Record Retention Management 

& Confidential Destruction 

Secure Offsite Storage 

1.800.957.5051 x137 

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necessary, with appropriate appeals. Experience in dealing with 

insurance carriers and HMOs is a must. BME has this experience. 

Additionally, its CMC billers have resolved many Palmetto issues 

for its clients. 

Your collection agency and/or billing company should be 

knowledgeable of the Balance Billing Act and in identifying those 

accounts that fall within the purview of the act. The last thing a 

physician needs during these difficult times are issues with the 

Department of Managed Health Care. BME has had success in 

resolving balance billing issues for its clients. 

Finally, the bottom line is return on your investment. 

You have invested your time and resources in providing your 

patients with quality medical care. You are entitled to proper 

reimbursement. 

BME is endorsed by the California Medical Association, 

the Santa Clara County Medical Association, and the Monterey 

County Medical Society. BME is a full-service collection agency 

and billing company meeting the needs of its clients for over 60 

years.

classifieD aDs 

office space for 

rent/lease 

first VacancY in oVer 32 Years! 

• SALINAS 

Located on West Laurel Drive in Salinas. 

This suite is approximately 4,000 sq. ft. 

Ideal for a medical partnership or satellite 

facility. For information please call Dr. 

Paul Farrell at 831/424-9853. 

sHareD MeDical space 

AVAILABLE FOR LEASE • WEST SAN 

Jose near cUpertino 

Approximately 1,000 sq. ft., four rooms 

with shared reception area, waiting room 

area, and kitchen area. Great visibility on 

De Anza Blvd. Call brokers to tour: Alice 

Teng, 408/282-3808. 

MEDICAL SUITES • LOS GATOS – 

SARATOGA 

Two suites, ranging from 1,000 to 1,645 

sq. ft., at gross lease cost. Excellent 

parking. Located next door to Los Gatos 

Community Hospital. Both units currently 

available. Call 408/355-1519. 

MeDical office for lease/ 

sUBlease/sale 

Office in close proximity to O’Connor 

Hospital for lease/sublease/sale. Please call 

408/923-8098 for more information. 

MEDICAL SUITES • GILROY 

First class medical suites available next 

to Saint Louise Hospital in Gilroy, CA. 

Sizes available from 1,000 to 2,500+ sq. 

ft. Time-share also available. Call Betty at 

408/848-2525. 

MeDical office space for lease 

• SANTA CLARA 

Medical space available in medical 

building. Most rooms have water and 

waste. Reception, exam rooms, office, and 

lab. X-ray available in building. Billing 

available. 2,500–4,000 sq. ft. Call Rick at 

408/228-0454. 

OFFICE SPACE FOR LEASE • SAN JOSE 

600–1,900 sq. ft. in West Valley Medical 

Building, second floor, elevator, separate 

entrance. Call Helen at 408/243-6911. 

LOS GATOS OFFICE $1.99 

GROSS/$2.30 FULL 

1,500 – 9,000 sq. ft. of offices and/ 

or rehab in heart of Los Gatos. 

www.536NSantaCruz.com. 408/656-8265. 

OFFICE SPACE FOR SUBLEASE • MTN 

VIEW 

Two exam rooms and one doctor’s office, 

five days a week, shared waiting room, 

in Mountain View, on South Drive. Call 

650/967-7471. 

OFFICE TO SHARE • LOS ALTOS 

Options include two exam rooms plus 

office. Newly remodeled office space 

perfect for cosmetic dermatologist, facial 

plastic, or plastic surgeon. Near El Camino 

Hospital. Call 650/804-9270. 

BRAND NEW HIGH END 

MEDICAL CONDOS– 

DOWNTOWN LOS GATOS 

Design/build-to-suit opportunities 

for sale/lease. On-site parking. In the 

heart of prestigious downtown Los 

Gatos. Unit sizes 1,400 sq. ft. and up. 

Contact Matt–408/282-3835. www. 

colliersparrish.com/losgatos. 


office eXaM rooMs to lease 

Two nice and large exam rooms 

(dedicated), shared waiting room. Available 

five days a week, 2585 Samaritan Drive, 

San Jose. Please call 408/356-7788 for 

more information. 

MEDICAL OFFICE TO SHARE • 

sUnnYVale 

One exam room plus one large office, 

shared waiting room and front office. 

Newly built, 1,280 sq. ft. Call 408/438- 

1593. 

PRIME MEDICAL SPACE • PRIME SAN 

Jose location 

2,048 sq. ft. ready to occupy medical 

office, previously occupied by RAMBLC 

Pediatric Group. Located at 6140 Camino 

Verde Dr, San Jose, in the Santa Teresa 

Medical/Professional Center across from 

Kaiser Hospital. Call Virginia at 408/528- 

0571. 

office sUite aVailaBle 

Location is highway 85 at De Anza. One 

suite available. Currently configured with 6 

tx rooms/offices, entry, large master office 

with balcony. Street signage to 100,000 

cars a day. Marble entry. Zoned medical/ 

office. No variance required. Looking for 

established business/practice that values 

prime location in beautiful building. 

Please be qualified. No start ups. Contact 

Dr. Newman at 408/996-8717. Brokers 

welcome if you have a client. Compare with 

space by Good Sam at $2.00 sq. ft. + 3 N. 

ELEGANT AND SPACIOUS LOS 

GATOS MEDICAL OFFICE 

Available to share with prominent aesthetic 

dermatologist. This upscale office has 

seven exam rooms, a lab, two large 

administrative offices, and a marble and

atHerton sQUare MeDical/ 

DENTAL BUILDING 

A newly upgraded Class A building 

offers a variety of spaces from 1,166 

sq. ft. and up for medical/dental 

use at 3301-3351 El Camino Real, 

Atherton. Tenant improvement 

allowances available to design suite 

to meet your needs. Excellent onsite 

parking, close to Stanford and 

Sequoia. Trask Leonard, Bayside 

Realty Partners, 650/282-4620 or 

Alice Teng, Colliers, 408/282-3808. 

granite waiting room with comfortable 

seating for eight patients. Call Irene at 

408/358-5757 to schedule your private 

showing. Price is negotiable. 

MEDICAL OFFICE FOR LEASE • LOS 

altos 

Fantastic location. The unit is 1,050 sq. 

ft. Four + exam rooms, plus an additional 

doctor’s office. Large reception and waiting 

room. Includes basement for storage. 

Located on Altos Oaks near El Camino 

Hospital. Two private parking spaces. Call 

650/575-6889. 

MEDICAL OFFICE • O’CONNOR 

Hospital area 

Office in elegant medical office building 

with ample parking, within one block 

of O’Connor Hospital. 1,600 sq. ft. to 

share, 800 sq. ft. per physician. Common 

bathroom and waiting room, no triple net, 

$2.75 per square foot. Call 408/292-3609 

and leave a message. 

MeDical office space 

aVailaBle for lease 

2,045 RSF, Class A Medical Office. 

Conveniently located near O’Connor 

and Good Samaritan Hospitals. 

Easy access to Highway 17. Parking 

5/1,000. For questions and touring 

information, call Colliers, Alice Teng, 

408/282-3808 and Patrice DeLorey, 

408/282-3848. 

priVate practice/ 

office for sale 

FOR SALE OR LEASE • MENLO PARK 

MEDICAL BUILDING 

New construction high end medical 

building on Menlo Park/Atherton border. 

11,885 sq. ft. building. Divisible into four 

condos (2,400 sq. ft.+). Great parking. 

Contact Dan (agent) for pricing and 

additional information at 650/473-4773 or 

email: dskehan@ccarey.com. 

priVate practice for sale 

IM/FP/GP. Primary care practice for sale, 

including inventory and equipment. Close 

to O’Connor Hospital. If interested, please 

call Stacy at 408/297-2910. 

priVate practice for sale 

Available immediately. Urgent Care/Family 

Practice in West Valley area. Established 30 

years, $0 down. Contact Helen at 408/476- 

3450. 

LOS GATOS OFFICE FOR SALE 

Luxurious 9,000 sq. ft. office with 

seven offices, full kitchen, 3,700 ft. 

Physical Therapy floor, lockers, showers. 

www.536NSantaCruz.com or 408/656- 

8265. 

eMploYMent 

opportUnitY 

occUpational MeDicine 

PHYSICIANS • PRIMARY CARE, 

ORTHOPEDICS, & PHYSIATRY 

Our occupational medical facilities offer 

a challenging environment with minimal 

stress, without weekend, evening, or “on 

call” coverage. We are currently looking 

for several knowledgeable and progressive 

primary care and specialty physicians 

(orthopedist and physiatrist) interested 

in joining our team of professionals in 

providing high quality occupational 

medical services to Silicon Valley firms 

and their injured employees. We can 

provide either an employment relationship 

Continued on page 42 


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classified ads, continued from page 41 

including full benefits or an independent 

contractor relationship. Please contact 

Dan R. Azar MD, MPH at 408/790-2907 

or e-mail dazar@allianceoccmed.com for 

additional information. 

CONDO/COTTAGE 

rentals 

HoUse for rent/sale in taHoe 

Northstar at Tahoe house for rent, lease 

or for sale, walk to ski area, four bedroom, 

three bath. Call 408/348-0926. 

OCEAN FRONT CONDO ON KONA 

coast 

Beautiful setting on the big island of 

Hawaii. Sleeps four. Great Views. Call 

408/354-3253 for more info. 

Owners 

Bill & Debbi Ricks 

408-354-5613 

Pajaro Dunes 

Beachfront Condo 

Shorebirds #58 

2 Bedroom -- 2 Bath 

Top Level -- Great Ocean View 

Great for Families 

for sale 

BEAUTIFUL HAWAIIAN CONDO 

Poipu Beach, Kauai. Lovely 2 BR/2 BA 

condo, across street from ocean. Recently 

remodeled bathroom and kitchen with 

granite countertops, new carpeting 

throughout. Three lanais with ocean and 

mountain views, and the tropical gardens 

which make the Nihi Kai complex so 

special. Price reduced to $785,000. Call 

650/949-3353. 

OAK MEMORIAL PARK CEMETERY 

plots 

Oak Hill Memorial Park--single plots for 

sale by owner in sold-out hillside section. 

Selling two for $10,000 or all four for 

$18,000 (transfer fees included). No 

brokers involved. Contact Joyce at 408/377- 

Rental Agent 

Pajaro Dunes Company 

1-800-564-1771 

2459. 


WANTED 

peDiatric practice 

Will buy Pediatric practice in South Bay. 

Call 408/455-2959. 

MEDICAL BILLING 

PHYSICIAN NETWORK • MEDICAL 

BILLING AND CONSULTING 

serVices 

Over 18 years of experience managing 

medical and specialty billing; customized 

to fit the needs of your practice. Services 

include, but are not limited to, full medical 

billing (including patient statements), 

coding, authorization, insurance eligibility, 

monthly summaries, and financial 

counseling. Call us today and allow our 

professionals to reduce the frustration and 

time consumed processing medical claims 

and account follow-up, so you can focus 

your valuable time on patient care. Office: 

408/998-8537, Email: physnet@sonic.net.

name Specialty City 

Mary Abusief *REN [*OBG] Palo Alto 

Joel Bronstein US Stanford 

Peter Bui PSHN Santa Clara 

Elwyn Cabebe ON HEM Mountain View 

Charlie Deng EM Alhambra 

Shane Dormady ON HEM IM Mountain View 

Peter Fay IM Sunnyvale 

Ramesh Gopi DR Cupertino 

Tobias Hays *PD San Jose 

Bowen Jiang US Stanford 

Wesley Kong U Mountain View 

Roger Lucero FP Gilroy 

Van Mai GP Santa Clara 

Aditi Mallick US Stanford 

Ingerlisa Mattoch *ATP DMP San Jose 

Anjuli Mehrotra PD AI San Jose 

Vidya Mhamunkar OBG Cupertino 

Richa Misra IM Campbell 

Roberto Neisa US Stanford 

Karen Purcell *REN [*OBG] San Jose 

Christopher Quan IM Mountain View 

Juan Rodriguez US Stanford 

Ankur Sangoi PTH Mountain View 

Clyde Duane Larsen, MD 

*Pediatrics 

2/20/35 – 6/8/09 

SCCMA member since 1974 

MEMBER NEWS & HaPPENINGS 

Welcome 34 new Members! 

Perry A. Olsen, MD 

*Anesthesiology 

5/8/24 – 5/16/09 

SCCMA member since 1962 

in Memoriam 


name Specialty City 

Wendy Shelly REN [*OBG] San Jose 

Takudzwa Shumba US Stanford 

Stephanie Smith US Stanford 

Geoffrey Spencer *GE [*IM] San Jose 

Serena Tan *PD Los Gatos 

Margo Thienemann *CHP *P Palo Alto 

Raymond Tsai US Stanford 

Kevin Wang PMR Santa Clara 

Byron Wilson ON HEM Castro Valley 

Melissa Wu IM Los Gatos 

Calvin Yang P Saratoga 

*Board Certified 

US -- Unspecified 

[ ] Not Practicing

Who are you? We are 

EnviroMerica. We are a Bay Area-based 

private company that helps hundreds of 

medical and dental offices in Northern 

California with all of their regulatory 

compliance issues. We insure our clients 

are up to all standards, keeping their 

offices safe and keeping them clear from 

hefty fines that are often levied by the 

regulatory agencies – such as CAL/ 

OSHA, Department of Health Services, 

Environmental Protection Agency, as 

well as the Medical Board of California. 

EnviroMerica has been helping medical 

practices for more than 12 years. 

How many medical offices 

do you work with? EnviroMerica 

concentrates its services solely in the 

Bay Area. We work with more than 300 

different medical and dental offices. 

Where are you located? Our 

offices are conveniently located in Belmont, 

California – just south of the San Francisco 

Airport. 

What do you do? We provide 

comprehensive products and services to 

bring all of our client offices up to complete 

regulatory standards. Our services 

include annual training, up-to-date and 

customized safety manuals, all appropriate 

office documentation including complete 

COMPAny: enviroMerica 

MEMBER BENEFIT: REGUlaTORY cOMPlIaNcE PaRTNER 

envirOMerica 

Frequently Asked Questions 

and compliant material safety data sheets 

books, plus complete physical compliance 

of the office. Via an insurance policy, we 

guarantee all of our clients against any and 

all fines they may receive from any of the 

regulatory agencies. 

Do you have a guarantee? Yes. 

We guarantee to cover any regulatory fine, 

up to a million dollars, incurred upon any 

of our clients. 

How much does it cost? The 

initial evaluation is being offered without 

charge, at this time, to all members of 

MCMS and SCCMA. EnviroMerica 

generally charges $275 for this service. 

Our rates for ongoing service and 

protection vary depending on the number 

of employees at the practice. In total, we 

charge much less than most offices spend 

to take care of these issues on their own. 

For members of the MCMS and SCCMA, 

we offer additional discounts. 

How long does the evaluation 

take? A full evaluation can take up to 

one hour, if time permits. If less time is 

available, our compliance experts can 

provide a very thorough evaluation in 

less than 30 minutes. In each case, the 

EnviroMerica Compliance Expert needs at 

least 15 minutes to share his findings with 

the owner-doctor. 

MeMBeR BeneFIt: via an insurance policy, enviroMerica guarantees 

all of their clients against any and all fines they may receive from any of the 

regulatory agencies. MCMS and SCCMA members receive a complimentary 

CAL/OSHA inspection given by enviroMerica (valued at $275). 

COntACt: Call 888/323-0583 for more details. 


Why is this important? First 

and foremost, California’s regulations are 

in place to help assure safety and privacy 

for your office’s staff and patients. Our 

services help your office to abide by all 

of these safety and privacy regulations. 

Secondly, the state regulatory associations 

have the authority to levy heavy fines upon 

medical offices. Recently, we have seen 

fines exceeding $50,000. EnviroMerica 

protects medical practices from heavy 

business-threatening fines. 

Products/Services 

OSHA/DHS COMPLIANCE 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

Customized OSHA Manuals 

Customized MSDS Manuals 

NFPA Chemical Labeling 

All Required Signs and Labels 

In-Office OSHA Training 

Employee Posters 

Updates CAL/OSHA, DHS Forms 

Customized Records Manual 

Customized Evacuation Map 

Updates and Maintenance 

Surprise Inspection Protection 

Appeal Support 

Hearing Representation 

WASTE MANAGEMENT: EPA/ 

DTSC 

• Waste Pick-up (Red Bags) 

• Sharps Pick-up 

• Expired Pharmaceutical Pick-Up 

• Hazardous Material Pick-Up 

• Spore Testing (for Autoclave) 

• Mail Back Sharps Containers 

CALL 1-888/323-0583

THE DIABETES SOCIETY IS THE ANSWER 

TO EFFECTIVELY MANAGING BLOOD GLUCOSE 

LEVELS IN YOUR DIABETIC PATIENTS 

The Diabetes Society is an independent non-profit organization founded in San Jose as a 

one-stop shop for diabetes education and support in the communities you serve! 

Services Offered: 

• ADA certified 3-step diabetes self-management program 

• Nutrition education and counseling 

• Free meters and instruction 

• Group classes (English and Spanish) 

• Support Groups (English and Spanish) 

• Insulin start appointments and pump training 

• Weight loss consultation and carb counting 

• Children’s diabetes camps throughout California 

Easy referral process with a variety of fee options including 

most insurance plans, Medicare and local IPA’s 

> If you never thought about us for your patients, now is the time < 

For more information or brochures: 

1165 Lincoln Avenue, Suite 300, San Jose, CA 95125 

(408) 287-3785 Fax: (408) 287-2701 Email: info@thediabetessociety.org 

When you have questions 

about eating disorders... 

...we’re here to help. 

Awareness, Recovery, Advocacy 

www.edrcsv.org 

408-559-5593 

Eating Disorders Resource Center 

NEW Free Support Group 

EDRC is pleased to annound a new support 

group and information session for family 

members and loved ones of individuals 

suffering from eating disorders. Please join us 

for support throughout the healing process. 


WHERE: El Camino Hospital 

Meeting Room “DE” (on ground floor) 

2500 Grant Road 

Mountain View, CA 94040 

WHEN: Every 4th Saturday of the month 

9:30 a.m. – 11:00 a.m. 

For further information on this support group or any 

other EDRC services, please contact us at 

408-559-5593 or katie@edrcsv.org.

The MLC Website has been designed to allow easy 

access to information for participating organizations, 

their members, and other health care professionals. 

On the site you will find: 

• News and Information: MLC reports, meeting 

summaries, and an events calendar 

• Educational Tools: CME courses, tools, and 

patient education materials 

• Resource Center: Interpreter Services Database, 

MLC presentations, and links 

• About the MLC: Member organizations, 

participation agreements, and policies 

The Interpreter Resource Database is a county-by-county 

database providing information on interpretation and translation 

services. The database is updated regularly, and listings may be 

sent to the CAFP for inclusion. 

The Interpreter Resource Database includes: 

• Interpretation Resources by Phone, VMI or On-Site 

• Language Lines 

• Community Resources 

• Interpretation Equipment 

• Training for Physicians and Staff Members 

• 

Websites in Languages Other Than English

When was the last time a doctor came to YOU? 

I’m Dr. Jon Wack, Medical Director of the 

Vascular Institute at California Pacific Medical 

Center, a unique program with specialists from 

four disciplines—interventional radiology, 

cardiology, vascular surgery and neurosurgery 

—working together to provide the most sophisticated 

array of treatment options for all aspects of 

vascular disease. 

Since the 1970’s, we’ve been on the forefront of 

new technologies —from aortic aneurysms to claudication; 

from uterine fibroids to neoplasms. Today, 

we are the only private California hospital using 

the Yttrium 90 treatment. We have the experience 

to know what works—and what doesn’t— 

in minimally invasive treatment. 

I’d like to make an appointment to see you in 

your office. Why? I, or one of my team 

mates, would like to take just a few minutes to 

familiarize you with our facilities, equipment, staff 

—and discuss treatment options for your 

next complex patient. 

The Vascular Institute offers: 

• Board certified, fellowship trained vascular specialists 

• Unparalleled care for patients with vascular disease 

• Endovascular abdominal and thoracic aortic aneurysm repair 

• Minimally invasive lower extremity revascularization 

• Renal and visceral stenting procedures 

• Carotid stenting and endarterectomy 

• Endovascular and open options available and recommended 

without bias 

• Tumor embolization and radiofrequency ablation 

• Uterine fibroid embolization 

• In 2008, HealthGrades® ranked California Pacific “Best in the 

San Francisco Area for Cardiology and Overall Cardiac Services.” 

Call me at 415-600-7459 • www.cpmc.org/services/heart

THE 

BULLETIN 


700 Empey Way, San Jose, CA 95128-4705 

Address service requested 

Does Your Insurance Company Have the Strength to Endure? 

Strength and flexibility. That’s what your practice needs to thrive during 

challenging economic times. NORCAL Mutual Insurance Company has 

received an “A” (Excellent) financial rating from A.M. Best, the leading 

provider of insurance industry ratings, for the past quarter century. 

Our financial stability has allowed us to declare more than $372 million 

in dividends to our policyholders. 

Visit www.norcalmutual.com today, or call 800.652.1051. 

PRSRt StD 

U.S. Postage 

PAID 

San Jose, CA 

Permit No. 503 

Our passion protects your practice 

NORCAL Mutual is proud to be endorsed by 

the Santa Clara County Medical Association 

as the preferred professional liability insurer 

for its members.

Membership Has Its Benefits - Santa Clara County Medical Society

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