MSSNY Pulse – January 10, 2025

Need Help Resolving Insurance Claims? MSSNY Has Recouped Over $12 Million for Physicians

Friday, January 10, 2025
Need Help Resolving Insurance Claims? MSSNY Has Recouped Over $12 Million for Physicians

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The Medical Society of the State of New York’s (MSSNY) Physician Payment and Practice Service continues to deliver remarkable results for New York physicians. In 2024 alone, it recovered over $3 million, bringing the total recovered since 2021 to more than $12 million. This vital service provides members with comprehensive support in resolving claims, addressing takebacks, managing billing challenges, and ensuring practices thrive in today’s complex healthcare landscape.

MSSNY’s expert payment and practice service assists with issues ranging from overturned claims and takebacks to larger systemic challenges, including excessive medical record requests and prepayment reviews that impede cash flow. The service also advocates directly with insurance companies and regulatory bodies, including CMS, DOH, and DFS, ensuring physicians can focus on patient care while staying compliant with healthcare regulations.

Members enjoy exclusive financial benefits, paying as low as 5% of recovered claims, compared to non-member rates of 20%. With success stories, including recoveries ranging from $1,500 to $115,000 per claim, MSSNY has proven its ability to secure favorable outcomes for practices of all sizes and specialties.

To learn more about how MSSNY can safeguard your practice’s revenue and enhance operational efficiency, contact their team at [email protected].

Don’t let unresolved claims or administrative burdens hold your practice back! Leverage MSSNY’s expertise for peace of mind and financial success.

MLMIC Medical Professional Liability Insurance

Book Your MSSNY House of Delegates Sponsorship or Journal Ad Today!

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MSSNY’s 2025 House of Delegates is quickly approaching, and we still have sponsorship packages and journal ads available.

The deadline for sponsorship booking and journal ad art is February 21, 2025. Book your sponsorship or ad today!

Attention Medical Students and Residents

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Time is on Your Side!  We have a few more slots open for submissions of Abstracts for MSSNY’s 2025 Poster Symposium.  If you are interested in submitting your abstract, please contact [email protected].

Women Physicians Leadership Academy Spring Sessions

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Registration is now open for MSSNY’s MESF Women Physicians Leadership Academy! Dr. Tochi Iroku-Malize will lead three virtual sessions on Saturday, February 1st, Sunday, March 2nd, and Saturday, March 15th, from 7:45 a.m. to 11:15 a.m. These sessions will focus on Designing Your Medical Career, Enhancing Physician Wellness and Wellbeing, and The Importance of Networking. Upon completing the three sessions, participants can earn up to nine continuing medical education (CME) credits. To register, please see the links below:

Preventing Maternal Mortality: Recommendations for Action

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On January 16 at 12pm the Department of Health will explore the current state of maternal mortality and spotlight key initiatives in New York State such as the Maternal Mortality Review Board, the Advisory Committee, community engagement efforts, and the Maternal Home Collaborative. Participants will gain valuable insights into actionable strategies to prevent maternal deaths and explore a model designed to enhance maternal health outcomes.

Register here for Continuing Medical Education (CME) credits.

Please email us any questions you would like us to address at [email protected]

For questions: Please send an e-mail to [email protected], as notify01 is a non-monitored mailbox.

Save the Date! NCMS & NAM Membership Meeting – March 2025

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The Nassau County Medical Society (NCMS) and Nassau Academy of Medicine (NAM) are pleased to announce their Spring Membership Meeting, scheduled for Tuesday, March 18, 2025, at 6:00 PM. The event will take place at Jericho Terrace, located at 249 Jericho Turnpike, Mineola, NY 11501.

This year’s meeting will feature a distinguished guest speaker, Dr. Dan Shapiro, Director of the Chartis Center for Burnout Solutions. Dr. Shapiro is renowned for his expertise in addressing professional burnout, offering insights and strategies to promote resilience and well-being within the medical community.

Attendees are encouraged to RSVP via the Nassau County Medical Society’s official website at www.nassaucountymedicalsociety.org.

Join us for an engaging evening of networking, professional development, and meaningful discussions about the challenges and opportunities in modern medicine.

MSSNY Classifieds

MSSNY’s P2P Program Supports Physician Mental Health

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The Medical Society of the State of New York’s Peer 2 Peer program offers support to physicians, residents and medical students facing stress and burnout by connecting participants with peer coaches who are trained to actively listen and provide feedback. “Too many doctors are suffering in silence because they fear that if people knew what was going on in their heads, others would look at them differently. The P2P Program allows doctors to help our peers manage their battles confidentially,” says MSSNY member and Assistant Treasurer Dr. Frank Dowling.

 Full Story: MD News (1/6)

CPT Codes for Prior Authorization: Reporting Prior Authorization–Related Activities Within E/M Services (99203, 99204, 99205, 99213, 99214, 99215, 99358, 99452, 99080)

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Prior authorization (PA) is an administrative process that requires physicians or other qualified health care professionals (QHPs) to obtain approval from a health insurance carrier before a service, supply, or medication will be authorized if provided to a patient. The process may include extensive review and discussion leading to physician attestation to affirm the appropriate care path, all of which can involve a significant amount of time and work for the physician or other QHP. This article provides information on how PA-related work performed by physicians or other QHPs is recognized within evaluation and management (E/M) office or other outpatient codes and other codes in the Current Procedural Terminology (CPT®) code set. Continue Reading

NGS Addresses Claim Denials Related to HCPCS Code G2211

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National Government Services (NGS) has reported an issue impacting Part B providers in Jurisdictions JK and J6 regarding claim denials for the HCPCS G2211 add-on code. The problem stems from a coding update on December 5, 2024, by the National Correct Coding Initiative. This update now requires HCPCS G0463 as the primary code for G2211, resulting in denials when G2211 is billed with CPT codes 99202-99205 and 99211-99215 for dates of service between January 1 and September 30, 2024, if processed after December 5, 2024.

NGS has reached out to the Centers for Medicare & Medicaid Services (CMS) for guidance on resolving the issue. Providers are advised that the NGS Provider Call Center cannot offer additional information at this time. Updates will be posted on the NGS website as they become available.

No immediate action is required from providers. Monitor NGS communications for updates on this issue and the timeline for resolution. For now, continue standard billing practices while awaiting further instructions.

NYRx Medicaid Pharmacy Prior Authorization Programs Update

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On October 25, 2024, the New York State Medicaid Drug Utilization Review Board (DURB) recommended changes to NYRx, the Medicaid pharmacy prior authorization (PA) program. The Commissioner of Health has reviewed the recommendations of the Board and has approved changes to the NYRx Preferred Drug Program (PDP) within the fee-for-service (FFS) pharmacy program, as outlined.

The NYRx Education & Outreach Call Center is available by phone at 1-833-967-7310 or by email at [email protected] from 8:00 AM to 5:00 PM ET, Monday through Friday, excluding holidays. Would you like to meet with us too? Click here.

Registration Now Open: Arranging for Home Health Care – What Referring Physicians & Practitioners Need to Know

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Struggling with home healthcare referrals? Join MSSNY’s webinar Arranging for Home Health Care on January 14 at 7:30 AM. Learn to streamline referrals, understand eligibility, and collaborate with home health services. Register now to simplify the process and improve patient care!

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at [email protected].

Prepare for H5N1: Join Jan. 15 CME Webinar

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Since April 2024, H5N1 avian flu cases have emerged, raising serious concerns. Join us on January 15 at 7:30 AM for Highly Pathogenic (H5N1) Avian Flu: What’s Old is New Again. Learn from Dr. William Valenti about risks, best practices, and resources. Register now to stay informed!

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at [email protected].

Sellers Insurance

Mastering Social Media: NCMS Webinar for Healthcare Professionals

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The Nassau County Medical Society (NCMS) and Nassau Academy of Medicine will host a valuable webinar, “Managing Your Social Media Presence,” on Wednesday, January 15, 2025, from 6:00 PM to 7:00 PM.

Led by Mirsade Markovic, Esq., Senior Attorney at MLMIC Legal Department, and Deanna Mirro Altmann, RNC, Risk Management Consultant, the webinar addresses the dual potential of social media as a powerful marketing tool and a source of legal and reputational challenges. Participants will gain practical insights into leveraging social media for patient engagement while mitigating risks like advertising liabilities, confidentiality breaches, and workplace distractions.

This interactive session will provide actionable strategies for handling negative patient reviews, crafting effective social media policies, and maintaining professionalism in digital interactions. Attendees will also be eligible to earn 1.0 AMA PRA Category 1 Credit™ through MLMIC’s MSSNY-accredited program.

Registration is open at this link. Don’t miss this opportunity to enhance your social media practices and protect your professional reputation.

New Year, New Opportunities: Secure Your Future with the Physician Life Income Plan

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Please join us on Thursday, January 23rd, at 6 pm for a webinar introducing the MSSNY Physician’s Life Income Plan (PLIP). We are excited to announce our new exclusive member benefit, which is only available to our members!

The Physician’s Life Income Plan is a supplemental retirement program designed to lower taxes and protect assets. Some of the key features of this program include:

  • Tax Advantages (tax-free accumulation, tax-free withdrawals, and tax-free distribution to beneficiaries)
  • 100% Creditor Protection in NYS (a solution to possible liability legislation changes pending in NY)
  • Full Liquidity (maintain access and control of assets at all times)

The largest Fortune 500 companies have used this strategy for almost 50 years. Now, through your MSSNY membership, it is available to physicians! Register Now

Strategies for Investing Success in 2025

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Get 2025 started with this insightful investing update from Altfest!  This webinar will outline market risks and opportunities they are watching for the road ahead:

  • Outlook for the 2025 economy
  • Incoming Trump administration policies
  • Impact of AI tool adoption
  • Inflation risks
  • Status of the bond market
  • Portfolio positioning

Live Webinar Jan. 30th @6pm ET

Reserve your seat now!

Can’t make it to the live session?  No problem!  Everyone who registers will receive a link to the recording after the webinar.

Streamline Your Payment Process with CardConnect

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MSSNY members gain exclusive access to secure, cost-effective payment solutions tailored to healthcare practices. Enjoy optimized rates, next-day funding, and dedicated 24/7 support. Simplify your operations today. Connect with Our Payment Expert Mark Bristow 914.506.1984

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