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says the likelihood of fraud coming into play is especially high when insurance companies determine physicians owe them a significant amount of money. “When the dollar amounts are high [in


this case more than $1 million], insur- ance companies may conclude it’s more than a simple error and suspect the phy- sician of wrongdoing,” she said. Mr. Androphy recommends physi-


cians take billing and coding seriously and consult with a competent expert. (See “TMA’s Coding Resources,” page 55.)


“Spend the money. It’s worth its


weight in gold. Physicians need experts specifically trained on billing and coding for their specialties,” he said.


stability matters.


If there is one thing to learn from the recent financial turmoil, knowing who to trust is paramount.


Medical Protective, a proud member of Warren Buffett’s Berkshire Hathaway, has always believed that to provide our healthcare providers the best defense in the nation, our financial stability needs to be rock-solid, stronger than any other company.


Stability even in the worst of times.


Medical Protective is the only medical professional liability insurance company to protect their healthcare providers through all the business and economic cycles of the last 110 years, including the tough economic times of the Great Depression. We are also proud to have provided unmatched defense and stability during all the medmal crises.


TMA to Congress: No sneak torts


The Texas Medical Association, the Texas Medical Liability Trust, and other liabil- ity insurers are asking Congress to make sure the Patient Protection and Afford- able Care Act (PPACA) does not create new theories of liability or alter the rules governing medical professional liability lawsuits. They wrote the chair and rank- ing minority member of the House En- ergy and Commerce Committee that they support HR 816, the Provider Shield Act, sponsored by U.S. Reps. Phil Gingrey (R- Ga.) and Henry Cuellar (D-Texas). The group said in its letter that judges


and personal injury lawyers could use certain provisions of the health system reform law “to establish a national ‘stan- dard of care’ to prove negligence in such lawsuits when a physician’s personalized care for his or her patients may not ad- here to the federal payment or billing/ coding guidelines. Such a threat can have a chilling effect on patient safety and stifle future efforts to improve the standard of care for all patients.” They added that the bill, pending be-


fore the Energy and Commerce Commit- tee, is “non-controversial, bipartisan leg- islation that can and should be passed this year and that will make a true differ-


September 2012 TEXAS MEDICINE 57


We have received higher ratings from A.M. Best and S&P than any other carrier in the healthcare liability industry.


Trust Stability. Trust Medical Protective.


Serving Texas doctors since 1916. Contact us today for your FREE expert guide to Texas medmal insurance.


Call: 800-4MEDPRO ext. 3704 Email: experts@medpro.com Visit: www.medpro.com Contact your local Medical Protective agent


All products are underwritten by either The Medical Protective Company® or National Fire and Marine Insurance Company,®


approval and may be offered on an admitted or non-admitted basis. ©2012 The Medical Protective Company.®


both Berkshire Hathaway


businesses. Product availability varies based upon business and regulatory All Rights Reserved.


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