TMAIT can help physicians determine the amount and the type of life insur- ance coverage that suits their needs. For assistance, call (800) 880-8181.


about the Seasons of Life for Physicians program or to request help, call the BCB- STX Office of Physician Advocacy project coordinator at (972) 766-8823.


have access to information about their patients’ hospital stays to ensure con- tinuous, high-quality care. The lists of actions recommended in this report can then serve as a guide as physicians care for recovering patients.” The responsibilities outpatient physi- cians should consider include:


Helping physicians in times of need


Blue Cross and Blue Shield of Texas (BCBSTX) offers its Seasons of Life for Physicians program to medical practices that are experiencing loss through the death of a physician. Eduardo Sanchez, MD, BCBSTX vice president and chief medical officer, says the program’s ob- jective is to provide unrivaled, concierge- class customer service to alleviate any unnecessary obstacles that might arise while addressing claims and payment matters following a physician’s death. To ensure all claims are closed, BCB-


STX dedicates a provider advocate spe- cialist to each physician’s office. Dr. San- chez says the program creates a one-stop shop that communicates directly with offices. The provider advocate specialist does the following:


• Addresses outstanding or open claims, • Initiates a claims report for the past six months,


• Identifies inconsistencies during claims adjudication,


• Intercepts unresolved claims to facili- tate quick resolution,


• Contacts appropriate medical staff directly for claims involving medical decisions,


• Coordinates with applicable depart- ments to help finalize claims, and


• Generates a completion report once it has been determined that all claims have been closed.


The Seasons of Life for Physicians


program also includes assisting retir- ing physicians with finalizing claims in a timely fashion to ease the closing of their practice. Physicians do not need to be members of BCBSTX networks to receive assistance. For more information


Capital Medical Clinic seeking


Board Certified Internist Outpatient Care Only


Interested Candidates please submit your CV to Mr. Pete Hager at


phager@capmedaustin.com April 2013 TEXAS MEDICINE 55


AMA post-hospital patient safety principles


A report from the American Medical As- sociation outlines a list of five responsi- bilities physicians in outpatient settings should consider when caring for patients who have recently completed a hospital stay. A panel of experts developed the list after examining how to improve safe- ty and reduce the rate of hospital read- missions for patients transitioning from an inpatient hospital stay back into their homes. It is part of the recommenda- tions contained in There And Home Again, Safely, released by the AMA’s Center for Patient Safety. To read the report, visit www.ama-assn.org/go/ambulatorysafety. “When a patient leaves the hospital to go home, they are transitioning back into the care of their outpatient primary care and specialty physicians,” said AMA President Jeremy Lazarus, MD. “These physicians play integral roles in helping patients fully recover, and coordination between inpatient and outpatient teams is key to ensuring success. Physicians in ambulatory care settings must first


• Assessment of the patient’s health, • Goal setting to determine desired out- comes,


• Supporting self-management to en- sure access to resources the patient may need,


• Medication management to oversee needed prescriptions, and


• Care coordination to bring together all members of the health care team.


This report comes on the heels of an announcement from Medicare that it will accept the newly created Current Procedural Terminology (CPT) codes for care coordination to pay physicians for the management of patients recently dis- charged from a hospital or skilled nurs- ing facility. The AMA CPT Editorial Panel created the codes to capture transitional care management services, including time spent discussing a care plan, con- necting patients to community services, transitioning them from inpatient set- tings, and preventing readmissions. n


Crystal Zuzek is an associate editor of Texas Medicine. You can reach her by telephone at (800) 880-1300, ext. 1385, or (512) 370-1385; by fax at (512) 370-1629; or by email at crystal.zuzek@texmed.org.


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