determination to practice medicine and care for our patients in the best manner possible is immeasurable and our effort never ending,” Dr. Torres said.
Claim your claim from Aetna settlement
March 28 is the deadline for physicians to postmark claims for part of the $120 million settlement in a lawsuit against Aetna over payments for out-of-network services. The settlement covers physi- cians and health care practitioners who delivered out-of-network services to Aetna subscribers any time from June 3, 2003, to Aug. 30, 2013, and received less than the billed charge. There are two options for filing a
claim. One involves submitting detailed documentation of the out-of-network services you provided, the bills you sub- mitted to Aetna and the patients, and the payment you received. WhatleyKal- las, LLP, one of the private law firms in- volved in the case, has published a step- by-step guide, available at www.texmed .org/AetnaUCR, to help physicians and other health care professionals maximize their recovery from the settlement. The Texas Medical Association, the
American Medical Association, and the medical societies of California, Connect- icut, Florida, Georgia, North Carolina, New Jersey, New York, Tennessee, and Washington sued Aetna in 2009 over its use of databases licensed from Ingenix, a UnitedHealth Group Inc. subsidiary. Ingenix underpaid physicians for out-of- network services, the lawsuit said. It also challenged other ways Aetna determined out-of-network payment rates and ac- cused Aetna of failing to disclose how
it figured those rates. A patient filed a similar suit in 2007. Aetna, United, and other insurers
agreed to stop using the Ingenix data- base in settlements with the New York State Attorney General in 2009. That settlement created FAIR Health to take over and improve the database and es- tablish transparent, current, and reliable health care charge information. Additional information about the settlement, including claim forms, can be found on the Aetna UCR settlement website,
www.aetnaucrsettlement.com.
Helping colleagues with potentially impairing conditions
NORTH TEXAS CERTIFIED DEVELOPMENT CORPORATION OFFERS LONG-TERM, LOW INTEREST FINANCING.
• COMMERCIAL REAL ESTATE • EQUIPMENT PURCHASE • IMPROVEMENT, EXPANSION, OR RELOCATION • NEW PRACTICE START-UP • PRACTICE SALES & PURCHASE
Physician stress leaves some doctors vul- nerable to substance use disorder, espe- cially alcohol dependency. This may be a patient safety problem and a potential career-ender for physicians unless they receive treatment. If you suspect a col- league may be struggling with a sub- stance-related impairment, you can help. The Texas Medical Association’s up-
dated Texas Medical Board Investigations: A Physician’s Guide Through the Disciplin- ary Process lists these early signs of sub- stance use disorder among physicians:
• Overworking to retreat from over- whelming personal and professional conflicts,
• Working irregular and inefficient hours,
• Demonstrating poor and irregular sleeping and eating habits, and
• Withdrawing from social and family activities.
EXPERIENCE. SERVICE. RESULTS.
Contact a 504 Loan Expert in your area listed at
www.NorthTexasCDC.com or 972-516-0514 Ext. 101
To order the book, visit http://bit .ly/1er7C3Z. The book also outlines behaviors that
may plague physicians in later stages of impairment:
• Difficulties diagnosing and managing patients,
44 TEXAS MEDICINE March 2014
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