Table of Contents: July 2007

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Vol. 103 No. 7  


Measuring the Measurement
A growing number of health insurance companies are using rating systems to rank physicians on the cost and quality of care they deliver. Most rely on claims data to purportedly measure physicians' cost efficiency and quality of care. But physicians are concerned these programs are really economic credentialing, and argue that scientific studies have proven claims data alone are inadequate to truly judge quality of care. They're also worried that rating systems will confuse patients.

By Ken Ortolon 


A Historic Increase
Medicaid patients' access to care is improved, and payments to physicians treating children on Medicaid are raised significantly in a new budget approved by the legislature in May. The Medicaid budget increases are among the largest in history. A special physician committee will advise state officials on how to fairly allocate the new funding.

By Ken Ortolon 


Physicians Win Again
Insurance giant Blue Cross and Blue Shield is the latest company to settle the federal antiracketeering lawsuit that TMA and other state medical associations filed in 2001. The settlement includes a guaranteed cash payment of more than $128 million. All practicing Texas physicians can further benefit in prospective and retrospective changes.

By Crystal Conde 


Getting Back to the Country
The Texas College of Osteopathic Medicine has launched a new program to identify students who want to live and practice in rural areas and give them the unique skills needed to succeed as small town doctors. It's called the Rural Osteopathic Medical Education of Texas program.

By Ken Ortolon 


A Shot in the Arm
TMA's Be Wise - Immunize program's newest resource gives physicians information they need on best practice guidelines, communication tools, immunization schedules, ImmTrac Texas Immunization Registry information, outreach initiative details, vaccine safety standards, and other Texas-specific resources.

By Crystal Conde 


TMA delegates call for Medicare fee reform, more physicians
Josie T. Williams, MD, named TMA president-elect
"We are TMA"
Interviewing candidates the smart way
Three Rivers halts solicitation, plans changes
Be Wise - Immunize can help you prevent disease 


New Technology Brings New Liability Exposures
Make sure you identify and resolve liability exposures that arise in using electronic medical records. TMLT has some tips to avoid trouble.

Getting Paid for Emergency Care
Obtaining a Medicaid number will help you get paid when you treat an unassigned Medicaid patient in an emergency room.

Billing Medicare for Joint Services
You should follow certain rules in billing Medicare for joint services, such as when you and a nonphysician practitioner routinely provide patients split or shared evaluation and management services in a hospital inpatient, outpatient, or emergency department setting.

Don't Submit Duplicate Medicare Claims
If you submit more than one Medicare claim to TrailBlazer Health Enterprises for the same item or service, expect your duplicate claim(s) to be denied.

Teamwork Vital in Filing Good Claims
The entire practice team plays a vital role, from the receptionist who gathers demographic information, to the nurse and physician who prepare documentation, to the coding, billing, and reimbursement personnel who get the claims out the door. 


Development of a Federally Qualified Health Center in Houston, Texas (abstract)

By Patrick McColloster, MD 


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