Florida Medical Association

FMA Magazine Fall 2015

Magazine of the Florida Medical Association

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17 www.FLmedical.org FLORIDA MEDICAL MAGAZINE | FALL 2015 sional services through the FMA's preferred vendor program and the Lawyer Referral Service. In terms of physicians' major concerns, Fowler said that many doctors are worried about the transition to ICD-10 and the implications of the recently passed Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). "Many physicians are also curious about the minimum payment standard that's supposed to be implemented under our statewide Medicaid Managed Care Program next year," he said. "However, the most common questions we get are from physicians who are dealing with all too common occurrences such as denied claims and lengthy authorizations. As o en as possible, we work to help those physicians by reaching out to the payers directly on their behalf." e FMA's payment advocacy has helped countless members cut through red tape that otherwise would have taken their practices many hours to untangle. For example, one member called and said that a major health insurer was frequently denying her claims. "She had done everything she could to verify that these denials were occurring by no fault of her own. However, even a er spending hours on the phone, she had gotten nowhere with the insurer's provider relations department," Fowler said. "Fortunately, we were able to reach out to the payer and get her in touch with a member of their senior management team. From there, her issue was quickly resolved. It's been several months and the problem hasn't recurred since." If you need assistance with a payment issue, call the FMA at (800) 762-0233 so that we can advocate for you and help protect the nancial health of your practice. If you've run into problems with denied claims and other roadblocks to being reimbursed by third party payers, you don't have to go it alone. The FMA has successfully helped many members who were previously denied payments through our coding expertise and payment advocacy efforts. We hope that you'll keep these services in mind during the upcoming transition to ICD-10 and throughout the ongoing implementation of Florida's Statewide Medicaid Managed Care program. Remember, these services are included in your FMA membership dues and can be accessed by contacting us. Benefi ts include: Coding assistance: e FMA employs an experienced certifi ed coder. Advocacy services: e FMA works directly with major commercial insurers and governmental payers to help resolve outstanding issues. Technical assistance: e FMA can help answer questions related to Medicare pay-for-performance programs and other third party payment models. FMA Director of Payment Advocacy Jarrod Fowler directly assists member physicians who are dealing with denied claims, overdue payments, coding questions and other common issues. He can also serve as an intermediary between doctors and payers, and if a member has a problem that requires outside assistance, Fowler can help him or her get discounted profes- The FMA's payment advocacy team solves your reimbursement problems bottom line

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