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Insurance and Risk Management Strategies for Physicians and Advisors

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ISBN-10: 0763733423

ISBN-13: 9780763733421

Edition: 2005

Authors: David E. Marcinko

List price: $215.95
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Description:

For practicing physicians, selecting a knowledgeable insurance advisor and developing a comprehensive personal and corporate risk management plan can be a daunting task. As a consequence of today's litigious environment in the healthcare industry, physicians must now carefully assess their personal and practice risks as they seek to be indemnified should an event or cause of action occur. This process requires integrated knowledge of the healthcare industrial complex, as well as the rapidly changing insurance industry. Fortunately, Insurance and Risk Management Strategies for Physicians and Advisors confronts the reality that insurance planning in healthcare is decidedly more complex than…    
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Book details

List price: $215.95
Copyright year: 2005
Publisher: Jones & Bartlett Learning, LLC
Publication date: 8/25/2004
Binding: Paperback
Pages: 332
Size: 6.06" wide x 8.96" long x 0.72" tall
Weight: 1.100

This book is destined to become the classic practice management textbook for all physicians and is a must-read for the nations more than two million, independent healthcare providers and their related business advisor. --Antonio Silva, MD, MBA Emory University - Goizveta School of Business Atlanta, Georgia An interdisciplinary team of experts teaches new comers how to open, staff, and equip an insurance-friendly office for patients, and how to raise the capital necessary for it. New coverage in the second edition includes how to write a medical office business plan; compliance methods, risk and programs, and the insurance CPT coding issues; six-sigma initiatives; futuristic information…    

About the Editor
Dedication
Foreword
Preface
Introduction for Condensed Reading and Review
Contributing Authors
Afterword
Insuring the Doctor's Life
The Geneva Papers on Risk and Insurance Theory
Acturial Sciences
Social Insurance
Risk Management Principles
General Types of Insurance Policies for Physicians
Life Insurance Taxation
Health Insurance Overview
Life and Health Insurance Policy Provisions
Annuity Overview
Annuity Taxation
Long-Term Care Insurance
Additional Readings
Websites
Insuring the Doctor's Property and Possessions
Fee Only Insurance Consultant
General Types of Policies Covering Possessions
Automobile Insurance Overview
Umbrella Liability Insurance Overview
Evaluting Insurance Companies and Policies
Policy Replacement
Lifetime (Viatical and Senior) Settlements
Needs Analysis Approach to Life Insurance
Additional Readings
Websites
Insuring the Doctor's Practice
Business Uses of Life Insurance
Other Business-Related Insurance
Miscellaneous Insurance Policies
Additional Readings
Websites
Risks of Medical Practice Noncompete Agreements
Restrictive Covenants Defined
Covenants for the Sale of a Medical Practice
Covenants as Part of a Medical Employment Contract
"Reasonable" Covenant Terms
Remedies for Covenant Breach
Agreements Restricting the Practice of Medicine
Conclusion
References
Additional Readings
Documentation and Medical Records Risks
Historic Purpose of Medical Records
The Medical Records Revolution
Documentation Guidelines for Evaluation & Management Coding
Legal Statutes Regarding Medical Billing
References
Health-Care Compliance Risk Management
The Compliance Process
The Rules
Conclusion
References
Risk Management in Modern Medical Practice
Medicare Recoupment Risks
Health-Care Fraud Risks
Provider Health-Care Fraud Considerations
The Kennedy-Kassenbaum (HIPAA) Act
The Balanced Budget Act
The Federal False Claims Act
Money Laundering
Civil Asset Forfeiture Risks
Self-Referral Risks
Federal Agency Risks
Occupational Safety and Health Agency Risks
Drug Enforcement Agency Risks
Environmental Protection Agency Risks
Health and Human Services (Office of Civil Rights) Risks
Antitrust Risks
Business Practice Litigation Risks
Patterns of Practice Risks
Managed Care Contractual Risks
Historic Bars to Managed Care Lawsuits
The Contract Capitulation Dilemma
Employee Risks
Vicarious Risks
Deselection Risks
Risks of Collateral Consequences
Medicare 5-Year Exclusion Risks
State Board Action Risks
Malpractice Risks
New Practice Risks
Education Debt Load Risks
Suggestions to Help Avoid Medical or Legal Risks
Conclusion
Additional Readings
Websites
Sexual Harrassment Risks in Medical Practice
Preferential Treatment
Hostile Medical Office Work Environment
Unreasonable Interference With Work Performance
Two-Pronged Test for Offensive Behavior
Examples of Sexual Harassment
Gender-Based Animosity
Same-Sex Harassment
Doctor-Employer Liability
Disciplinary Actions
Tangible Employment Action
Punitive Damages
Financial and Economic Costs
Commonsense Approach
Endnotes
Medical Office Workplace Violence Risks
Introduction to Medical Workplace Violence
Case Example
Health-Care Workplace Violence Defined
Financial Risk Management Impact of Workplace Violence
Assessing the Risk of Workplace Violence
Contributing Factors to Workplace Violence
Focusing on Prevention: The Zero Incidents Approach
Establish a Workplace Violence Prevention Committee
Disastrous Planning Mistakes
Analyzing the Business Impact of a Workplace Violence Incident
Cost of Implementing a Prevention Effort
The Hidden Cost of Conflict
Cost of Recovery After an Incident
Assessment
Summary
References
Additional Readings
Medical Malpractice and Tort Reform Risks
Malpractice Insurance History
Background
The Corporate Tort Reform Movement
Physician Self-Regulation
The Medical Malpractice Crisis
Conclusion
References
The Capitation Liability Theory
The Liability Insurance Industry
The Liability Premium-Setting Process
The Capitation Liability Theory
Premium Structures and Models
Liability Coverage Forms
The Contrary Viewpoint
Miscellaneous Liability Factors
Current Trends
Specialty-Specific Insurers
Conclusion
References
Additional Readings
Websites
Endnotes
Medical Malpractice Trial Risks
Dear Doctor, You Have Been Served a Lawsuit
The Trial Players
Burden of Proof
Types of Trials
Discovery Process
Depositions
Motions In Limine
Jury Selection
Opening Statements
Presentation of Evidence
Summation
Final Instructions
Jury Deliberations
The Verdict
Preventing and Reducing Incidents of Malpractice
Conclusion
Additional Readings
Websites
Endnotes
Financial and Operative Risks of Divorce
Domestic and Spousal Issues
Prenuptial Agreements
The Decision to Divorce
An Overview of Family and Divorce Law
Other Tax Considerations of Separation and Divorce
Older Divorcing Medical Professionals
Additional Readings
Divorce Websites
Additional Websites
Asset Protection Principles
Getting Started
Appreciating the Risks
Asset Protection Tools
Complex Asset Protection Tools
Timing Is Everything
Additional Readings
Endnotes
Selecting Insurance Agents and Risk Management Advisors
Insurance Company Selection
Introduction to Insurance Agent Selection
Why Do Regulators Target Insurance Agents?
Hiring the Right Insurance Agent
Insurance Agent Titles and Credentials
Medical Risk Management Societies and Specialists
The Role of Advisor/Agent Teamwork
Acknowledgments
Index