To our surprise, coverage through The Doctors Company was denied.  The basis of the declination was the insurance company’s underwriting opinion that the MILD procedures was a “surgical” procedure and not included in the scope of practice for a pain management physician.  Assuming the easy solution entailed simply increasing the medical specialty classification to one the underwriter agreed included this exposure (in other words: higher premiums), a request was made to change the medical specialty classification.  This request was also denied as the carrier’s underwriter opined the procedure was intended to be performed by surgeons only and thereby they would not extend coverage under any circumstances.

The next step was to determine if other carriers might be able to extend the coverage for the client to perform the MILD procedures while maintaining the same or better coverage and pricing already in place.  After several inquiries and submissions and many, many conversations explaining the procedure, coverage was offered with another insurance company willing to extend coverage for the doctor to perform the MILD procedure within his practice.  All in all the additional premium to the doctor is $1,500 per year to include the MILD procedure.  A satisfactory result for all those involved.

As always, it is wise to contact your qualified medical malpractice insurance broker to determine whether you have the coverage you need.  Never assume your medical malpractice insurance covers you for any new procedures, contracts, locations or healthcare providers. As a matter of course, we will always look for the best coverage at the best price by querying several sources for you. We do all the running around so you can concentrate on what it is you do!

This was the hope back in the day when IPAs touted improved patient delivery systems.  In the case of IPAs favorable claim outcomes never materialized.  Will the same happen with ACOs?  Time will tell but in the interim we are working to take advantage of the possibility of lower rates from the nations best companies by developing group purchasing programs for our ACO clients.

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The aggregate limit for a physician with separate limits is $50,000; for an entity with separate limits, $50,000 to $250,000, based on group size. DataShield™ covers costs for:

• Information & network security liability — Protection against claims alleging unauthorized release of personal information, violations of information privacy law, or unauthorized use of/access to your computer system.
• Media liability — Protection against claims arising from material published on a Web site, in ads, etc., including allegations of libel, slander, copyright infringement, or patent violations.
• Regulatory privacy proceedings & regulatory fines & penalties — Coverage for defense of HIPAA violations, state information privacy law violations, etc; and for certain related fines and penalties.
• Customer notification & credit monitoring expenses — Coverage for expenses incurred through information breaches, including costs of notifying affected parties and providing them with credit monitoring services.
• Electronic data recovery & replacement expenses — Coverage for expenses incurred to recover or replace electronic data lost or damaged because of a computer virus, hacking or other system invasion.

Each of the five areas of coverage has its own $50,000 aggregate limit, subject to a $50,000 total aggregate limit.

Consider securing coverage that allow for some flexibility in the rating base to better accommodate individual and group needs.  For example, Medical Protective offers an occurrence-based, group policy that allows for a built-in tail if turn-over is likely.  The Doctors Company on the other hand can offer a group FTE policy with individual physician limits.  As yet another option, various companies are willing to offer a per encounter policy – though the drawback is the possibility of an audit billing at year end.

The coverage options are varied and complex and worth taking the time to understand.  In the end, intensivists MUST consider price, coverage, and carrier stability or face the risk of unexpected insurance expenses over the long haul.

Presidio Insurance Solutions – the experts in medical malpractice insurance solutions.

www.PresidioInsurance.com

The state of California attempts to provide consumers with the information they need to obtain coverage from an insurer they deem financial stable.  Generally, the total written premium (all the money to be collected on policies the company issues to health-care providers like physicians and surgeons) and the incurred loss (a figure which represents claims paid out by the insurer plus this figure can include an adjustment for reserves set aside for claims to be paid) can provide a picture of medical malpractice insurers financial stability.  However, actual financial documents are also available on the insurance department website for further inquiry into the financial stability of any medical malpractice insurance company.

The Doctors Company easily topped the group market share list of medical malpractice insurance companies in California with over $200 Million ($210,609,883) in written premium.  Norcal Mutual Insurance Company a distant second with over $150 Million in written premium.  Medical Protective, the Berkshire Hathaway company, comes in at just under $30 Million in California.  Its worth noting  The Doctors Company acquired SCPIE (AHI) and this acquisition is reflected in thewritten premium, and Berkshire Hathaway remains strong on a national level though the California market share reflects a conservative and stringent underwriting approach offering medical malpractice insurance only for the best of the best.  A newer player in the medical malpractice industry, Fairway RRG reported just over $7 million in written premium for all of 2009 (and even more worrisome is the Fairway RRG incurred losses reported of over $3 Million for 2009).

California market share data should be considered prior to purchasing medical malpractice insurance - lest you find yourself with a medical malpractice carrier touting great discounted rates without the money to actually pay the claims.  With the exorbitant costs of medical malpractce insurance, you definetely need to consider if you get what you paid for.  Always, always, always check the AM Best Ratings and financial data before purchasing a policy because in medical malpractice insurance there is always safety in numbers!

However, with the proper training credentials verified, some medical malpractice insurance policies will extend coverage to OB’s and Gynecologists performing aesthetic procedures such as vaginal rejuvenation.  Presidio Insurance works with Medical Protective, The Doctors Company and Norcal Mutual Insurance who will generally consider extending coverage for some of the following aesthetic procedures: Tumescent Liposuction, Botox & Fillers, Cellulite treatment and Vaginal Rejuvenation Therapy, which can be done surgically or minimally invasive with lasers.   Laser Vaginal Rejuvenation Therapy can be done within an hour in the practitioner’s office and the convenience of a  very short recovery period.  However, this is a procedure that only recently has grown in popularity and many medical malpractice insurance policies are not designed to cover it. 

Anytime there is a change in scope of practice, removing or adding procedures, staff or even contracts, it is a good idea to check with your medical malpractice insurance broker and confirm your policy provides coverage. 

 Visit us at www.PresidioInsurance.com for more information on this coverage or call us directly at (800)317-6411.

 hCG, or human chorionic gonadotrophin is a glycoprotein hormone produced in pregnancy.

During pregnancy, the placenta produces hCG which allows the body to mobilize fat and use it as energy for both mother and fetus.

Performed within Alternative Medicine Practices, although the process appears harmless (and reportedly has has little to no side effects), within a medical weight loss regimen, medical malpractice insruance companies are ballking at covering the hCG procedure.  The traditional “admitted” market carriers (for example,  Norcal, Medical Protective and The Doctors Company) will generally exclude this procedure altogether when seen within the alternative medicine setting.  A separate policy is available to cover this exposure.  We recommend alternative healthcare facilties specifically disclose the procedure to their medical malpractice insurance company to make sure the procedure is covered under their policy.

Presidio Insurance has a Medispa & Alternative Healthcare Practices Program that extends coverage for the hCG procedure, as well as any other alternative procedures (i.e. aesthetics, acupuncture, naturopathic medicine, etc.).

Visit our website wwww.PresidioInsurance.com or call us directly (800)317-6411 to speak with a Medispa/Alternative Healthcare Program Specialist.

American Society of Plastic Surgeons (ASPS) – 5%

American College of Physicians (ACP) – 5%

American Association of Neurological Surgery (AANS) – 5%

American Association of Otolaryngology – Head & Neck Surgery (AAO-HNS) -5%

California Society of Pathologists (CSP) – 5%

If you don’t belong to any of these specific societies, there are a few other medical malpractice insurance discounts that are available. Keep in mind these discounts are applied in addition to many other available discounts. Often we encourage our clients to join a medical society when the membership dues are affordable and the 5% discount amounts to far more than the cost of the membership.

For more information on The Doctors Company, feel free to contact Presidio Insurance Solutions at (800)317-6411 or visit our website at www.PresidioInsurance.com

The Doctors’ Company has announced an average rate decrease of 5.1% while Medical Protective has announced an overall premium decrease of 3%. These rate reductions are averages so individual physicians may see greater or lesser changes depending upon specialty, loss history and limits of liability. The Continental Casualty Company (CNA) has indicated that there will be no rate change this year.

Presidio Insurance Solutions provides Oregon physicians and surgeons a one-stop shopping experience. We find the lowest rates with the best coverage from all the top Oregon medical malpractice insurance companies.

For additional information, contact Presidio Insurance Solutions at (800) 317-6411.