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Premierprofile

Dividends Paid to Vested Stockholders

InventaMed Healthcare Group

Premier Profile: Amigenics

Medical Billing Services Advantages

Welcome to the winter edition of the Premier Physicians Insurance Company Newsletter! We begin this

new fiscal year with the announcement that, for the first time, Premier Physicians is paying dividends totaling hundreds of thousands of dollars to our shareholder physicians. Premier Physicians’ ability to pay out after just three years as a company is further proof that we are carrying out strong, stable growth, even during these times of economic and insurance industry instability.

Premier Physicians faced many nay sayers when it started writing policies just four short years ago. Now, in keeping with our commitment to give back to the physician community, we are able to pay dividends to our shareholders, reflecting our excellence in client selection, risk management and claims control.

Premier Physicians is growing in other regions as well. We recently attended Valley Health Systems MEC Retreat where we presented our successes to medical industry representatives from all over the Las Vegas area. Attending this conference armed with the recent news of our dividend payout was a huge coup for Premier Physicians as our success, in spite of many marketplace obstacles, became the buzz of the conference.

In other exciting news, we have recently announced our partnership with InventaMed Healthcare Group, led by award winning practice consultant Rebecca Neaman InventaMed will offer full medical practice

development and technology integration for physicians’ practices.

Partnering with InventaMed is key to ensuring our physicians are provided with the best-in-class products and services, designed to improve their practices, lower their liability risks and improve their bottom line.

Best of all, InventaMed will offer substantial discounts to our members for this national service. Later in this newsletter, you will find several articles on InventaMed’s specific areas of expertise, including Electronic Medical Records Systems, Billing Services and more.

As we grow with our successes, we are growing our marketing efforts as well. You will notice our newsletter is growing in size as we continue to bring valuable information to our shareholders. Additionally, we are launching a blog, located on the Premier Physicians website that will help spread news instantly to our members. Visit www.ppicdocs.com/blog to subscribe to the RSS feed.

As always, Premier Physicians’ staff can be reached at 702-220-8160 or toll-free at 866-371-7742. Please also continue to visit the website for relevant information, located at www.ppicdocs.com

Dr. Warran Volker, Chairman

Chairman’s Message

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We are happy to announce that Premier Physicians Insurance Company has partnered with InventaMed Healthcare Group to provide

comprehensive consulting and business solutions for Premier Physicians members!

The new Las Vegas-based company expands upon Premier Physicians’ current practice management services to include full medical practice development and technology integration for physicians’ practices.

InventaMed Healthcare Group is unique in its access to physician advisors, insurance executives, financial consultants and healthcare technologies. Currently included in its platform of services are: Electronic Medical Record (EMR) evaluation and transition; banking and financing programs; billing and contracting solutions; media and marketing services; insurance programs; and consulting.

“Practice management consulting on its own is not enough to help physicians with the complex needs of today’s practices,” said Dr. Warren Volker. “They need full ‘medical development’ and a firm that actually offers a comprehensive platform of products and services as opposed to simply suggesting them. InventaMed provides that and more, and is a fantastic addition to the services offered by Premier Physicians Insurance Company,” stated Volker.

Nationally-recognized healthcare consultant Rebecca Neaman, formerly of Southwest Healthcare Management, has been named InventaMed’s President of Practice Management Consulting. She was recently recognized by In Business Las Vegas as Health Care Headliner and Practice Manager of the Year for 2009.

“InventaMed can help doctors run healthy practices, but it is more than just a practice management firm,” says Neaman. “We provide medical development that offers integrated technological and financial solutions to physicians, which allows physicians to provide better service to patients.”

The services provided through InventaMed are a valuable addition to the host of benefits available to Premier Physicians members!

More information about the products and services offered through InventaMed can be found at

www.imhcg.com. You can reach Rebecca or any of her highly experienced staff by calling the InventaMed offices at 888-338-DOCS.

InventaMed Healthcare GroupYour Practice Made Perfect

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Having your staff bogged down by health insurance and Medicare claims paperwork could be costing your practice thousands of dollars every year. According to The New England Journal of Medicine, “Physicians’ overhead and billing expenses take up 43.7% of their gross

professional income.”

Once you endure the paperwork phase of filing your medical claims, you have a long wait for your money. The typical turn-around time is 60 days, according to the Health Care Financing Administration.

On top of all that, typical claims filing has a rejection rate of 30%, some offices even higher. Filling out the forms on paper and mailing them takes time, then the completed forms can sit in the office of the insurance company for weeks. The process is highly inefficient.

Electronic claims services offer a cure. You can quickly solve your insurance billing problems by electronic claims processing. Your overhead will be lower, your cash flow will increase dramatically, and rejected claims will fall to about 2%.

Solving a Big, Big Problem:

When you outsource your insurance claims filing, you free up time for your staff and office manager for more productive tasks. Electronic claims processing saves 4-1/2 hours a day! This is In addition to the 50% lower overhead.

The Benefits:

Faster Payments- instead of waiting up to 60 days, your money will be in your account in 7 to 21 days. Electronic filing speeds up things at the insurance provider’s end with no data entry needed.

Lower Rejection Rate- real time editing will catch errors that could cause an unpaid claim. Rejection rate is less than 2%.

Recapture Lost Dollars- the system will refile existing claims returned with errors and/or missing information. Claims filed to all carriers and payors, including Medicare and Medicaid.

Real Time Reporting- you will have the ability to view your claim’s status from any computer with Internet access, 24 hours a day, 7 days a week.

Outsourcing your insurance claims filing frees up your time so you and your staff can focus on patient care, not bill collecting.

Medical Billing Services AdvantagesBy: Rebecca Neaman, InventaMed- Practice Management Consultant

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Doctors who believed in taking back ownership of their medical malpractice insurance are now being rewarded. Premier Physicians Insurance Company announced recently that the company will issue its first shareholder dividend in the third quarter of 2009, after just three

years in operation. Wholly owned by its policyholders, Premier Physicians Insurance Company has provided Nevada physicians with a medical malpractice insurance model they control and profit from. The financial success of Premier Physicians is due to the careful selection of applicants, precise underwriting and proactive risk management policies adhered to by its management company, Capstone Management Group.

As one of Nevada’s largest medical malpractice insurance carriers, Premier Physicians provides an unmatched combination of integrity, expertise, and financial strength, and has saved its members over $3 million in premiums when compared to their prior med-mal coverage. The company will begin issuing the dividend checks to vested shareholders – totaling hundreds of thousands of dollars – starting this quarter.

“Our strengths lie in our ability to understand the needs of physicians and continuously evolving with the marketplace. This allows us to deliver the most competitive medical malpractice coverage, while building strategic relationships that expand our capabilities, creating value for the company and its members. This dividend is evidence of that growing value,” said Dr. Warren Volker, Chairman of Premier Physicians Insurance Company.

Nino Pedrini, President of Capstone Management Group, said, “The secret is in maintaining a disciplined approach in a competitive market. It’s easy to give into the temptation to participate in rate wars. Any company can grow its market share by buying business, but that simply destabilizes the value of the company and the market itself. Capstone remains committed to responsible management, and it’s paying off for Premier Physicians’ members.”

Dividends Paid to Vested ShareholdersBy: Steve Keltie- Director of Marketing

Don’t miss this opportunity to get hands-on experience with the latest Tablet PC and EMR technology! Electronic Medical Records Showcase Dinner hosted by InventaMed Healthcare Group

November 10, 2009 If you are moving toward a digital environment, but are concerned about the technology choices, then make this product showcase your first step in finding the right solution. The showcase will explain everything you need to know about the EMR Stimulus money and how

to make it work for your practice!

Lawry’s Prime Rib 4043 Howard Hughes PkwyLas Vegas, NV 89169-0964

Cocktails and Dinner will be providedSpace is limited... R.S.V.P. today! 702-220-4190

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In a national survey conducted in 2008 by the New England Journal of Medicine, only 13% of United States healthcare providers were using a basic Electronic Medical Records (EMR) system in their offices. Current EMR system users may be slim, but popularity is on the rise. EMR

systems offer many advantages when implemented correctly in healthcare practices. EMR systems can increase productivity, cut down on errors, increase patient satisfaction, cut expenses, and add to the practices’ overall bottom line. Choosing the right system may seem daunting, but can be well worth the research. So, how does a successful healthcare provider choose the right system?

1)Request a prospectus on the company. Any reputable software company will have one and it should go into detail about how long the company has been in business, where the company is headed, and how much money is being allocated to development. Does the company have current clients located in the area, are they open to making changes at a customer’s request and how often is the system updated?

2)Request a full demonstration. Any sales rep can make a bad EMR system look amazing and functional. Once the overall functionality is seen, ask for references, and if available, demo reference contact information. A demo reference is a client who is already using the system and has offered to demonstrate the software to other potential users. More can be learned from a client who uses the system on a daily basis than a sales rep. Some software companies will even loan you an electronic tablet to use for a couple of weeks, enabling your practice to try the system before you purchase.

3)Get a return on investment breakdown. A reputable software company has already completed the research and can easily show how their EMR system can save companies thousands of dollars long term.

4)Make sure the system is user friendly and flexible to both you and your staff. Some software is robust from a clinical perspective, but from your support staff’s perspective, it may be inadequate and too time intensive.

5)Lastly, it is never too late to change systems. Keep a spreadsheet of pros and cons of your current EMR system. If you realize that the system is not sufficient, start searching for a new one. Having the right system can be the difference between a thriving practice and a stagnant practice being limited by technology.

Looking forward, EMR system implementation may be required by law in all medical offices. Financial incentives from the government of up to $44,000 per provider are available if the EMR system is in place within the next 12 months. The EMR system must be a government qualified and certified system to receive the incentive. The guidelines can be confusing, so be sure your prospective system qualifies. The sooner you start your research for implementing an accomplished EMR system, the sooner your practice will reap the benefits.

How to Choose the Right EMR SystemBy: Rebecca Neaman, InventaMed- Practice Management Consultant

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Nationwide compliance with the new Federal Trade Commission’s Red Flag rules is required by November 1, 2009

and many doctors don’t even know it. The banking industry and other financial institutions are very aware of the pending regulation, but other industries like the healthcare industry are unaware and are going to get a rude awakening on or soon after the deadline.

If required businesses are not within compliance as of November 1, 2009, a fine of up to $2,500 per violation and/or prosecution is possible. The Red Flag Rules are a new FACTA (Fair and Accurate Credit Transactions Act of 2003) requirement that helps protect consumers from possible identity theft by requiring an entity that regularly extends, renews or continues credit to compile a list of possible red flags that may indicate identity theft. Examples of such industries are hospitals, clinics, medical practitioners, financial institutions, utility companies, telecommunication companies and auto dealers.

Red Flag requirements are designed to help prevent fraud and reduce possible cases of identity theft. Medical practitioners fall under the Red Flag compliance because of the collection and storing of clients personal information. Medical identity theft surfaces when a patient seeks care using the name or insurance information of another person, which can result in both false billing and the potentially life-threatening corruption of a patient’s medical records.

Under the new Red Flag law, organizations must go through a list of potential red flags to ensure that the person who is performing the transactions is, in fact the real person. In the past, obtaining a drivers license or government ID was the only way of verifying a person’s identity, but with new technologies and higher than ever cases of identity theft, this method is no longer reliable.

The Red Flag regulation only provides a guideline for which businesses need to follow. Medical Offices must have measures in place to verify, authenticate, and validate a client’s identity and respond if an identity breach occurs.

While the essence of the Red Flag compliance rules is to have a program in place to detect and mitigate possible identity theft, it is up to the individual practice to resolve any breach.

In an effort to add value to what the government requires, Premier Physicians has taken the compliance requirement one step further. For Premier Physicians members who sign up with AEGIS ID Protect, Premier Physicians will provide at no cost to their members an insurance policy for breach response, recovery and resolution. More information can be found on the Red Flag Rules and Compliance Help at http://www.aegisredflag.com/ or at the FTC website http://www.ftc.gov/bcp/edu/pubs/business/alerts/alt050.shtm.

Red Flag Is Not a Choice, It’s the Law

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Recently I have been spending more time in the offices doing in-services and talking about the basic risk management questions the staff have. I base this information on the ECRI manual, Physician Office Fundamentals in Risk Management and Patient Safety, and then expand the

research as needed. Our recent “hot button” issue has been informed consent, not to be confused with signing a consent form. Medical assistants, nurses, and front office staff may not facilitate this process, and may only sign as a witness to the signature of the patient. The required educational process must be completed by the physician and charted as such prior to the patient signing. Please read the following from the AMA regarding informed consent:

Informed consent is more than simply getting a patient to sign a written consent form. It is a process of communication between a patient and physician that results in the patient’s authorization or agreement to undergo a specific medical intervention. In the communications process, you, as the physician providing or performing the treatment and/or procedure (not a delegated representative), should disclose and discuss with your patient:

•The patient’s diagnosis, if known•The nature and purpose of a proposed treatment or procedure•The risks and benefits of a proposed treatment or procedure•Alternatives (regardless of their cost or the extent to which the treatment options are covered by health insurance)•The risks and benefits of the alternative treatment or procedure•The risks and benefits of not receiving or undergoing a treatment or procedure

In turn, your patient should have an opportunity to ask questions to elicit a better understanding of the treatment or procedure, so that he or she can make an informed decision to proceed or to refuse a particular course of medical intervention.

This communications process, is both an ethical obligation and a legal requirement spelled out in statutes and case law in all 50 states. (For more information about ethical obligations, see the AMA’s Code of Medical Ethics, contained in the AMA PolicyFinder). Providing the patient relevant information has long been a physician’s ethical obligation, but the legal concept of informed consent itself is recent.

The first case defining informed consent appeared in the late 1950’s. Earlier consent cases were based in the tort of battery, under which liability is imposed for unpermitted touching. Though battery claims occasionally occur when treatment is provided without consent, most consent cases generally center around whether the consent was “informed”, i.e., whether the patient was given sufficient information to make a decision regarding his or her body and health care. Because informed consent claims, unlike battery claims, are based on negligence, they generally are covered by liability insurance.

Informed ConsentBy: Abby Hudema, Risk Management Coordinator

Informed Consent- continued on next page

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To protect yourself in litigation, in addition to carrying adequate liability insurance, it is important that the communications process itself be documented. Good documentation can serve as evidence in a court of the law that the process indeed took place. A timely and thorough documentation in the patient’s chart by the physician providing the treatment and/or performing the procedure can be a strong piece of evidence that the physician engaged the patient in an appropriate discussion. A well-designed, signed informed consent form may also be useful, but an overly broad or highly detailed form actually can work against you. Forms that serve mainly to satisfy all legal requirements (stating for example that “all material risks have been explained to me”) may not preclude a patient from asserting that the actual disclosure did not include risks that the patient unfortunately discovered after treatment. At the other extreme, listing

all of the risks may not be wise either. A comprehensive listing will be difficult for the patient to understand and any omission from the list will likely be presumed undisclosed. If you are using a form that contains a list, consider, with your attorney, inserting language indicating that the list is not exclusive (such as “included, but not limited to”) before the list begins. Medicare participating physicians must also be cognizant of CMS’s requirements for informed consent.

The Risk Management team at Premier Physicians wants to have an active role in assisting you with reducing your risk. We are able to provide you with research and legal assistance for any operational questions you may have so do not hesitate to call. Please feel free to contact me at 702-521-3376 regarding Risk Reduction in-services in your office.

Informed Consent- Continued

Welcome Aboard!

A warm welcome to Marshall Gunter! Marshall will be joining Jim McMahon and Abby Hudema in our Risk

Management division. He will be visiting offices and presenting a new binding arbitration form, and generally just “touching base” with you.

The risk management team at Premier Physicians will now be coming directly to your office for risk reduction seminars. We know you’re busy, so we asked many of our practice managers what would be the easiest way to

schedule in-services. The answer was to offer seminars in the office, on their schedule! We will be covering subjects from the ECRI Risk Management book ranging from Legal Fundamentals and Confidentiality Issues to Medical Record Management and Error Reporting. We can also customize a program to fit your needs, and we are always happy to research Risk Management questions for you. We are currently working to schedule seminars. For more information, please call Abby Hudema, RN at 702-521-3376 or Marshall Gunter at 702-301-0145.

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Premier Profile: Amigenics

Amigenics is an innovative adult multi-specialty medical clinic in Las Vegas. The practice’s approach to healthcare

is very unique and different from others in the nation. The board-certified staff of physicians and genetic counselors offer personalized disease risk screening, clinical evaluations, genetic counseling and treatment plans for a variety of conditions that affect adults today.

Amigenics’ approach is unique. The physicians combine comprehensive medical evolutions with the revolutionary technologies of advanced medical imaging and genetics. They specialize in diagnosing and treating conditions such as breast cancer, colon cancer, neurological conditions and cardiovascular disease.

At Amigenics, teamwork makes the dream work and that is reiterated from the physicians to the office staff. Amigenics medical staff

is committed to working as a team with the patient, their family and their other healthcare providers to ensure the highest quality of care and the best patient outcomes.

Dr. Robb Rowley and Dr. Eric Hanson are the two board-certified physicians that make up Amigenics. They are both certified in Internal Medicine, Preventative Medicine and Genetics. Erica Ramos is a board-certified genetic counselor. She counsels patients and families before and after the genetic evaluations to explain results and explore options.

Amigenics has been a Premier Physicians member since 2008. Amigenics takes pride in their patients’ care and practices active risk managament. Amigenics believes in the Physician owned model and enjoys contributing to lower premiums for all Premier Physicians members.

Education Committee By Dr. Marc Vennart, MDChairperson, Clark County Medical Society CME\Education Committee

As the newly appointed Chair of the Clark County Medical Society’s CME/EDU committee, I am looking forward to offering unique and informative learning opportunities to our members. The current climate in medicine is in urgent need of strategies to “self-govern” in areas of patient

safety, risk reduction and malpractice/tort reform, as well as education regarding the on-going health care reform issues. These are just a few of the biggest challenges facing us in the coming year.

CCSM has partnered with Premier Physicians Insurance Company to maximize our CME opportuni-ties. We will be organizing seminars on medical legal topics with key speakers from various law firms in the valley. We will then host a valuable patient safety program based on the the airlines’ Crew Resource Management model of communication, teamwork, and maximum utilization of resources to accomplish these tasks.

Participation from the local medical community is vital to identify local issues and needs. If you have a topic you feel needs to be explored, please submit your input.

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We hope you enjoyed this issue of Premier Profile. If you would like more information about anything you’ve read today, please contact us at:

Toll Free: 866-371-7742 - Fax: 775-823-9775Email: info@ppicdocs.com - Web site: www.ppicdocs.com

These last several months have been active ones in the legislative arena. Much attention has been focused on the national health care reform debate; however, it will be equally important to focus on local legislation, especially with this being an election year.

One important initiative will be campaigning to maintain the malpractice reform legislation that is currently in place. The Premier Physicians’ legislative committee plans to work with local attorneys and legislators to forward this goal. We saw several important pieces of reform legislation come under attack last year and we can rest assured, the fight will come around again.

Other news: In the first week of October, the Nevada Captive Insurance Association held its annual conference. Scott J. Kipper, the new Nevada Insurance commissioner, and his staff held a Best Practice Symposium and provided some updates on the initiatives of the Department of Insurance (DOI).

The meeting was very informative and some of the key points on new regulations include: 1) the DOI will now be entirely funded by fees instead of state funds; 2) new DOI initiative to expand Nevada’s captive insurance program to become nationally recognized; 3) new DOI initiative to streamline the exam process for accreditation.

As the year progresses, I will working closely with our lobbyist and the Medical Society to represent our Premier Physicians members.

Legislative UpdateBy: Dr. Annie Cheanvechai, MD- Chairperson, Clark County Medical Society Legislative Committee

2009 Stockholders’ Meeting

The 2009 Stockholders’ Meeting will be held at The M Resort in Las Vegas on November 9, 2009. The meeting will present a review of the 2008-2009 fiscal year performance as well

as a preview of 2010! Please keep an eye out for your invitation. We look forward to seeing everyone!

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Dividends are now being paid to vested shareholders.

One of Nevada’s leading medical malpractice insurance carriers will begin issuing dividend checks totaling hundreds of thousands of dollars to vested shareholders in the third quarter of 2009. Premier Physicians has saved its members more than $3 million in premiums to date. Our members chose to reclaim control of their own medical malpractice insurance and they are being rewarded.

Interested in becoming a Premier Physician? Call us toll-free at 1-866-371-7742 or visit us at www.ppicdocs.com

• 100% physician owned and controlled• Reinsured by Lloyd’s of London• All medical specialties eligible for coverage• Direct Access, saving you time and money• Discounts given for medical society members

Dividends Paid.