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WINTER 2009

Premier
profile

Dividends Paid to Vested Stockholders
InventaMed Healthcare Group
Premier Profile: Amigenics
Medical Billing Services Advantages
PREMIER PROFILE :: WINTER 2009

Chairman’s Message

W
elcome to the winter edition of development and
the Premier Physicians Insurance technology integration for
Company Newsletter! We begin this physicians’ practices.
new fiscal year with the announcement that,
Partnering with
for the first time, Premier Physicians is paying
InventaMed is key to
dividends totaling hundreds of thousands of
ensuring our physicians
dollars to our shareholder physicians. Premier
are provided with the
Physicians’ ability to pay out after just three
best-in-class products and services, designed
years as a company is further proof that we
to improve their practices, lower their liability
are carrying out strong, stable growth, even
risks and improve their bottom line.
during these times of economic and insurance
industry instability. Best of all, InventaMed will offer substantial
discounts to our members for this national
Premier Physicians faced many nay sayers
service. Later in this newsletter, you will find
when it started writing policies just four
several articles on InventaMed’s specific areas
short years ago. Now, in keeping with our
of expertise, including Electronic Medical
commitment to give back to the physician
Records Systems, Billing Services and more.
community, we are able to pay dividends to
our shareholders, reflecting our excellence in As we grow with our successes, we are
client selection, risk management and claims growing our marketing efforts as well. You will
control. notice our newsletter is growing in size as we
continue to bring valuable information to our
Premier Physicians is growing in other
shareholders. Additionally, we are launching
regions as well. We recently attended Valley
a blog, located on the Premier Physicians
Health Systems MEC Retreat where we
website that will help spread news instantly to
presented our successes to medical industry
our members. Visit www.ppicdocs.com/blog to
representatives from all over the Las Vegas
subscribe to the RSS feed.
area. Attending this conference armed with
the recent news of our dividend payout As always, Premier Physicians’ staff can be
was a huge coup for Premier Physicians as reached at 702-220-8160 or toll-free at 866-
our success, in spite of many marketplace 371-7742. Please also continue to visit the
obstacles, became the buzz of the conference. website for relevant information, located at
www.ppicdocs.com
In other exciting news, we have recently
announced our partnership with InventaMed
Healthcare Group, led by award winning
Dr. Warran Volker, Chairman
practice consultant Rebecca Neaman
InventaMed will offer full medical practice
PREMIER PROFILE :: WINTER 2009

InventaMed Healthcare Group
Your Practice Made Perfect

W
e 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.
PREMIER PROFILE :: WINTER 2009

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

H
aving 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.
PREMIER PROFILE :: WINTER 2009

Dividends Paid to Vested Shareholders
By: Steve Keltie- Director of Marketing

D
octors 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.”

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 Pkwy
Las Vegas, NV 89169-0964

Cocktails and Dinner will be provided
Space is limited... R.S.V.P. today! 702-220-4190
PREMIER PROFILE :: WINTER 2009

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

I
n 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.
PREMIER PROFILE :: WINTER 2009

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

N
ationwide compliance with the new
Federal Trade Commission’s Red Flag Under the new Red Flag law, organizations
rules is required by November 1, 2009 must go through a list of potential red flags to
and many doctors don’t even know it. ensure that the person who is performing the
The banking industry and other financial transactions is, in fact the real person. In the
institutions are very aware of the pending past, obtaining a drivers license or government
regulation, but other industries like the ID was the only way of verifying a person’s
healthcare industry are unaware and are going identity, but with new technologies and higher
to get a rude awakening on or soon after the than ever cases of identity theft, this method is
deadline. no longer reliable.

If required businesses are not within The Red Flag regulation only provides a
compliance as of November 1, 2009, a fine of guideline for which businesses need to follow.
up to $2,500 per violation and/or prosecution Medical Offices must have measures in place
is possible. The Red Flag Rules are a new to verify, authenticate, and validate a client’s
FACTA (Fair and Accurate Credit Transactions identity and respond if an identity breach
Act of 2003) requirement that helps protect occurs.
consumers from possible identity theft by
requiring an entity that regularly extends, While the essence of the Red Flag compliance
renews or continues credit to compile a rules is to have a program in place to detect
list of possible red flags that may indicate and mitigate possible identity theft, it is up to
identity theft. Examples of such industries the individual practice to resolve any breach.
are hospitals, clinics, medical practitioners,
financial institutions, utility companies, In an effort to add value to what the
telecommunication companies and auto government requires, Premier Physicians has
dealers. taken the compliance requirement one step
further. For Premier Physicians members
Red Flag requirements are designed to help who sign up with AEGIS ID Protect, Premier
prevent fraud and reduce possible cases Physicians will provide at no cost to their
of identity theft. Medical practitioners fall members an insurance policy for breach
under the Red Flag compliance because of response, recovery and resolution.
the collection and storing of clients personal
information. Medical identity theft surfaces More information can be found on the Red Flag
when a patient seeks care using the name Rules and Compliance Help at
or insurance information of another person, http://www.aegisredflag.com/ or at the FTC
which can result in both false billing and the website http://www.ftc.gov/bcp/edu/pubs/
potentially life-threatening corruption of a business/alerts/alt050.shtm.
patient’s medical records.
PREMIER PROFILE :: WINTER 2009

Informed Consent
By: Abby Hudema, Risk Management Coordinator

R
ecently 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 Consent- continued on next page
PREMIER PROFILE :: WINTER 2009

Informed Consent- Continued
To protect yourself in litigation, in addition all of the risks may not be wise either. A
to carrying adequate liability insurance, it is comprehensive listing will be difficult for the
important that the communications process patient to understand and any omission from
itself be documented. Good documentation the list will likely be presumed undisclosed.
can serve as evidence in a court of the law that If you are using a form that contains a list,
the process indeed took place. A timely and consider, with your attorney, inserting language
thorough documentation in the patient’s chart indicating that the list is not exclusive (such
by the physician providing the treatment and/ as “included, but not limited to”) before the
or performing the procedure can be a strong list begins. Medicare participating physicians
piece of evidence that the physician engaged must also be cognizant of CMS’s requirements
the patient in an appropriate discussion. A for informed consent.
well-designed, signed informed consent form
may also be useful, but an overly broad or The Risk Management team at Premier
highly detailed form actually can work against Physicians wants to have an active role in
you. Forms that serve mainly to satisfy all assisting you with reducing your risk. We are
legal requirements (stating for example that able to provide you with research and legal
“all material risks have been explained to me”) assistance for any operational questions you
may not preclude a patient from asserting may have so do not hesitate to call. Please feel
that the actual disclosure did not include risks free to contact me at 702-521-3376 regarding
that the patient unfortunately discovered Risk Reduction in-services in your office.
after treatment. At the other extreme, listing

Welcome Aboard!

A
warm welcome to Marshall Gunter! schedule in-services. The answer was to offer
Marshall will be joining Jim McMahon seminars in the office, on their schedule!
and Abby Hudema in our Risk We will be covering subjects from the ECRI
Management division. He will be visiting Risk Management book ranging from Legal
offices and presenting a new binding arbitration Fundamentals and Confidentiality Issues
form, and generally just “touching base” with to Medical Record Management and Error
you. Reporting. We can also customize a program
to fit your needs, and we are always happy
The risk management team at Premier to research Risk Management questions for
Physicians will now be coming directly to your you. We are currently working to schedule
office for risk reduction seminars. We know seminars. For more information, please
you’re busy, so we asked many of our practice call Abby Hudema, RN at 702-521-3376 or
managers what would be the easiest way to Marshall Gunter at 702-301-0145.
PREMIER PROFILE :: WINTER 2009

Premier Profile: Amigenics

A
migenics is an innovative adult multi- is committed to working as a team with the
specialty medical clinic in Las Vegas. patient, their family and their other healthcare
The practice’s approach to healthcare providers to ensure the highest quality of care
is very unique and different from others in the and the best patient outcomes.
nation. The board-certified staff of physicians
and genetic counselors offer personalized Dr. Robb Rowley and Dr. Eric Hanson are the
disease risk screening, clinical evaluations, two board-certified physicians that make up
genetic counseling and treatment plans for a Amigenics. They are both certified in Internal
variety of conditions that affect adults today. Medicine, Preventative Medicine and Genetics.
Erica Ramos is a board-certified genetic
Amigenics’ approach is unique. The physicians counselor. She counsels patients and families
combine comprehensive medical evolutions before and after the genetic evaluations to
with the revolutionary technologies of advanced explain results and explore options.
medical imaging and genetics. They specialize
in diagnosing and treating conditions such Amigenics has been a Premier Physicians
as breast cancer, colon cancer, neurological member since 2008. Amigenics takes pride
conditions and cardiovascular disease. in their patients’ care and practices active
risk managament. Amigenics believes in
At Amigenics, teamwork makes the dream the Physician owned model and enjoys
work and that is reiterated from the physicians contributing to lower premiums for all Premier
to the office staff. Amigenics medical staff Physicians members.

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

A
s 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.
PREMIER PROFILE :: WINTER 2009

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

T
hese 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.

2009 Stockholders’ Meeting

T
he 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!

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: 775-823-9775
Email: info@ppicdocs.com - Web site: www.ppicdocs.com
Dividends Paid.
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.

• 100% physician owned and controlled Interested in becoming a
• Reinsured by Lloyd’s of London Premier Physician? Call us
• All medical specialties eligible for coverage toll-free at 1-866-371-7742 or
• Direct Access, saving you time and money visit us at www.ppicdocs.com
• Discounts given for medical society members