The Financial Benefits of a Risk Management Audit Action Plan

By Steve Griffin, President of Insurance People

Risk Management is a great avenue to protect your business from potential lawsuits or government fines, thus keeping your business from being shutdown due to poor control of your operations.

A Risk Management Audit Action Plan will properly evaluate your current risk management controls relating to safety policies and procedures, claim reporting practices, workers compensation, disaster planning, employment practices, and education or training needs. Assuming the project uncovers deficiencies, Insurance People assists in the design of a current insurance program to ensure that the assets of your business are properly protected and managed.

Insurance People will act as a consultant in critiquing your business’ current risk management program. In order for the audit process to be effective, the business management team must be supportive and involved. All information gathered by Insurance People will only be shared with individuals approved by the management team.

Once Insurance People meets with the business’ management team to outline the Risk Management Audit process and its benefits, we put together a plan for review and approval by the management team. Everyone then discusses the audit process and make the appropriate changes to the action plan.

Next, we begin to gather information related to claims, safety, contracts, and business continuity, as well as additional information to complete the step. Insurance People meets with selected representatives to gain understanding of operations and risk management strategies. Then, Insurance People and the business management team partner to complete the Intelligence Quotient for Risk Management (IQRM) related to their industry.

Insurance People will present our audit findings and interview observations to the business management team. We then begin to work hand-in-hand with the business management team to implement the appropriate risk management policies, procedures and controls.

Long term, the benefits of the Audit Action Plan are increased stability for both cost and insurability, positive growth of the business, less government intervention, and building a solid risk management program for others to follow and learn from.

Insurance People is an independent agency providing Commercial, Personal, and Benefits insurance. Please feel free to contact me at steve@inspeople.com or (919) 383-0442.

In Retirement, Plan to Make Your Money Last – Todd Grantham

In Retirement, Plan to Make Your Money Last
Provided By: Todd G Grantham, Northwestern Mutual

Some people have a clear idea of how they want to live once they stop working. For many others, however, retirement is a step into the great unknown. The problem is, without a roadmap for turning your savings into a sustainable stream of income, it’s difficult to create the type of lifestyle you want for the future.
Planning for retirement is a lifelong process that should begin as soon as you start working and continue throughout your retirement years. But whether you are five years from retiring or 30, the following can help you achieve financial security for when the big day finally comes.

Step 1: Practice retirement

Like most people, you may spend years fantasizing about the day when you can finally stop working. But what will your retirement look like? Financial experts recommend that you think about what you want to do when you retire and then “practice” some of it first. For example, if you’d like to move to a warmer climate, try vacationing there several times to get a sense of what it might cost and how it feels not just in the winter, but in the heat of summer. Similarly, if you plan watching your grandkids full time, take a week or two to do a test run. The goal is to try out your plans, determine whether you truly enjoy and can afford them, and make any needed adjustments before you commit.

Step 2: Match your expenses and income

As you think about your lifestyle in retirement, your expenses will fall into two groups: essential expenses (your “needs”) and discretionary expenses (your “wants”). Within discretionary expenses, you also may have one-time expenditures, such as funding a grandchild’s education or adding a sun porch to your home. Whether you make a spreadsheet on your computer or simply list your expenses on a pad of paper, the goal is to create a retirement budget that captures as many anticipated costs as possible.

Next, consider the money you’ll have coming in. Typically, retirees draw from three categories of income in retirement: guaranteed sources of income (such as Social Security, pensions and lifetime income annuities), savings and investments, and any employment income.

Once you know what you’re likely to have coming in, pair your income and expenses based on their priority, matching your “needs” with your guaranteed income sources first. If the predictable income you expect won’t cover all your essential expenses, you may want to either adjust your plans or consider converting a portion of your savings into a regular stream of income. Conversely, if you have a surplus, you can use the “extra” money to cover any discretionary expenses.

Step 3: Decide which account type to tap first

One way to maximize the amount of money you may have in retirement is by planning the order in which you spend your different investment accounts. The starting point is to consider whether you plan to use your assets for ongoing expenses in retirement or to pass them along to your heirs or charities.
For many, it makes sense to draw from your taxable accounts first in order to keep the assets in your retirement accounts growing tax deferred for as long as possible. Tax-exempt accounts, such as Roth IRAs, should be spent last. However, there is no rule-of-thumb when it comes to the order in which you should liquidate your assets.

If you plan to pass your assets along to your heirs or charities, you may want to spend tax-deferred assets with the intention of bequeathing taxable assets, which receive more-favorable tax treatment when inherited.
The order in which you withdraw your retirement savings is an important decision that becomes even more complex once you reach age 70 ½. That’s when you must begin taking annual required minimum distributions (RMDs) from your IRAs and retirement plans.

Because each person’s situation is unique, you should include both your financial professional and tax advisor in these discussions.

Step 4: Protect your savings

Consider putting enough money into a savings or liquid money market account to cover your withdrawal needs for at least two years. This can help prevent taking money out of your investments when the market and share prices are trending downward.

If you haven’t already, consider funding a long-term care plan (LTC) as well. LTC funding can help protect your retirement nest egg from the financial impact of the costs of extended care either at a facility or in your home.

Step 5: Fine tune along the way

Spending retirement assets can be even more complex than building them: Your retirement savings need to provide reliable income to meet your ongoing expenses for the rest of your life. Reviewing your plan annually and keeping it current is vital to making this happen.

Consider just some of the things that can change in a year. Your marital or health status could change; your investment returns and inflation rate could fluctuate; and your employment status and expected retirement date might shift. Each of these can have a profound impact on the amount of money you may have to spend in retirement.

That’s why it’s important to work with a financial professional who understands that retirement planning is an ongoing process — someone who knows what it takes to accumulate assets for retirement, mitigate the risks that can affect your retirement years, and how to turn your funds into a distribution plan designed to generate sufficient income to meet your lifestyle needs for as long as you need it to.

Article prepared by Northwestern Mutual with the cooperation of Todd G Grantham. Todd G Grantham is a Wealth Management Advisor with Northwestern Mutual, the marketing name for The Northwestern Mutual Life Insurance Company (NM), Milwaukee, Wisconsin, and its subsidiaries. Todd G Grantham is an agent of NM based in Durham, NC. To contact Todd G Grantham, please call (919) 401-0345, e-mail at todd.grantham@nm.com or visit at granthamfinancial.com. This information is not intended as legal or tax advice.

Is it Time for a Practice Assessment? – Deborah Wilkins

Deborah A. Wilkins
Medical Practice Advisory Group, LLC
www.mdpracticeadvisorygroup.com
dawilkins@mdpracticeadvice.com
919-321-1656

Many physician owners and medical practice managers report that they are frustrated by never having adequate time to do an operational or financial assessment of their practices to identify and correct the problems which are negatively impacting profitability and productivity. This is because managers are constantly attending to the daily needs of the practice, putting out fires, resolving personnel problems, dealing with cash flow issues and physician-generated concerns. As necessary as these activities are to operating a successful practice, they are generally not related to improving practice performance and profitability.

An operational assessment and continuous process improvement project is designed to provide the practice with a blueprint for achieving greater efficiency and profitability over the short-term and long-term. A comprehensive operational assessment and improvement process project assesses the following twelve areas of medical practice operations in a top to bottom manner:

1. Profitability and Overhead Expenses,
2. Accounts Receivable Management,
3. Productivity, Capacity and Staffing
4. Scheduling, Patient Access and Patient Satisfaction
5. Patient Flow, Operational Efficiency and Office Organization
6. Coding, Reimbursement and Medical Records
7. Patient Billing, Insurance Processing and Collections
8. Compliance and Risk Management to include:
 HIPAA Compliance
 OSHA Compliance
 Malpractice Risk Reduction
 Human Resources Compliance
9. Personnel Management
10. Facility and Equipment Management
11. Information Technology Systems
12. Strategic Planning and Marketing

A comprehensive practice assessment which evaluates all of the above-listed areas, utilizes a three-page checklist. However, because each medical practice is unique, with its own specific needs, these assessment projects are tailored to focus on those specific areas of concern to your practice. The areas of focus for each assessment project should be discussed and agreed upon in advance.

A practice assessment checklist tailored to the needs of your practice is the primary tool utilized for assessing the operational areas included in the project. Each item on the checklist is reviewed and discussed in detail in the report. Where applicable, the assessment checklist also includes a comparison of the group’s financial and productivity data with industry standard national and/or regional medians and “best practices” benchmarks for the client’s practice size. Using standard measures, benchmarking provides a continuous process for measuring an learning about your practice’s productivity, costs, profitability and quality. Although medical practices, even those in trouble, often report the use of benchmarks, they are rarely integrated into the daily operations of the practice or used to create accountability or drive performance improvement. If practices truly wish to master their business systems, benchmarking must be used to drive performance to achieve “best practice” standards.

Typically, it takes about a week to acquire the information that is necessary for solo practitioners to upwards of a month or more for larger groups, wherein interviews must be scheduled with every member of the staff and time is spent observing the processes in the office from check-in and check-out, to billing, to medical records, to the clinical area. Once the site work is finished, work on the report commences, which takes anywhere from six to eight weeks and sometimes longer, depending on group size. The Practice Assessment report (report of findings and recommendations) focuses primarily on problems, deficiencies and/or concerns identified as a result of the analysis of the information provided by the practice and through direct observation. All of the identified problems and/or deficiencies listed on the assessment checklist having a direct or indirect negative impact on practice cash flow and/or profitability are further analyzed in the report. This analysis/assessment explains how the identified problem or deficiency affects practice cash flow and/or profitability; it also offers recommendations for changes or improvements that should be implemented to resolve the identified problems and discusses options on how to implement the recommended action(s).

Upon completion of the assessment and compilation of the report of findings and recommendations, a meeting should be scheduled to discuss and elaborate on the final report and answer any questions relative to the information and recommended change initiatives.

A medical practice assessment is of tremendous benefit to a practice in expediting the process of identifying operational inefficiencies and problems inherent in nearly every practice, large or small, which are negatively impacting practice productivity, cash flow and profitability. The assessment also assists the practice in prioritizing those recommended actions which will have the greatest immediate impact on improving practice performance and profitability.

Isn’t it time your practice has a check-up?

MHA Logo_Full

MHAworks is a commercial architecture firm, founded in 1988.  With a staff of over 30 professionals providing architecture, interior design and planning. For over 20 years Healthcare Design has been the premiere expertise of MHAworks. Our healthcare studio has extensive design experience in both private clinic and hospital settings, as stand-alone facilities and as complex renovations of major hospitals. We capitalize on the unique challenges of planning for clinics, hospitals and centers. Some of these considerations include attention to existing conditions, phasing while the building is still in use, and user group and stakeholder consensus.

Brian Maxwell

Brian Maxwell offers an experienced perspective on healthcare design. He is recognized for bringing innovation and strategic vision to a wide variety of healthcare planning and design projects. Brian specializes in leading project teams for healthcare clinics, hospital renovations and medical office buildings throughout North Carolina. During his 24-year career, clients have benefited from consistent involvement in the total design process, a hands-on approach to programming and planning, and unmatched professional performance.

For more information visit www.mhaworks.com

UNCH NS7F 1 NCCC  UNCH 3 Bed Tower

 

Bill Fivek President and CEO

Total Medical Compliance

Bill joined the company in 2005.  Bill worked with Motorola for over 20 years in technology and customer service, prior to joining TMC.  Bill has been a technical educator for over 27 years. He has given various technical presentations to diverse audiences worldwide. He has passed the required training to be recognized by the US Department of Labor to be an OSHA General Industry Outreach Trainer in March of 2006.  Bill graduated in 1984 with a BSEE from the University of Delaware.

Bill@totalmedicalcompliance.com

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Total Medical Compliance provides affordable OSHA and HIPAA compliance programs for health care facilities and organizations.

Total Medical Compliance (TMC) offers OSHA and HIPAA compliance solutions for healthcare and related business industries. We offer onsite and eCompliance products and services as well as customer support, to allow our clients to structure a program that best fits their needs. Whether your needs are for a small practice, or a large hospital network, TMC will put a customized OSHA and HIPAA compliance program in place that assures your total compliance.

Extraordinary Customer Support

Total Medical Compliance offers hands-on, full service customer support for online and in-person clients-the only company that provides this level of service. We are a one-stop shop offering training, customer support, manuals and webinars. At TMC, every client is unique, and we offer multiple solutions to help meet your OSHA and HIPAA compliance needs.

Our Commitment

We are committed to provide new OSHA and HIPAA compliance programs our clients need, and offer those programs in a convenient and cost effective manner.  Our mix of programs and delivery methods has grown as our client needs and regulatory environments have grown.  We stay up to date with new trends and issues in healthcare so we can provide early assistance to the healthcare community and our clients with regulatory issues.  Most importantly, we work with our clients as “real-time partners” to achieve their compliance or accreditation, rather than simply providing a how-to-guide that requires them to do all the work. Our goal is to be their primary resource for HIPAA and OSHA compliance, as experts in the field.

Our Mission

To provide our clients with expert, timely and beneficial knowledge on their OSHA and HIPAA compliance.  We will supply extraordinary customer service and solutions in the eyes of our customers and employees through the highest ethical and moral standards.

Ask our clients and others working in the industry about us. 

We are proud members of the Better Business Bureau (BBB). We have attained A+ status and have received no complaints (members since 4/18/11).

We are your one-stop shop offering training, customer support, manuals and webinars!

Total Medical Compliance

Insperity-logo

I am Amanda Bokesch and I am a Business Performance Adviser with Insperity. I have been working with small businesses for the last 6 years helping them to run better, grow faster and make more money.  As a Business Performance Adviser at Insperity, I am dedicated to helping businesses succeed by taking care of the items that could be distracting them from what matters most – growing the business.
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My goal is to help entrepreneurs find ways to tie their people to their business goals. I invest heavily in learning about the unique challenges of each business and help them devise a plan for how to confront many of the most difficult challenges, including:

Attracting and Retaining Top Talent
Reducing Health Care Costs
Minimizing Risk
Offloading Administrative Burdens
Making each company an even better place to work!

My clients achieve measurable bottom line results because they have time to focus on what is most important. My personal approach is not to sell but rather to listen, understand, educate and whether through Insperity’s suite of services or another path altogether, I can provide ideas and recommendations for putting your business plan on the fast track.

Amanda.Bokesch(at)insperity.com

http://www.insperity.com/

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cst DATA LOGO
  • CST is a local, privately owned document management company
  • CST Data was started in October 2001 in a 5000 sf. leased facility in Charlotte, N.C.
  • Currently operates out of a 13,500 sf. Facility in Concord, NC and a 10,000 sf. facility in Southwest Charlotte, N.C.
  • CST Data performs scanning services for healthcare, government, construction, financial, legal, educational, and general business customers across the Southeastern U.S.
  • We offer document conversion, storage and retrieval systems, scanning hardware and software, disc publishing systems, forms creation software and a full line of tablet PC’s for the forms software
  • CST Data also offers data conversion services  ( such as film to digital and digital to film conversion)
  • CST offers integration services to integrate scanning systems with your current operational system.

Create

CST Data offers document imaging services, which is the process of converting your paper documents into digital replicas. The electronic files are stored on your company’s computer network or on a web-based image repository. They’re fully searchable, so your employees spend less time searching through countless files for a single document, and they require no physical storage space. Did you know that it costs you $20 in labor to file a document, $120 in labor to find a misfiled document and $220 in labor to reproduce a lost document? In a business climate where organizations are constantly searching for ways to cut costs and increase productivity, digital files provide a dramatic impact to your bottom line.

 Distribute

Your digital archive makes it easy for your employees to find the information they need, but the benefits of electronic files go beyond internal use. CST Data’s digital file sharing services make it easy for you to share your information outside your organization as well. With digital files, there’s no need for endless photocopying or printing stacks of paper to mail. Now, sending your information is as simple as creating an encrypted disc, sending an e-mail, or granting secure access to information to authorized users by a password-protected document grant.

Preserve

Your document archive represents knowledge your organization has spent years acquiring. Only about a quarter of your data is newly created—the rest is “redundant data,” data that was created in the past and must be retained for use in the future. It’s critical that you store and adequately protect this priceless information, and digital archiving is the most efficient and safest way to do that. With digital archiving, you can retain old information for future use, meet your increasing record storage needs without using physical space, and live up to your industry’s compliance and legislation requirements.

CST Data archives your documents and makes them fully searchable, so the information you need is always at your fingertips. We also create a data backup to ensure that your documents are protected for years to come, even in case of a disaster.

Keeping your data safe

CST ensures that your data is always there when you need it with hard copy disc media backups at your location, as well as in a fireproof vault at CST Data’s location. CST also maintains additional backups with two redundant RAID 5 servers and on multiple off-site hard drives in a secure location. CST also stores all of your papers after scanning until you’re sure you’re satisfied with your digital files.
Why CST Data? 

  • Corporate information on paper carries the following inherent risks and inefficiencies
  • Paper can get lost or misplaced
  • Paper is subject to fire, water or other environmental damage
  • Consumes valuable  real estate for physical storage
  • Consumes  valuable employee time for  finding and re-filing documents
  • Documents must be copied for information sharing
  • There is little security or disclosure tracking ability in a paper based system
  • Increases time and difficulty for performing audits
  • Non compliant for many industry regulations
  • Corporate information resides in multiple non related locations
  • Paper and the information it contains, degrades over time
  • Results in customer dissatisfaction due to delayed response time

Going Digital…The opposite of all the above

 

WANT TO LEARN MORE ABOUT HOW CST DATA

can help you save time, space and money while
protecting your irreplaceable documents?

 

CST Data

Mark Rigsbee

http://www.cstdata.com/

10725 JOHN PRICE ROAD, SUITE A
CHARLOTTE, NC 28273

Phone:    704-927-3282

Toll Free: 866-383-3282
Fax:         704-927-3287

mrigsbee@cstdata.com 

 

Durham Veterans Hospital Donation Drive

For the months of September and October the members of Leading Edge Healthcare Professionals collected items for the Durham Veterans Hospital.  Many of the patients at the Durham VA attend the hospital for wellness visits, physical therapy, specialized care and hospice. The Durham VA takes great care to support Veterans with their needs

Our organization values the Durham VA and recognizes that helping our Veteran’s is a wonderful way to give back to our community and to those who risked their lives for our freedom. This is a small token of appreciation for the huge sacrifice our Veterans have made on our behalf.  We will continue many community projects throughout the year. For ways that you can donate and help this wonderful organization please go to http://www.durham.va.gov/giving/index.asp. If you have a local cause that you would like us to consider for our next service venture, please contact: info@leadingedgehealthcareprofessionals.com

 

LEHP Donations to VA Hospital
Item Quantity
Keurig Coffee Packages

3

Lotion Bottles

8

Hormel Meals

16

Styrofoam cup packages

5

Toothpaste

20

Toothbrushes

21

Sweatpants

21

Sweatshirts

5

Pairs of Tennis Shoes

28

Queen sized air mattress

2

Packs of underwear

10

Packs of UT-shirts

2

Package of 10 pairs of socks

2

20 piece set of silverware

1

Cookware set

1

Book of stamps

1

Total Items

146

LEHP Group Photo Durham VA

The Feds and Their Regs:

What Certain Government Regulations Mean For Your Dental Practice

By: Joan Kassel, MLIS with Professional Risk Associates

“The most terrifying words in the English language are; ‘I’m from the government and I’m here to help.’” – Ronald Reagan

As an insurance agent for a company with a focus on medical/dental professional liability, Mr. Reagan’s words could not be truer. Nearly every day someone in our office receives a call from a provider stating they are retiring or accepting employment with a hospital or other large organization. The reasons for this are, “I just don’t want to deal with all the bureaucracy;” “it’s frustrating to try and keep the doors open when the government expects you to deal with all the red tape just to get the small amount they are willing to reimburse;” and “the good guys are getting caught up in their hunt for the bad guys.” For those of you who continue practicing independently in this ever-changing regulatory environment, I hope you will find these tips helpful in your dental practice.

False Claims Act Cases

There has been an increase in the number of False Claims Act cases brought against dentists and orthodontists. Under both the Federal and State False Claims Act law, private parties having direct knowledge of fraudulent conduct are authorized to bring a civil suit against the violator on behalf of the government. These civil suits are known as qui tam actions. The private parties who initiate the qui tam actions are called “relators” and can share in any money recovered as a result of their qui tam action. Your dental practice should develop, implement, and adhere to all statutory and regulatory requirements set out in an effective compliance plan. Some of the allegations of violation include:

  • Billing Medicaid for services not medically necessary
  • Billing for services not provided
  • Billing Medicaid for services provided by a dentist excluded from participation in the Medicare and Medicaid programs
  • Failure to document the dental services provided
  • Unlicensed individuals providing dental services
  • Giving something of value to an individual in exchange for the referral of a patient for Medicaid covered dental services

Tips For Voluntary Compliance

The seven basic components of a voluntary compliance program can be found at http://oig.hhs.gov/authorities/docs/physician.pdf (See page 59436 Federal Register/Vol. 65 No. 194/Thursday, October 5, 2000/Notices Section II, “Developing a Voluntary Compliance Program.”)

Anti-Kickback Statute and Stark Law

“In some industries, it is acceptable to reward those who refer business to you. However, in the Federal health care programs, paying for referrals is a crime.”[i] The Anti-Kickback Statute is a criminal law prohibiting the knowing and willful payment of “remuneration” to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal health care programs (e.g., drugs, supplies, or health care services for Medicare or Medicaid patients). The Stark law, or physician self-referral law, prohibits physicians from referring patients to receive “designated health services” payable by Medicare or Medicaid from entities with which the physician or an immediate family member has a financial relationship, unless an exception applies. The Stark law and the Anti-Kickback Statute are similar but not the same. It’s important for you to know the difference.

 

Visit the Office of Inspector General’s website: https://oig.hhs.gov/compliance/provider-compliance-training/files/StarkandAKSChartHandout508.pdf to view their “Comparison of the Anti-Kickback Statute and Stark Law.”

The Government’s Version of “Alphabet Soup”

Have you ever heard of or been involved in a RAC, ZPIC, CERT and/or MAC audit? If not, you are one of the lucky few! The government has recovered billions of dollars through their auditing efforts. If you find yourself involved in an audit and decide to appeal the findings, it could cost as much as $50K to $80K to go through the entire two year process. This figure does not include fines and/or penalties that may be assessed. Even if you use an outside billing service, you are still responsible. The following are suggestions to help prepare for a government audit, including but not limited to:

  • Identify who needs to be involved in the process
  • Develop policies and procedures that clearly designate roles and responsibilities for each piece of the audit process, including coders assigning codes, business office staff who may receive denials, revenue integrity auditors who review records, and HIM clerks who process or copy charts for each request
  • Develop organizational education regarding the increase in government audits and the need for clear and concise documentation
  • Develop education specific to each department in the revenue cycle process and the department’s role in the audit program
  • Determine the different types of record requests and time frames
  • Distinguish the various types of appeals to secure each claim

Your malpractice insurance carrier may pay for certain government regulatory violations but there are exceptions. It is important to find out what, if anything is covered before you are faced with an allegation of violation. There are resources for additional coverage options for government regulatory/billing errors & omissions policies. If you have any questions, please do not hesitate to contact Professional Risk Associates at 800-318-9930 or visit us online at profRISK.com for more information.

 

About The Author

Joan Kassel

 

Joan Kassel, MLIS joined Professional Risk in 2000, and focuses her expertise on medical & dental professional liability. She also specializes in educating and providing healthcare professionals with options for Billing E&O, Privacy/Security Breach, Employment Practices Liability, and Directors & Officers insurance. Joan also writes and instructs insurance continuing education courses for PIA of Virginia and DC. Connect with Joan on LinkedIn by visiting: https://www.linkedin.com/profile/view?id=49104720

Disability Income Insurance: How Today’s Decisions Impact Tomorrow’s Choices

Disability Income Insurance: How Today’s Decisions Impact Tomorrow’s Choices

 Provided By:  Todd G Grantham, CFP®, MSFS, CLU, ChFC  Northwestern Mutual

Doctors and dentists nationwide clearly understand the importance of having disability income insurance (DI) to protect the time and money they’ve invested in their profession. And most have considered at length what would happen to them, their incomes, their families and their careers if they suddenly found themselves injured or ill – leading them to seek the protection a DI policy provides.

So what’s the problem? DI is a complex buying decision – with varying stipulations in policy contracts that impact the type of benefits a policy owner might receive at time of claim. The problem is that busy medical and dental professionals can’t find the time to fully understand key concepts in their policies, and many would be surprised to find how those details could affect them at the time of claim.

Many doctors think that if they are unable to perform their principal medical duty, their “bread and butter,” they would be totally disabled and receive full disability benefits. But that’s not typically the case with “own occupation” coverage (the kind of DI that has traditionally been recommended for medical and dental professionals). It would only be true if the insurance company determines that they have only one principal duty at the time of claim. And, of course, most medical professionals have more than one principal duty.

Consider the example of a surgeon, whose primary source of income comes from performing surgery, but who also does non-surgical patient consultations. If this surgeon suffers a hand injury and is no longer able to perform surgery, they would likely consider themselves totally disabled. However – based on typical “own occupation” and even “own specialty” definitions – if they are still able to consult with patients, they may be considered partially disabled and would receive only partial disability benefits.

To help eliminate this kind of misperception, Northwestern Mutual introduced the patented* “Medical Occupation Definition” of total disability. The only definition of its kind in the industry, it was designed specifically for – and with input from – the physicians and dentists it impacts.

Disability Income Insurance: Today’s Decisions – Pg 2

 The Medical Occupation Definition differs from typical “own occupation” and “own specialty” definitions because it provides physicians, dentists and podiatrists, in certain situations, the flexibility to choose between continuing to work and receiving a partial benefit, or not working at all and receiving full benefits. This is an important difference that typical “own occupation” and “own specialty” definitions do not offer at the time of claim.

Consider the chart below, which outlines how the definitions compare in various circumstances:

 

Definition: If unable to do all of your principal duties AND not gainfully employed If unable to do all of your principal duties AND are gainfully employed in another occupation If capable of doing SOME, but not ALL of your principal duties
Typical “Own Occupation” or “Own Specialty” definitions You will be considered totally disabled and receive full disability benefits You will be considered totally disabled and receive full disability benefits You will be considered partially disabled and must be gainfully employed to receive a proportionate benefit
Northwestern Mutual’s patented* Medical Occupation Definition You will be considered totally disabled and receive full disability benefits You can earn up to 20% of your pre- disability income and still receive full disability benefits In specific circumstances, you will have the flexibility to decide to:

Continue gainful employment and receive a proportionate benefit

OR

Cease gainful employment and receive full monthly benefits

 Disability Income Insurance: Today’s Decisions – Pg 3

Unfortunately, no one can predict the type of disability they will have, or control whether that disability will prevent them from doing their job (or seeking alternative employment). This is why the flexibility of the Medical Occupation Definition is so critical; at a time when so much hangs in balance, it provides medical professionals a choice about their future.

Northwestern Mutual has created an online tool called the “Disability Income Insurance Knowledge Center for Physicians and Dentists” that illustrates how the Medical Occupation Definition compares with other definitions of total disability. Medical professionals are invited to visit Todd G Grantham’s website at toddgrantham.com to access the tool, enter information about their practice, and find out for themselves how each definition would impact them at the time of claim.

The definition used in your policy is just one of the variables that must be considered carefully when choosing disability insurance. Although the prospect of having to rely on any type of disability insurance is something no one likes to think about, taking the time to do so can lead to a vitally important outcome:  knowledge that what you want and what you need matches what your policy can do for you.

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Article prepared by Northwestern Mutual with the cooperation of Todd G Grantham. Todd G Grantham is a Financial Representative with Northwestern Mutual, the marketing name for the sales and distribution arm of The Northwestern Mutual Life Insurance Company (NM), Milwaukee, Wisconsin, its affiliates and subsidiaries. Financial Representative is an agent of NM based in Durham, NC. To contact Todd G Grantham, please call (919) 401-0345, e-mail him at toddgrantham.com or visit his Web site at toddgrantham.com.

 

*U.S. Patent No. 8,775,216, issued on methods and systems for processing insurance claims in accordance with disability income insurance policies the scope of which cover the Medical Occupation Definition of disability