If you register for workshops on our website, simply enter the discount amount in the box and drop the coupon in the mail or bring it to us on the day of the workshop. Each coupon can only be used once, but it is transferable to another OPA member. So you’re welcome to pass it along to an early career psychologist who could use an extra discount. Enter the original member’s name and license number on the coupon so we can apply the correct discount amount and then write in the attending member’s name and license number just below. Only one member coupon per person, per workshop.

By: Bobbie Celeste, PhD, OPA Director of Professional Affairs

Top Five:
1. Late payment by private insurers is in violation of Ohio’s prompt payment laws.

2. Significant rate cuts in connection with CPT code changes. APA Practice attorney Alan Nessman noted that sizeable cuts (10% for 90834) have been identified in NE, NY, OR, PA, TN and WA.

3. Companies paying the same amount for 90837 and for 90834. The parity question is whether companies are paying the same reimbursement for similarly paired medical/surgical CPT codes with a substantially different CMS valuation, e.g., different levels of office visits.

4. Companies not paying codes that have been valued by CMS (or at least not listing them in their fee schedule), e.g., 90837 or interactive complexity 90785) Note: CMS has NOT yet valued crisis codes 90839 and 90840 so these also may not be valued yet by insurers. If you use these, set your own fee.

5. Companies such as UBH/Optum requiring pre-authorization for 90837.

The Next Web did a story detailing the problem:

“Attacks typically consist of Yahoo users receiving an email from a friend or colleague (and sometimes a completely unknown party) containing a link that if clicked on, results in the account being hijacked. Some say their hijacked accounts send emails to select individuals, others report they get sent to all their contacts, and one even noted that they went out to ‘anyone I had ever received and/or sent a message to.’

We asked the users who got in touch with us if they got such an email and clicked on the link. Reports were mixed: some said they got an email and clicked the link, some said they got the email but didn’t click, and others said they never got such an email.

Amongst those that did click on a link, however, there was at least one aspect that recently seems to corroborate: the attackers have apparently been referencing a non-existent MSNBC news report in the email.” To read the full story, click here.

Despite efforts by Yahoo, its users are still being affected. A spokesperson said, “We’re committed to protecting our users and their data. We strongly urge our users to change their passwords frequently and to use unique, alphanumeric passwords for each online site they visit.”

For more information, please see this story from LiveScience.com. Remember to use caution and your common sense when it comes to email.  Dangerous emails usually contain a link or include text with grammatical and typographical errors.

For those of you unable to vote electronically, you may request a paper ballot from Denise Brenner, Director of Operations and Member Services, by Thursday, March 14, 2013 at 5 p.m. Requests for paper ballots after this date cannot be accommodated.

This year’s candidates are Peg Richards Mosher, PhD and Bob Stinson, PsyD, JD, ABPP.  To view the platforms, please click the candidate name.

I have spent time recently following the general listserv discussion regarding recent changes in the medical billing and insurance industry which have affected so many of us, particularly those of us in private practice. It is quite helpful for me as president to follow such discussions. Doing so allows me to make sure I get a better understanding of the challenges and concerns of our members. For those of you who are less aware of the issues, or may not be part of the listserv, the main circumstance which created difficulties was the recent change in procedure codes by the American Medical Association. The AMA’s code definition is used by most insurance companies to understand and in turn compensate us for what we do as psychologists. After the most recent change in codes and definitions, many psychologists now feel they are unable to spend the time with clients, or get the right services authorized, which they feel are necessary.

Following the changes, during the ensuing listserv discussion, many of our members expressed considerable frustration, stating they feel that many of the rules and changes implemented by the insurance companies are not in the best interest of clients and arbitrarily or unfairly limit services which are indicated and appropriate. Others have stated they believe the companies limit general access to psychological services by limiting participation on insurance panels. Most importantly, many members expressed concerned that OPA is not doing everything it can to help psychologists with these issues, leaving them feeling powerless. This latter opinion provoked the most concern for me as leader of our association.

In an effort to ensure that the association is being responsive to these concerns, I would like to hear from individuals who feel we could be addressing these concerns, and advocating on behalf of Ohio psychologists in the face of these overwhelming circumstances. If you would like to give me feedback, please email me. Please use “feedback” as your subject line, and make sure you include your suggestion about what the association should be doing to address your concerns.

It is important to realize that advocacy is not just something that OPA does for you. We do a lot of it, but what really matters is how well we inform and motivate you to get to know your legislators and advocate with them as constituents. Ohio legislators are very accessible, particularly when they are back in their district. Our Legislative Day, May 22, 2013 provides an opportunity to learn how to be a good advocate and to begin to build your relationship with your state senators and state representatives. Your voice matters.

And you need to be advocates in other realms as well. As was stated in the recent discussion about CPT code issues on the listserv, complaints you file with the Department of Insurance are critical. When we go talk to them it is really difficult to make a strong case about a problem if they haven’t been hearing from individual psychologists. Your voice actually carries more weight than ours, since you are more directly involved in the delivery of service and interacting with insurers. Your voice matters.

A point of emphasis for us this year as we pursue our strategic goals is to develop a network of OPA members that is connected to every state senator. The Senate Network will be a key focal point of our advocacy work over. Contact Bobbie Celeste or me to become part of this network. We need your voice.

We collaborate with the APA Practice Organization to be sure that advocacy at the federal level is effective. You see the action alerts that Dr. David Hayes, our Federal Advocacy Coordinator posts when Ohio psychologists are being called upon to reach out to our senators and members of Congress on key issues. Our response to these alerts is important. Ideally, OPA members will get to know our two senators and their congressperson to become a health care resource for them. Your voice matters.

Under the general advocacy statement in the plan is the goal to increase timely communication with OPA members. This is important because you need to know what we are doing. It is important that you be informed so that you can be comfortable in getting involved in advocacy and becoming a resource for your legislators. We in central office sometimes have a tendency to get immersed in doing advocacy, assuming that you will know we have your back. We need to do a better job of letting you know what we are doing. When I took time the other day to post an update on how we are addressing the CPT code problems, the response was really gratifying. I felt like Sally Field at the Oscars.

Our goals also include broadening our advocacy agenda beyond legislative efforts by including more business, insurance and public sector issues as they relate to psychologists. Here is another place you be helpful by informing us of problems, issues, or creative ideas for expanding OPA’s advocacy.

This year our agenda will include the Psychology Law, the Demonstration Project for appropriately trained and certified public sector psychologists to be authorized to prescribe medication in a select few Ohio prisons, Medicaid Expansion, Regulation of Applied Behavior Analysts and insurance reform relating to prior authorizations. At the federal level: Medicare, electronic medical records and the definition of physician are likely to be points of emphasis. We want to continue to educate the Department of Insurance and legislators about your problems with third party payers in Ohio. We are finishing up a complaint letter to the Department of Insurance on a recent problem with a major insurer in Ohio. We are working to address issues relating to the availability of internships, student loan forgiveness and health disparities. Planning for an internship consortium is underway and we are working with Medicaid to facilitate payment for supervised interns.

An important goal is to educate Ohio psychologists about the National Healthcare Plan roll-out and implications as they occur, including providing webinars and training on practice strategies needed to keep pace with changes. We had some workshops at our 2012 Convention on topics related to this and it is a primary focus of the 2013 Convention (October 30-November 1, 2013). We developed our two free webinars for OPA members on CPT codes and PQRS to help you all understand these important areas and received a great response.

The final goal in this area is to maintain OPA’s current collaborative relationships and include three new ones during each of the next three years. I was recently asked for a list of the coalitions with whom we are involved and was amazed as I created it. These coalitions link us with a broad range of organizations and magnify our impact on public policy. There is also a long list of organizations that have the potential to be one of the three new collaborations. I am anxious to see how we can work together with some of the organizations with whom we don’t have a strong relationship now.

Watch for more about our Strategic Plan!

Many people assume their loan would be forgiven if they became disabled, but that may not be the case. According to Department of Education guidelines, you would need to be totally and permanently disabled in order for the loan amount to be discharged. And even if your disability qualifies, the loan may not be discharged until 3 years after you become disabled!1 These are very stringent requirements and could leave you vulnerable to having to make loan payments – even when you’re not earning an income.

Another more proactive solution is to buy Individual Disability Income (DI) Insurance. This coverage helps protect your income in a variety of situations – even if your illness or injury is short term or a partial disability.

To make this protection more affordable, Principal Life Insurance Company offers Ohio Psychological Association members a 10% association discount on Individual DI policies. Watch this presentation to learn more.

Disabilities Do Happen
“One in four of today’s 20-year-olds will become disabled before they retire.”
– Social Security Administration, Fact Sheet, March 2011.

1 Disabled World News (2011-10-27) – Information on cancellation consolidation deferment and discharge of student loans including repayment calculator and income based repayment chart:
http://www.disabled-world.com/disability/education/repayment-calculator.php#ixzz2HbcqK9Fq

Disability insurance issued through Principal Life Insurance Company, Des Moines, Iowa 50392. Disability insurance has certain limitations and exclusions. For specific costs and complete details of coverage, contact a Principal Life representative.

The President-Elect will serve as an officer for three consecutive years, one year each as President-Elect, President and Past-President. As an officer of the Board, the President-Elect attends monthly Executive Committee meetings and quarterly Board meetings, participates in APA’s State Leadership Conference in March and typically attends APA’s convention. The President-Elect assists the President and is mentored to be the association’s top leader. The President-Elect develops plans for initiatives to be undertaken during his/her Presidency and recruits committee chairs and committee members. As President, the individual presides at Executive Committee meetings and Board meetings, and represents OPA at various regional and state functions. Working within OPA’s mission and Board policies, the President-Elect/President/Past President provides leadership to reach OPA’s goals.

OPA’s current President is Dr. Jim Broyles and Dr. Kathy Ashton is the President-Elect. Dr. John Rudisill is serving as Past-President. View the current list of Board of Directors as well as a list of Past Presidents.

When nominating, please remember these rules:
• A prospective candidate must receive 20 nominations from OPA members to have his/her name appear on the ballot.
• Each member shall nominate not more than one person for each office.
• Only full members (not affiliates members) may nominate.
Submit nominations for each office, along with your name, to Heather Gilbert.

“Support the personal and professional lives of psychologists throughout their lifespan, from student status through retirement.”

We have been working on many fronts to make progress toward this goal.

Our Early Career Psychologist Committee just completed a survey that gives us some very helpful data on the demographics of our ECPs and what they want and need from OPA. Significant discussions are occurring on how best to respond to what the data tells us. ECPs who want to join the ECP Committee should contact me.

OPAGS, our graduate student group, is planning to do a similar survey. Their plans are well underway for a day-long program scheduled for Saturday, February 16, covering all facets of applying for and getting internships. An important project that our Foundation is pursuing is to develop a collaborative for the purposes of creating new internship opportunities for Ohio graduate students.

As a free member benefit we have provided two recent webinars for OPA members. Each offered one-hour of free CE to OPA members. Dr. Bobbie Celeste and Dr. Howard Bonem presented on the new CPT codes at the end of December. On January 3, Dr. Alice Randolph presented on Medicare’s Physician’s Quality and Reporting System (PQRS). These are both critical topics that can impact your income. These webinars are available online for those who missed the live presentations. Thanks to Dr. Celeste, Dr. Bonem and Dr. Randolph for volunteering their time to develop and present these important and timely programs.

The process of making disability insurance available to OPA members at a discounted price through the Principal Financial Group, has made us aware that many OPA members need support in estate and financial planning. Disability insurance is a very important financial tool to assure income when health concerns keep you from working. We are working to develop a broader range of financial planning and management resources for OPA members.

We tried to respond to what many of you told us was a serious need with our two attempts to develop an alliance insurance program for OPA members. The committee that coordinated this worked hard and we were all disappointed that we fell short of the numbers we needed to establish a plan. We haven’t quit in our search for a way to help OPA members find high quality, affordable health insurance. The responses from many of you when our second attempt failed and the ideas and comments we received continue to underscore how important this is to many of you. Many of you expressed disappointment that we had fallen short of our goals for applications. Your questions mirrored our questions when we first started the process:

• Can we join with other professions to form a group that is large enough to enable us to get good coverage and good rates? No, we are limited to OPA members/psychologists and employees of member psychologists in developing our Alliance Plan. After about two years of coverage, once we fully establish the plan, we can offer health insurance to OPA graduate student members and psychologists and others working under contract for an OPA member.
• How far off were we in getting the number of applications we needed? The second time around we ended up with fewer applications than we had the first time (only about 125-we needed 1000). This was extremely disappointing since we thought we had done a better job of marketing this opportunity than we did the first time, including inviting non-members to submit applications with the understanding that if they wanted the insurance after getting the rates they would have to join OPA, and much greater visibility at Convention.

We still believe that health insurance for OPA members is an important member benefit and are investigating other options to find a way to do this. We suspect that many people opted not to submit an application and to wait to see how the Affordable Care Act impacts access to health insurance. We are also monitoring this to see what the quality and cost of insurance is for members in the future and whether we can do better.

Have you heard about our PROS Group? (Psychologists Retired of Ohio). They meet periodically at the OPA Central Office. They have been writing articles and developing materials to help guide OPA members as they move toward retirement. Considering the average of our members, guidance in retirement planning will be important to large numbers of members in the years ahead. Many recent retirees tell us how ill prepared they were for the process of retiring and for the transition from work to retirement.

If you have suggestions for specific things that OPA could do to be more supportive of members through the life span of their involvement in OPA, please let me know. We welcome your suggestions!