THE NEW LOOK OF SVMIC 2016 SVMIC Risk

FEBRUARY | 2016
A Newsletter of Mutual Interests
THE NEW LOOK OF SVMIC
On the eve of our 40th year in business, we’re proud to announce the
creation and adoption of a new logo and website. While our look may have
changed, our core values, mission, and focus on our policyholders never will,
remaining as strong and unwavering as it has for forty years.
“The Mobius Square” was inspired by the Mobius Strip—a unique geometric
curiosity. Our Mobius Square features four swirling bands that represent
strength, balance, synergy, and dynamics. These shapes wrap together to
represent the protection we offer our physician policyholders.
Risk Pearls
by Julie Loomis, RN, JD
Over the course of forty years, many things have changed, but never
our financial stability, high policyholder satisfaction, and dedication to
defending physicians’ reputations. While this new logo represents an
important milestone and a dramatic visual change in our branding, our
focus on physicians will always remain strong. At SVMIC, we exist first and
foremost to serve our policyholders.
A positive patient experience
at every interaction may
be invaluable in avoiding a
malpractice claim, even in the
face of an adverse outcome.
Patients who view you as
caring for them, not just
treating them, may be more
forgiving of human error.
Creating a positive patient
experience can be achieved
by engaging and training
exceptional employees to
create a patient-centered,
caring environment.
2016 SVMIC Risk
Management
Seminar
Schedule
April, May & June
April
5&6
Chattanooga,
TN
April 14
Knoxville, TN
April 20 Springdale, AR
April 21
Fort Smith, AR
April 22 Morrilton, AR
May 5
Cookeville, TN
May 10
Nashville, TN
May 11
Bowling Green,
KY
May 12
Paducah, KY
May 17
Decatur, AL
May 24
Memphis, TN
June 7
Florence, AL
June 23 Little Rock, AR
June 28
Chattanooga,
TN
June 29 Cleveland, TN
Specialty
Spotlight
ORTHOPEDICS
by Rochelle “Shelly” Weatherly, JD
A review of orthopedic closed
claims from 2009 – 2014 where
a loss was paid on behalf of an
insured reveals that there were
three basic areas (excluding
errors in medical judgment and/
or technical performance) that
contributed to the determined
indefensibility of the claims. These
reasons are illustrated in the graph
below:
Systems
23%
Communication 27%
Documentation
50%
DOCUMENTATION ISSUES
Appropriate
documentation
is one of the
most important
patient care and
risk management
skills a healthcare
professional can develop.
Inadequate documentation can
negatively impact your ability
to defend the care provided to a
patient.
As the graph above illustrates,
documentation issues were a
2
factor in 50% of claims paid in
orthopedics. Of those: 79%
were found to have inadequate
documentation due to such things
as incomplete pre-op work up and
patient history; incomplete or no
documentation of patient phone
calls; lack of sufficient information
to support the rationale for
treatment decisions; and sparse
or lacking documentation of
information given during the
informed consent process.
Specific case examples of
inadequate documentation include:
• Failure of the surgeon to
document the rationale for
waiting a week to remove
hardware in a patient with
a surgical wound infection.
Patient developed septic
shock.
• Failure to describe or define
disability status pre-op
which hampered the defense
of a case where plaintiff
alleged inadequate work
up and failure to consider
alternatives to surgery.
• Failure to document
telephone instructions given
to patient with post-op
complaint of pain and fever
leading to a swearing match
before a jury.
• Reliance on generic hospital
consent form rather than
preoperative documentation
of specific risks, benefits, and
alternatives discussed with
the patient/family hampered
defensibility.
Other documentation issues
present in the cases reviewed:
Untimely entries
The surgeon dictated the H & P
and op note two months after the
initial surgery and after post-op
complications which made such
note appear to be self-serving,
calling into question the integrity
of the entire record.
Erroneous Documentation
The surgeon dictated the
wrong level into the op note.
It is important to review and
authenticate as correct all dictated
notes.
COMMUNICATION ISSUES
Effective communication
is essential in
establishing trust
and building
good patient
rapport, which
in turn plays a role
in a patient’s perception of his/
her quality of care received. Of
the claims reviewed, 27% involved
communication breakdowns.
Of those, nearly three-fourths
involved a breakdown in
communication between the
physician and patient. Common
examples include:
• Insufficient patient
counseling: Failure to educate
regarding impact of smoking
on wound healing
• Inadequate discharge
instructions: Failure to
instruct as to what post-op
symptoms to look for and
report
• Lack of informed consent:
Failure to review pertinent
risks, benefits and
alternatives to proposed
procedure, and to ensure
patient’s questions are
answered.
Also observed in the cases
reviewed were breakdowns in
communication between treating
physicians. An example involves
a surgeon who failed to notify the
covering physician of the patient’s
axillary nerve block which most
likely complicated the recognition
and diagnosis of compartment
syndrome.
SYSTEMS ISSUES
Effective systems and
processes help
reduce adverse
events and claims
by decreasing
reliance on
memory or
informal mechanism
alone. Of the claims, 23% analyzed
involved a systems breakdown –
nearly all of these (88%) involved
wrong site surgery in spite of the
Joint Commission’s Universal
Protocol for Preventing Wrong Site,
Wrong Procedure, Wrong Patient
Surgery™. Examples included:
• Wrong level lumbar fusions
• Wrong side spacer used in
joint replacement
• Peroneal tendon repair
performed in error on right
foot instead of left
• Carpal tunnel release done
rather than ganglion cyst
removal
• Arthroplasty with removal
of scaphoid bone rather than
planned trapezium bone
LESSONS LEARNED
;; Document timely and completely - including history, instructions, and telephone calls as well as the
rationale for actions that may not be self-evident.
;; Engage in a full and clear discussion with patients about the nature of their medical condition, the
recommended treatment plan and the risks, benefits, and alternatives. Doing so not only discharges
your legal and ethical obligation to provide patients with sufficient information with which to make an
educated election about the course of their medical care, but may help create realistic expectations on
the patient’s part as to the outcome of treatment. Be careful not to educate above their comprehension
level. Be sure the details of all discussions with patients are documented in your office record rather than
relying on hospital consent forms which are not procedure specific and may not capture all details of the
conversation.
;; Provide surgery-specific written postoperative instructions to decrease the possibility of non-compliance
and reduce the number of call-backs from patients and family who may not remember your verbal
instructions.
;; Use the Joint Commission’s protocol designed to prevent wrong patient/site/procedure surgeries by
marking the surgical site appropriately with the patient/representative prior to surgery and use a time
out to review relevant aspects of the procedure with the surgical team and complete the verification
process.
3
Advanced Care Planning
Payable as of January 1, 2016
by Elizabeth Woodcock, MBA, FACMPE, CPC
As of January 1, 2016, physicians can bill
Medicare for advanced care planning services –
and actually get paid for them. Accompanying
the release of the 2016 Medicare Physician Fee
Schedule Final Rule, the Centers for Medicare
& Medicaid Services (CMS) revealed that it
was “finalizing its proposal that supports
patient- and family-centered care for seniors
and other Medicare beneficiaries by enabling
them to discuss advance care planning with
their providers.” Previously non-covered,
CMS agreed to use the existing codes – 99497
and 99498 – to pay for these services. The
CPT® codes for advanced care planning (ACP)
are defined as “including the explanation
and discussion of advance directives such
as standard forms (with completion of such
forms, when performed), by the physician or
other qualified health professional; first 30
minutes, face-to-face with the patient, family
member(s) and/or surrogate,” with the add-on
code, 99498, for each additional 30 minutes.
4
The base code – 99497 – pays about $80, but
it is subject to cost sharing. There is, however,
one exception – when the ACP accompanies
an Annual Wellness Visit (AWV) (G0438 and
G0439), CMS has agreed to reimburse both
services in full. This will mean that you will
need to dedicate more time on your schedule for
AWVs, but the rewards are significant.
Your patients gain a well-needed service, and
you can benefit from the additional $80 (or
more). CMS has requested a modifier -33
(Preventive Service) be added to the ACP code
when performed and billed in conjunction with
the AWV.
The ACP codes are not limited to being
performed in conjunction with the patient’s
Annual Wellness Visit. Indeed, CMS has agreed
that ACP can be paid on the same day as other
evaluation and management services – or as
a separate service. Physicians can certainly
perform, bill, and be paid for ACP, but this may
be a wonderful opportunity for your advanced
care provider. Note, also, that the ACP codes
include performing the services with a family
member(s) or surrogate, not necessarily the
patient. Finally, these codes are not reserved
exclusively for primary care physicians; any
qualified health care professional (QHCP)
involved in a medically necessary ACP can use
these codes. The American Medical Association
(the authors of the CPT® codes) define a QHCP
as “qualified by education, training, licensure/
regulation (when applicable) and facility
privileging (when applicable) who performs
a professional service within his/her scope
of practice and independently reports that
professional service.”
SVMIC IS
GOING
DIGITAL
In order to provide
you with more
timely and relevant
information, the
SVMIC Sentinel
becomes a digitalonly publication at
the end of 2016. It
will be emailed and
available on our
website; there will no
longer be a printed/
mailed version.
Please visit
our website
at
WWW.SVMIC.COM
to update
your
preferences
The Impact
of Creating
a Positive
Patient
Experience
by Stephen Dickens, JD,
FACMPE
We have long talked about patient
satisfaction in the healthcare
industry. Patient satisfaction surveys
have been a staple for years in
virtually every care delivery setting
from medical offices to hospitals.
Entire corporations have emerged
simply to gather and benchmark
this data. The best tool for gauging
patient satisfaction is generally
what is being said by patients and
their families in the community.
From a marketing perspective, we
know word of mouth can make
or break a physician’s practice
with both patients and referral
sources. From a risk perspective, we
know that patients who feel their
physicians and staff are interested
and compassionate are less likely to
pursue litigation in the event of an
adverse outcome. What about this
new concept of “patient experience”?
What exactly does that mean and
what is the difference between
experience and satisfaction?
The patient experience concept is
part of the shift from the traditional
fee for service payment model to
value-based purchasing. Surveys
under this new payment model ask
patients to provide their perception
of their level of care and their
interaction with physicians and staff.
Based on the patients’ responses,
the surveys are used to score
physicians. Those scores are made
publicly available to aid patients in
selecting their practitioners. This
patient feedback also becomes a
component of how physicians are
paid. Physicians with good scores
can potentially get increased
reimbursement, and those with poor
scores will see reductions. This model
is already in play in hospitals across
the country.
The problem with the patient
experience concept is that most
patients are not clinically competent
to evaluate the care they receive.
What they do know is whether the
experience is positive or negative
and how much knowledge they
received about their own condition
and care. Knowledge is the key in
this new model. A positive patient
experience results when a patient
is engaged with useful knowledge
about his or her own condition.
Physicians, and especially their
staff, are going to have to work
in concert to engage patients in
terms they can understand. This is
a tremendous shift from telling the
staff to just be nice. Given physicians’
time constraints, they will be more
dependent than ever on their staff to
help them in this new environment.
article continues on the next page
5
I recently had the opportunity to visit with a practice struggling with the concept of patient experience. During
the course of my presentation, we were able to identify the forces driving this – increasing healthcare costs, new
payment models, and the changing demands of patients. The staff was already well aware of these issues as they
see more and more patients with high-deductible health plans, required pre-authorizations, and complaints about
increasing premiums. When the staff stepped back, they realized their patients came to them not only sick, but
also frustrated with the whole healthcare system.
As we discussed the barriers to connecting with patients, we quickly identified communication problems
with one another and with patients. Departments were not sharing information with one another. Important
details such as: changes to physician schedules; medical assistants failing to properly room a patient; employees
substituting for one another; lab delays; patient messages; and changing payor panels are all examples of failures
to communicate that frustrated not only staff but ultimately the patients. By the end of our time together, we had
talked through the importance of effective communication as well as ways to establish rapport with patients, the
importance of follow through, how to deliver bad news, ways to respond to low health literacy, and what is truly
important to patients.
At the end of the session, everyone - physicians, clinical staff, and the clerical staff - understood they each have a
role in creating a positive patient experience. To do that, they must work together which means they must first
effectively communicate with one another. Every day now begins with a quick huddle to apprise coworkers of
important changes or updates. Beyond that, the physicians and staff now meet monthly to discuss in detail ways
to improve the patient experience and share vital information which impacts their ability to work together as an
effective team.
6
UNDERSTANDING UNDERWRITING
SVMIC’s Underwriting Committee
by James E. Smith, CPCU
Since 1976, physicians and surgeons have been relying
on SVMIC for protection from the risk of financial
loss and for a vigorous defense if they were to be sued
for allegations of medical malpractice. As a mutual
insurance company—meaning it is owned by its
physician policyholders—it has always been the goal
of the company to provide high-quality services at the
lowest possible cost to its owners and their practices.
The process of “underwriting” is a major way of
reducing the cost for all policyholders—by carefully
evaluating every individual physician’s risk through the
application process and screening out the outlier risks,
and thereafter maintaining a disciplined approach to
monitoring the ongoing risk of every policyholder.
The basic premise is that the risk of a medical
professional liability claim for any one physician is
random; that is, not related to individual characteristics
of the physician. However, it is well known that there
are a small percentage of physicians who exhibit
certain individual characteristics that at some point
result in a higher-than-average risk of incurring one or
more claims. The underwriting process is designed to
identify and “treat” such outlier risks.
As a physician-owned insurance company, it is natural
that the underwriting process would involve physicians
to assist in risk evaluation. From day one, SVMIC has
utilized a committee of physicians for this purpose—
charging its members with the responsibility of
acting for the long-term benefit of the policyholders
collectively.
Once a physician is deemed by SVMIC management
to be above average risk, he/she is referred to one of
the committees. It may take several courses of action,
including declination of an application for insurance,
non-renewal of an existing policyholder’s policy,
and/or offering renewal coverage only under certain
conditions (for example: imposing a deductible
whereby the physician has some “skin in the game”,
restricting the limits of liability or excluding coverage
for certain procedures or practice modes).
The committee has developed formal protocols
for the insurability of physicians with health and
impairment problems and has also developed
guidelines for insurability based on advancing age.
Early on, SVMIC’s Board established a grievance
process for adverse underwriting decisions.
When requested by the aggrieved physician, and
upon receipt of new supporting information, the
committee may review its previous adverse decision
at a subsequent meeting. At its discretion, the
committee may then appoint a subcommittee of two
or three members to conduct a personal conference
with the physician to determine if there indeed
has been a change in the risk or if the committee’s
previous decision should be sustained. Policyholders
(but not applicants) who do not prevail may request
that the Board reconsider the committee’s decision.
7
ICD-10
Transition:
The Meltdown
That Wasn’t
by Elizabeth Woodcock,
MBA, FACMPE, CPC
Don’t look now, but the transition
to ICD10 is turning out to be 2015’s
version of Y2K — the highly hyped
mega-meltdown of worldwide
computer systems that never
happened. Data released by the
Centers for Medicare & Medicaid
Services (CMS) in early November
illustrates how much of a nonevent ICD10 has been so far. CMS
expected that the big changeover
in diagnostic coding systems would
cause 10% of claims for professional
services to Medicare patients to be
denied. The actual result? Just that
– well almost. The percentage of
denials attributed to ICD10 errors
was actually 10.1% for the first
month that the new coding system
was in place.
It may be too soon to breathe a sigh
of relief, however. The numbers
released in November don’t reflect
how many claims could have
been denied for ICD10-related
deficiencies. That’s because in late
July, CMS, in conjunction with the
American Medical Association,
issued an agreement to allow a
12-month grace period for ICD10
denials. This year-long respite is
for denials based on specificity;
claims are being paid if the provider
has at least chosen the correct
8
family of the ICD10 codes. Other
payers – including Humana and
United Healthcare – have publicly
stated that they commenced claims
adjudication post-October 1 by
paying any claim that “made sense.”
The lack of chaos in switching from
ICD9 to ICD10 makes perfect sense
because the diagnosis doesn’t really
matter for purposes of payment
for evaluation and management
(E/M) services. There are only a
few diagnoses in the E/M universe
that tend to trigger payment
issues (an obesity diagnosis is
one). Outside of the E/M realm,
payment determinations are almost
entirely dependent on diagnoses.
For example, no payer would pay for
cataract surgery when the diagnosis
was knee pain. Before some nonE/M claims are even submitted,
providers must gain the payer’s
authorization to render the service –
a request that requires a “justifiable”
diagnosis.
Even without CMS’ 12-month
moratorium on specificity-related
denials, payers would have been
reluctant to start issuing a massive
number of denials. For one thing,
many physicians would have balked
at seeing those payers’ patients.
Congress – already on keen alert
to make sure the implementation
went smoothly – would likely have
responded to pressure from various
stakeholders and stepped into the
fray, just as it did earlier when it
delayed ICD10 implementation for
several years until October 2015.
So far, there has been no harm
done in paying claims without
attention to ICD10 details. But,
now it’s time to face the challenges.
The shift to a stricter “by the
book” interpretation of the new
coding system has already begun.
In recent days, practices have
reported that they now have one
or more payers denying requests
for prior authorizations when the
request lacked sufficient ICD10
detail. Practices are also seeing
payers parking more claims in
“medical review” or denying
services because the diagnosis did
not support the rendering of the
procedure. These payer actions
shouldn’t come as a surprise; claims
accuracy is the bedrock – albeit a
hard and unforgiving one – of our
reimbursement system.
Expect that 2016 will bring more
challenges related to ICD10. Your
best response is to rely on all that
training and education you invested
in leading up to October 1, 2015.
Code correctly; ensure that your
employees know how to get your
services authorized; and, equally
important, stay on top of denials
by fully researching and reworking
them promptly.
PHYSICIAN
LEADERSHIP
INSTITUTE
March 4-5, 2016
Marriott Nashville Airport,
Nashville, TN
Whether you are a solo practitioner or the leader of a
multi-physician group, the future of healthcare will
present new and unique challenges for your practice.
SVMIC
LAUNCHES
NEW
WEBSITE
SVMIC is proud to
unveil our brand new,
reorganized, and
redesigned website which
features mobile and tablet
compatibility so you
can access our valuable
resources even when
you’re not at your desk.
Learn strategies to meet these challenges during this
important two-day seminar.
Topics Include:
¾¾ Being a Physician Leader
¾¾ Payment Reform
¾¾ Practice Finances
¾¾ Human Resources
¾¾ Physician Behavior
¾¾ Conflict and Disruptive Behavior
¾¾ Compliance Issues
¾¾ Website Optimization/Social Media
To register, go to
WWW.SVMIC.COM
or call 615.846.8399
Continuing Medical Education Credit
Accreditation: This activity has been planned and implemented in accordance with the Essential
Areas and policies of the Accreditation Council for Continuing Medical Education through the
joint providership of the University of Tennessee College of Medicine and State Volunteer Mutual
Insurance Company. The University of Tennessee College of Medicine is accredited by the ACCME
to provide continuing medical education for physicians.
AMA Credit Designation: The University of Tennessee College of Medicine designates this live
activity for a maximum of 14.5 AMA PRA Category 1 Credits ™. Physicians should claim only the
credit commensurate with the extent of their participation in the activity.
Continuing Education for Non-Physicians: Non-physicians can obtain continuing education
credits for attending activities that award AMA Category 1 Credits ™ and other continuing medical
education credits to physicians. Check with your licensure/certification board for confirmation.
9
CLOSED CLAIMS REVIEW:
THE ADAGE ABOUT “PEOPLE WHO LIVE IN GLASS HOUSES”
STILL HOLDS TRUE.
This claim involved an obese 45-year-old male who presented to his general surgeon with a
ventral hernia. History included multiple abdominal surgeries and known adhesive disease.
The patient was admitted to the local hospital, a small facility that had no ICU or step down
unit, no on-site radiologist, and no OR staffing after 3 PM on a weekday. Hernia repair was
accomplished but with great difficulty due to lysis of very extensive adhesions involving
most of the small bowel. Recovery seemed largely unremarkable, and the surgeon was
proceeding with discharge on post-op day seven, when the patient suddenly experienced
severe abdominal pain around mid-day. Nursing staff observed a hard abdomen and absence
of bowel sounds. The surgeon was in the OR and asked an emergency physician to examine
the patient. That physician recommended transfer based on a tense and tender abdomen,
absent bowel sounds, and shallow breathing. Impression was acute abdomen - possible
intestinal perforation. The surgeon then ordered a CT scan. After reviewing the imaging
and the preliminary radiology report, the surgeon concluded that a perforation was not
demonstrated, though free air was shown. He elected to keep the patient overnight. The
patient seemed stable through the night but was observed to be unresponsive about 8 AM
on post-op day eight. A code was called, and air transport was initiated, but the patient
tragically died during transfer. Cause of death was suspected to be a bowel perforation.
10
GLASS HOUSES
By Jim Howell, JD
Following the patient’s death, the surgeon agreed to consult with the patient’s next
of kin and her attorney. Without seeking legal advice, the surgeon signed a formal
statement that pinned blame in no uncertain terms on the radiologist who had
interpreted the CT scan. In essence, the statement said that the surgeon’s primary
suspicion had been a bowel perforation, but the CT results had allayed that concern by
indicating that free air present in the abdomen was a normal amount of postoperative
air, not unexpected. According to the statement, because the radiologist had
misled the surgeon by failing to raise the possibility of a perforation, an immediate
and life-saving transfer to a major medical center was not accomplished.
A lawsuit ensued, and perhaps unsurprisingly the surgeon was named as a defendant,
along with the radiologist, the emergency physician, and the hospital. Finger pointing
among the defendants was abundant. Plaintiff’s experts criticized everyone except the
emergency physician, who was dismissed from the case. Most of the expert fire was
targeted at the surgeon, whose pre-suit statement was put into evidence. The radiologist
testified that he had interpreted the CT scan after being told by a hospital-employed
radiology tech that the patient had undergone surgery “a few hours” before the study.
The radiologist observed a moderate amount of free air, consistent with surgery in that
time frame. Thus, his preliminary report was relayed to the surgeon indicating “free intraabdominal air post-op.” Shortly thereafter, his final report was dictated into the chart,
noting post-surgical free air “related to abdominal surgery a few hours ago.” The surgeon
was reassured by the preliminary report. It was not clear whether the surgeon had taken
note of the final report with its clear signal that the radiologist was laboring under a
misunderstanding as to when the surgery had occurred. There was no direct communication
between the surgeon and the radiologist. The radiologist further testified that if he had
been aware that surgery had been done seven days prior, he would have suspected a
possible perforation, and he would have called the surgeon immediately. In focusing their
criticisms on the surgeon, plaintiff’s experts noted that he had personally reviewed the
CT imaging and noted the presence of free air, as conceded in his pre-suit statement.
Seven days from surgery, free air should have prompted an immediate transfer. Plaintiff’s
expert also said that unless a perforation could be quickly and definitively ruled out, it was
malpractice to leave this patient in this particular hospital, considering its limitations.
Stones thrown in “glass houses” can be amazingly counter-productive, as was
the case in this lawsuit. Such cases rarely work out well for the defense.
11
ABOUT OUR AUTHORS
Stephen Dickens is an attorney in the Medical Practice Services Department
with SVMIC. As a Senior Consultant in Organizational Dynamics, he advises
physicians and their staff on operations, strategic planning, leadership, patient
experience, and human resources. Mr. Dickens has spent over 20 years working
in medical practice, hospital, and home care executive positions. He is a Past
Chair of the Medical Group Management Association. During his tenure,
MGMA had more than 33,000 members working in over 18,000 healthcare
organizations where some 385,000 physicians practiced. Additionally, he is a Past
President of the MGMA Financial Management Society and Tennessee MGMA.
He is a Board Certified Medical Practice Executive and Fellow in the American
College of Medical Practice Executives.
Jim Smith is Senior Vice President of SVMIC. Mr. Smith received a Bachelor of
Science degree from Jacksonville State University in 1975 and earned the CPCU
designation from the Society of Chartered Property and Casualty Underwriters
in 1989.
Jim’s career began as a claims adjuster with Liberty Mutual Insurance Company.
Prior to joining SVMIC, Jim served in various Underwriting and Claims
positions rising to the position of Vice President, Underwriting. In 1991, Jim
was recruited by State Volunteer Mutual as Vice President of Underwriting,
where he has been since. He was promoted to Senior Vice President in 2012.
Mr. Smith served as a member of the Underwriting Section of the Physician
Insurers Association of America (PIAA) from 1990 to 2009, and was its
chairman from 1993 to 2001. He is a member of the Professional Liability
Underwriting Society (PLUS), and briefly served on its Industry Review Panel.
Jim Howell is Senior Vice President of SVMIC. Mr. Howell received a Bachelor of
Arts degree from Middle Tennessee State University in 1975. He received a Juris
Doctor degree in 1978 from the Marshall-Wythe School of Law at the College of
William and Mary in Virginia, and was licensed to practice law in Tennessee in
1978.
After practicing law in 1978-1979, Mr. Howell joined SVMIC in January 1980 as
a Claims Attorney. He has served in various capacities in the Claims Department
since that time, assuming management of the department in July 1996, when he
was named Vice President of Claims. He was promoted to Senior Vice President
in 2012.
Shelly Weatherly is Vice President, Risk Education and Evaluation Services for
SVMIC. Ms. Weatherly graduated from the University of Tennessee School of
Law, and is a member of the Nashville and Tennessee Bar Associations. Ms.
Weatherly has been with SVMIC for 26 years.
Prior to joining SVMIC, Ms. Weatherly served as Law Clerk on the Tennessee
Court of Appeals for the Honorable William C. Koch, as well as on the U.S.
District Court for the Middle District of Tennessee under the Honorable Charles
Neese. During 2015, she assumed leadership of SVMIC’s Risk Education
and Evaluation Services. Prior to 2015, she developed and administered the
company’s Risk Evaluation Services and earlier served as a Claims Attorney.
Ms. Weatherly is a frequent speaker on risk management, liability assessment,
and professional liability topics at medical professional association meetings,
medical schools and residency programs, and industry seminars.
Julie Loomis is Assistant Vice President of Risk Education for SVMIC where
she develops educational programs and assists policyholders and staff with risk
management issues. Ms. Loomis is a member of the Tennessee Bar Association,
Medical Group Management Association and American Society of Healthcare
Risk Managers (ASHRM). She recently contributed to ASHRM’s Medication
Safety Pearls. She serves on the Risk Management Committee of the Physician
Insurers Association of America. Ms. Loomis is a speaker on risk management
and professional liability topics at medical professional association meetings,
medical schools and residency programs, and industry seminars.
Elizabeth Woodcock is the founder and principal of Woodcock & Associates. She
has focused on medical group operations and revenue cycle management for more
than 20 years and has led educational sessions for the Medical Group Management
Association, the American Congress of Obstetricians & Gynecologists, and the
American Medical Association. She has authored and co-authored many books. She
is frequently published and quoted in national publications including The Wall Street
Journal, Family Practice Management, MGMA Connexion, and American Medical
News.
Elizabeth is a Fellow in the American College of Medical Practice Executives and a
Certified Professional Coder. In addition to a Bachelor of Arts from Duke University,
she completed a Master of Business Administration in healthcare management from
The Wharton School of Business of the University of Pennsylvania.
GET IN TOUCH
SVMIC.com
By Phone
800.342.2239
By Email
[email protected]
By Fax
615.370.1343
By Mail
101 Westpark Drive, Suite 300
Brentwood, TN 37027